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Filariasis

Updated : March 11, 2024





Background

Filariasis is a parasitic ailment spread by mosquitos. Chronic infection can cause extremity edema, hydroceles, and testicular tumors.   It is the world’s second leading cause of irreversible deformity and disability, after leprosy.

In an effort to eradicate this illness, the Global Programme to Eliminate Lymphatic Filariasis is offering mass drug administrations to populations residing in endemic areas. Many programmes have been established to increase participation in these drives.

Epidemiology

72 countries in the world are affected by this disease. Regions in subtropical and tropical climates are especially susceptible, especially in Africa, South America, Asia, the Caribbean, and the Western Pacific.

Filariasis is endemic to four nations in America, including the Dominican Republic, Guyana, Brazil, and Haiti. 1/3rd of children in these regions are infected with W. bancrofti in an asymptomatic manner. Men are 10 times more likely to suffer from this illness, and individuals are most affected in the fourth and fifth decade of life.

Anatomy

Pathophysiology

The primary host for this parasite disease is humans, and mosquitoes are the transmitters. The larvae of the mosquito get deposited in the blood. They settle in the lymph nodes and mature into adult worms. The larvae prefer to deposit in the femoral lymph nodes.

They reproduce sexually, and females birth innumerable microfilariae, which are released into the environment in a diurnal cycle. Females can lay eggs for about 5 years, and adults can survive until the age of 9.

The lymphatics become blocked as adult worms multiply, disrupting lymphatic drainage and increasing susceptibility to recurring infections, particularly fungal and streptococcal infections.

This acute, chronic inflammation causes fibrosis and lymphatic remodeling, prolonging contractile dysfunction and resulting in the dermal skin abnormalities seen in elephantiasis.

Etiology

The following 3 species of nematode parasites are responsible for causing filariasis:

  • Brugia malayi
  • Brugia timori
  • Wuchereria bancrofti

These parasites are generally transmitted through the following 5 genera of mosquitoes:

  • Anopheles
  • Culex
  • Mansonia
  • Ochlerotatus

Aedes

Genetics

Prognostic Factors

If diagnosed and treated at an early stage, filariasis has a favorable prognosis. The preferred form of treatment is 5 doses of DEC annually, administered in combination with albendazole or ivermectin. Patients with filariasis generally don’t present symptoms until they reach adulthood.

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

 

diethylcarbamazine 

On day 1: 50 mg orally after meals
On day 2: 50 mg orally Thrice a day
On day 3: 100 mg orally Thrice a day
On day 4 to 14: 6 mg/kg daily orally divided thrice a day



mebendazole 

(off-label)
Take a dose of 100 mg orally every twelve hours



 

diethylcarbamazine 

On day 1: 1 mg/kg orally after meals
On day 2: 1 mg/kg orally Thrice a day
On day 3: 1-2 mg/kg orally Thrice a day
On day 4 to 14: 6 mg/kg daily orally divided thrice a day



 

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References

https://www.ncbi.nlm.nih.gov/books/NBK556012/

Filariasis

Updated : March 11, 2024




Filariasis is a parasitic ailment spread by mosquitos. Chronic infection can cause extremity edema, hydroceles, and testicular tumors.   It is the world’s second leading cause of irreversible deformity and disability, after leprosy.

In an effort to eradicate this illness, the Global Programme to Eliminate Lymphatic Filariasis is offering mass drug administrations to populations residing in endemic areas. Many programmes have been established to increase participation in these drives.

72 countries in the world are affected by this disease. Regions in subtropical and tropical climates are especially susceptible, especially in Africa, South America, Asia, the Caribbean, and the Western Pacific.

Filariasis is endemic to four nations in America, including the Dominican Republic, Guyana, Brazil, and Haiti. 1/3rd of children in these regions are infected with W. bancrofti in an asymptomatic manner. Men are 10 times more likely to suffer from this illness, and individuals are most affected in the fourth and fifth decade of life.

The primary host for this parasite disease is humans, and mosquitoes are the transmitters. The larvae of the mosquito get deposited in the blood. They settle in the lymph nodes and mature into adult worms. The larvae prefer to deposit in the femoral lymph nodes.

They reproduce sexually, and females birth innumerable microfilariae, which are released into the environment in a diurnal cycle. Females can lay eggs for about 5 years, and adults can survive until the age of 9.

The lymphatics become blocked as adult worms multiply, disrupting lymphatic drainage and increasing susceptibility to recurring infections, particularly fungal and streptococcal infections.

This acute, chronic inflammation causes fibrosis and lymphatic remodeling, prolonging contractile dysfunction and resulting in the dermal skin abnormalities seen in elephantiasis.

The following 3 species of nematode parasites are responsible for causing filariasis:

  • Brugia malayi
  • Brugia timori
  • Wuchereria bancrofti

These parasites are generally transmitted through the following 5 genera of mosquitoes:

  • Anopheles
  • Culex
  • Mansonia
  • Ochlerotatus

Aedes

If diagnosed and treated at an early stage, filariasis has a favorable prognosis. The preferred form of treatment is 5 doses of DEC annually, administered in combination with albendazole or ivermectin. Patients with filariasis generally don’t present symptoms until they reach adulthood.

diethylcarbamazine 

On day 1: 50 mg orally after meals
On day 2: 50 mg orally Thrice a day
On day 3: 100 mg orally Thrice a day
On day 4 to 14: 6 mg/kg daily orally divided thrice a day



mebendazole 

(off-label)
Take a dose of 100 mg orally every twelve hours



diethylcarbamazine 

On day 1: 1 mg/kg orally after meals
On day 2: 1 mg/kg orally Thrice a day
On day 3: 1-2 mg/kg orally Thrice a day
On day 4 to 14: 6 mg/kg daily orally divided thrice a day



https://www.ncbi.nlm.nih.gov/books/NBK556012/