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Lymphatic filariasis in children: Clinical features, infection burdens and future prospects for elimination

Published online by Cambridge University Press:  03 August 2011

RANGANATHA KRISHNA SHENOY  and
MOSES J. BOCKARIE
RANGANATHA KRISHNA SHENOY
Affiliation:
Filariasis Chemotherapy Unit, TD Medical College Hospital, Alappuzha 688 011, Kerala, India
MOSES J. BOCKARIE*
Affiliation:
Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
*
*Corresponding author: Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK. Phone: +44(0)1517053343. Fax: +44(0)151 7053370. Mobile: +44 07595020694. E-mail: moses.bockarie@liv.ac.uk
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Summary

Lymphatic filariasis (LF), a common parasitic infection in tropical countries, causes lymphoedema of limbs, hydrocele and acute attacks of dermato-lymphangio-adenitis. Recent advances in diagnosis have helped to recognize that LF infection is often acquired in childhood. Newly available diagnostic techniques like sensitive antigen and antibody assays, Doppler ultrasonography and lymphoscintigraphy have helped to understand the subclinical pathology caused by this infection, which was hitherto generally believed to be irreversible. Recent studies indicate that drugs used in the mass drug administration (MDA) programme under GPELF are capable of reversing the sub-clinical lymphatic damage in children and provide benefits other than interruption of transmission. Albendazole and ivermectin used in MDA are effective against soil-transmitted helminthic infections common in children in LF endemic areas. Thus MDA had other ‘beyond LF’ benefits in treated children including increased appetite, weight gain, greater learning ability and concentration, better school attendance and prevention of anaemia. MDA should no longer be viewed as a measure for interrupting transmission alone. Recent findings of reversibility of early lymphatic pathology in treated children indicate that both MDA and ‘foot-hygiene’ measures are effective strategies in preventing and managing morbidity. Programme managers should effectively utilize this information to strengthen their advocacy efforts to achieve high and sustainable coverage in MDA.

Keywords

Lymphatic filariasischildrensubclinical pathologylymphangiectasiareversal of lymphatic damagepreventionmass drug administrationfoot-care
Type
Research Article
Information
Parasitology , Volume 138 , Special Issue 12: Symposia of the British Society for Parasitology Volume 47 , October 2011 , pp. 1559 - 1568
Copyright
Copyright © Cambridge University Press 2011

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