What are the treatments available for filariasis?

  Filariasis is a disease caused by roundworms or also known as nematodes. Filariasis will affect the lymphatic system and subcutaneous tissues. There are three filarial species. They are Wuchereria bancrofti, Brugia malayi, and Brugia timori. Mosquitoes are the vector. This means that this disease is transferred from one person to another via a mosquito. This infectious disease is a major cause of disability and disfigurement. In endemic areas, this disease will harm psychosocially and to the economy. Consult for treatments of filariasis to recover from this disease.

  Wuchereria bancrofti cause filariasis in sub-Saharan Africa, Southeast Asia, India, the Pacific islands, and the Caribbean. Brugia malayi present in China, India, Malaysia, the Philippines, Indonesia, and various Pacific islands. Brugia timori affects the Timor Island of the Indonesia population. 66.66% of patients with filariasis are Asian. Thanks to Mass Drug Administration (MDA) the burden of this disease is reducing globally. The overall cases of filariasis are reducing all over the world except in areas and countries which have not implemented the Mass Drug Administration (MDA).

  Those countries are still having a high number of filariasis cases. The majority of filariasis which accounts for more than 90% is caused by Wuchereria bancrofti. Chronic filariasis patients in India misses around 29 workdays per year due to complications. This disease and its complications are a burden to both patients and the community. Lymphatic filariasis is most likely to be acquired in childhood. One-third of children below the age of five are infected without showing any symptoms.

  Patients with lymphatic filariasis can remain asymptomatic or may develop signs and symptoms in association with adenolymphangitis, filarial fevers, hydrocele, chronic lymphatic disease, or tropical pulmonary eosinophilia. The clinical features are:

  • Fever
  • Painful lymph nodes swelling
  • Malaise
  • Inflammation of the epididymis
  • Chills
  • Myalgia
  • Headache
  • Inflamed plaques
  • Wheezing
  • Limb swelling
  • Scrotal swelling
  • Blood in urine
  • Frothy urine (protein in urine)

  The acute manifestations of this disease are:

  • Acute adenolymphangitis (ADL)
  • Acute dermatolymphangioadenitis (DLA)
  • Filarial fever
  • Tropical pulmonary eosinophilia

  The chronic manifestations of filariasis are:

  • Lymphedema
  • Renal involvement

  History taking, physical examinations, and investigations are very much important are making a diagnosis. History taking and physical examinations are useful to analyze and detect signs and symptoms. Investigations are important to provide pieces of evidence and findings to conclude a diagnosis of filariasis. The investigations are:

  • Circulating antigen detection
  • Blood smears
  • Polymerase chain reaction (PCR)
  • Antifilarial antibody test
  • Ultrasound
  • Lymphoscintigraphy

  Other diseases that may mimic filariasis are:

  • Loiasis
  • Onchocerciasis
  • Lymphedema caused by other diseases like malignancy
  • Bacterial lymphangitis
  • Podoconiosis
  • Nonfilarial hydrocele

  Filariasis may exist with other coinfections. The treatment is different if filariasis takes place with other coinfections. The treatments are as follows:

  • Filariasis without any coinfections can be treated with diethylcarbamazine (DEC) with or without doxycycline
  • Filariasis with Onchocerciasis can be treated with ivermectin
  • Filariasis with Loiasis can be treated with ivermectin followed by diethylcarbamazine (DEC) with or without doxycycline

  Mass Drug Administration (MDA) is an aggressive approach to eliminate filariasis in an area. In endemic areas, a regimen consisting of ivermectin, diethylcarbamazine, and albendazole is given. Consult for treatments of filariasis to recover from this disease.

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