Evaluation
of SEVA FILA CHEK & ICT filariasis test : Studies from this laboratory (9) showed that ICT is a rapid-format antigen test and quite convenient to detect microfilaraemia in field conditions. The SEVA FILACHEK immunoassays on the other hand are useful to detect active filarial infection as well as clinical disease cases associated with filariasis attending the hospital and thus help in the effective management of clinical morbidity and preventing recurrence in such cases in an endemic area (Table 6). | |||||||||||||||||||||||||||||||
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Management
of clinical filariasis: Acute,
chronic and occult cases of lymphatic filariasis usually do not show
microfilariae in peripheral blood. However the detection of specific
filarial antibody or antigen has been
found to be useful in the confirmation and
monitoring of active filarial infection in acute, chronic & occult
cases with appropriate period of DEC
chemotherapy for clinical relief and cure.In the recent years,
adult filarial worms have been demonstrated in
filarial cases with clinical manifestations (hydrocele and
lymphoedema), by Ultrasonography suggesting a need for chemotherapy for
elimination of the parasite in such cases.
OpDEC (optimal DEC therapy) was found to be very effective in acute
and atypical clinical manifestations such as asthmatic bronchitis,
pulmonary eosinophilia, monoarthritis, recurrent URI, pneumonia (super imposed infections) in
children and minimal hydrocele, epididymoorchitis, lymphanginitis,
lymphadenitis, pain and swelling in limbs and joints in adults living in filaria endemic areas. Judicial use of appropriate
antibiotics, analgesics, antihistaminic, diuretics, antifungals for
managing secondary infections and inflammatory reactions along with
physiotherapy and hygiene help in the successful management of clinical
filarial cases. A)
CHEMOTHERAPY : 1.
OpDEC
therapy: Diethyl carbamazine citrate (DEC) 6mg / kg body wt. / day in 3 divided doses for 21 days in each month for 3 - 12 months or more followed by quarterly immunomonitoring till the antibody / antigen becomes undetectable followed by for clinical relief and cure. Recurrence of manifestations was observed only in 0.2 - 0.5% of clinical filarial cases followed up in hospital study (8). 2. If the
patient does not tolerate Op DEC therapy: Starting with small doses of DEC (2 mg / kg body wt./
day) and gradually increasing to standard regimen (6 mg / kg body wt./
day) over a period of 3-4 days and continuing for 3 weeks in a month (10). 3. Other
chemotherapeutic trials in the field: a)
Coumarin:
Apart from the standard regimen of DEC, Coumarin 200 mg twice a day is
found to be helpful in the reduction of filarial oedema in the long run
(11). B) PHYSIOTHERAPY:
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