A major public health  problem

Human lymphatic filariasis is caused by the infection with major  nematode parasites Wuchereria bancrofti and Brugia malayi.  The  disease is quite prevalent in the developing tropical countries.  About 120 million people are infected  all over the world, of which  43 million  are affected with overt physical disabilities from filarial infection.    In India around 412 million people are living in  bancroftian endemic areas with 31 million people are estimated to be harbouring microfilariae and about 20 million people suffer from clinical manifestations of the disease, with about 7.5  million of lymphoedema cases and 13 million of hydrocele cases (1).   Further, millions suffer with occult filarial infection in endemic areas without diagnosis.  Filariasis is prevalent in all states and union teritories except Jammu & Kashmir, Himachal pradesh, Punjab, Hariana,Rajasthan,Meghalaya,Mizoram, Nagaland, Manipur, Tripura & Sikkim.
            Although the disease is never directly fatal, it is a debilitating one responsible for considerable morbidity and social stigma. In 1995, the World Health Organization (WHO) identified filariasis as world’s second leading cause of permanent and long term disability next only to mood affecting disorders (2). The global burden of lymphatic filariasis was estimated to be at least 850,000 DALYS (Disability Adjusted Life Years Lost) and India contributes 38% of the global disease burden. In endemic areas out of 1500 million children in the age group of 0-14 years,14 million harbour microfilaraemia, while 1 million suffer with lymphoedema and 2 million with hydrocele. 

Wide spectrum of clinical  manifestations in filariasis which need diagnosis and OpDEC therapy*

Acute & Chronic

*   Fever with chills and rigors
*    Lymphoedema with pain 
*    Lymphadenopathy
      (Cervical, Axillary, Inguinal& Generalised)
*    Chyluria / Haematuria
*     Funiculitis
*     Epididymoorchitis
*     Hydrocele

*     Elephantiasis


*    Pulmonary eosinophilia 
*     Mono & Polyarthritis
*    Tenosynovitis
*    Glomerulo nephropathy
*    Retroperitoneal lymphangitis
      (Acute abdomen)
*    Central serous retinopathy
recurrent scleritis       & macular oedema
*    Endomyocardial fibrosis
*    Urticaria
*    Recurrent URI
*    Asthmatic bronchitis

* Optimal DEC therapy (6mg / kg body wt / day for 21 days each month for 3-12 months).  The period  of   DEC   treatment is determined based on  immunomonitoring of  infection.


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