Lymphatic filariasis

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Lymphatic Filariasis or LF is one of Neglected Tropical Disease (NTD) as it affects more than one billion of people in the world. LF is caused by filarial thread-like worms; Wuchereria bancrofti, Brugia Malayi and Brugia timori[1]. The adult worms (microfilariae) can be found in human lymph nodes causing inflammation and fibrotic reactions[2].

When mosquito has a blood meal from an infected individual, parasite enters in the form of microfilariae and develop to an infective larval stage within a mosquito which then pass on to another human host when the next blood meal is taken. In human stage, infective larvae penetrate into the bite wound and develop into adult worms[3].

The infections are acquired as early as during childhood[4] LF can cause permanent damage to the kidney and lymphatic system. Since the lymphatic system fails, there will be a build up in fluids, resulting in swelling of various body parts (lymphedema). Swelling can occur at the arms or legs (elephantiasis), breast and genital area (hydrocele) for men[5]. There is an evidence reveals that nearly 120 million people were affected by lymphatic filariasis in 73 countries all over the tropics and subtropics of Asia, Africa and the Western Pacific[6]

Recent studies[7] shows the presence of endosymbionic alphaprotobacteria Wolbachia in adult worms (predominantly in female worms), which are found to be involved in heme symbiosis and a crucial factor for worm viability and fertility .

A drug combination (i.e albendazole together with either ivermectin or with diethylcarbamazine citrate) which is 99% effective against the parasite has been found and managed to treat people infected with the disease[8]. The manufacturer of one of these drug, SmithKline Beecham has pledged to support the global PELF by supplying the drug for free[9][10][11].

References

  1. Centers for Disease Control and Prevention. Parasites – Lymphatic Filariasis. Available from: http://www.cdc.gov/parasites/lymphaticfilariasis/ [Accessed 14th October 2016].
  2. Centers for Disease Control and Prevention. Parasites – Lymphatic Filariasis. Available from: http://www.cdc.gov/parasites/lymphaticfilariasis/ [Accessed 14th October 2016].
  3. CDC - Lymphatic Filariasis - Biology - Life Cycle of Wuchereria bancrofti. Available from: http://www.cdc.gov/parasites/lymphaticfilariasis/biology_w_bancrofti.html
  4. World health organization, W.H.O. 1. Lymphatic filariasis. [Online]. Available from: http://www.who.int/mediacentre/factsheets/fs102/en/ [Accessed 3 October 2016]
  5. The end fund. 1. Lymphatic Filariasis A Cause of Elephantiasis. [Online]. Available from: http://www.end.org/whatwedo/ntdoverview/lymphatic-filariasis [Accessed 4 October 2016].
  6. CDC - Lymphatic Filariasis - General Information - Frequently Asked Questions [Internet]. Cdc.gov. 2016 [cited 20 October 2016]. Available from: http://www.cdc.gov/parasites/lymphaticfilariasis/gen_info/faqs.html
  7. Slatko,B.E., Taylor, M.J., Foster, J.M. Wolbachia endosymbionts as an anti-filarial nematode target. Symbiosis. 2010; 51:55-65. Available from: doi: 10.1007/s13199-010-0067-1 [Accessed 29th September 2016].
  8. Ottesen EA, Duke BO, Karam M, Behbehani K. Strategies and tools for the control/elimination of lymphatic filariasis. Bulletin of the World Health Organization. 1997;75(6):491-503.
  9. A Guideline for Programme Managers [internet]. Preparing and Implementing a National Plan to Eliminate Lymphatic Filariasis; 2010 [cited 2016 Oct 18].fckLRAvailable from : http://www.filariasis.org/pdfs/Press%20Centre/Training%20Material/pmginco.pdf
  10. Ottesen EA, Duke BO, Karam M, Behbehani K. Strategies and tools for the control/elimination of lymphatic filariasis. Bulletin of the World Health Organization. 1997;75(6):491-503.
  11. A Guideline for Programme Managers [internet]. Preparing and Implementing a National Plan to Eliminate Lymphatic Filariasis; 2010 [cited 2016 Oct 18]. Available from:http://www.filariasis.org/pdfs/Press%20Centre/Training%20Material/pmginco.pdf

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