FILARIASIS

WHAT IS LYMPHATIC FILARIASIS (LF)?

Lymphatic filariasis (LF), commonly known as elephantiasis, is a disfiguring, disabling disease, usually acquired in childhood. According to CDC, it is the leading cause of permanent disability in people.

GEOGRAPHIC DISTRIBUTION
Lymphatic filariasis affects over 120 million people in 80 countries throughout the tropics and subtropics of Asia, Africa, the Western Pacific, and parts of the Caribbean and South America. In the Americas, only four countries are currently known to be endemic: Haiti, the Dominican Republic, Guyana and Brazil. In the United States, Charleston, South Carolina, was the last known place with lymphatic filariasis. The infection disappeared early in the 20th century. Currently, you can not get infected in the U.S.

WHAT MOSQUITOES?

In Africa, the most common vector is Anopheles and in the Americas, it is Culex quinquefasciatus. Aedes and Mansonia can transmit the infection in the Pacific and in Asia.

HOW IS LYMPHATIC FILARIASIS TRANSMITTED FROM ONE PERSON TO ANOTHER?

The adult produces millions of very small, immature larvae known as microfilariae, which circulate in the peripheral blood with marked nocturnal periodicity. The worms usually live and produce microfilariae for 4-6 years. Lymphatic filariasis is transmitted through mosquito bites. The microfilariae enter the body of a mosquito when it feeds on the blood of a person carrying microfilariae in their blood (mf carriers). It takes 7-21 days for the microfilariae to develop inside the body of the mosquito.

WHAT ARE THE SYMPTOMS OF LYMPHATIC FILARIASIS?

Usually asymptomatic until after the adult worms die. Permanent damage to lymph system and kidneys Swelling in the arms, breasts and legs. (lymphoedema). For men, the genital area also becomes swollen (hydrocele) Increased bacterial infections in the skin and lymph system. Hardening and thickening of the skin (elephantiasis)

WHAT IS THE IMPACT OF THIS DISEASE?

Permanent and long-term disability Pain, disfigurement, and sexual disability. Many women with visible signs of the disease will never marry, or are rejected by spouses and families Affected people frequently are unable to work because of their disability. This hurts their families and their communities. Everyday work becomes difficult due to frequent infections.

WHAT IS THE TREATMENT FOR LYMPHATIC FILARIASIS?

DEC (Diethylcarbamazine)

Even after the adult worms die, lymphoedema can develop. To prevent lymphoedema from getting worse Carefully wash the swollen area with soap and water every day. Use anti-bacterial cream on any wound. This stops bacterial infections. Elevate and exercise the swollen arm or leg to move the fluid and improve the lymph flow.

HOW CAN I PREVENT INFECTION?

Mass drug administration Control mosquitoes. Avoid mosquito bites. The mosquitoes that transmit the filarial worms usually bite between the hours of dusk and dawn Use mosquito nets/insecticide treated mosquito nets. Use mosquito repellent on exposed skin between dusk and dawn.

SCHISTOSOMIASIS

Schistosomiasis is a chronic, parasitic disease caused by blood flukes (trematode worms) of the genus Schistosoma.

TRANSMISSION
People become infected when larval forms of the parasite/ cercaria released by freshwater snails penetrate their skin during contact with infested water. In the body, the larvae develop into adult (lungs and liver) schistosomes. Adult worms live in the blood vessels where the females release eggs.

Some of the eggs are passed out of the body in the faeces or urine to continue the parasite life-cycle. Others become trapped in body tissues, causing an immune reaction and progressive damage to organs.

EPIDEMIOLOGY
Schistosomiais is prevalent in tropical and subtropical areas, especially in poor communities without access to safe drinking water and adequate sanitation. There are two major forms of schistosomiasis intestinal and urogenital caused by five main species of blood fluke Urogenital schistosomiasis is also considered to be a risk factor for HIV infection, especially in women.

FIVE MAIN TYPES OF BLOOD FLUKE

Species Intestinal schistosomiasis

Geographical distribution
Schistosoma mansoni Africa, the Middle East, the Caribbean, Brazil, Venezuela, Suriname

Schistosoma japonicum

China, Indonesia, the Philippines

Several districts of Cambodia and the Lao Peoples Democratic Republic

Schistosoma mekongi

Schistosoma Rain forest areas of guineensis and central Africa related S. intercalatum Urogenital schistosomiasis Schistosoma haematobium Africa, the Middle East

SYMPTOMS
Symptoms of schistosomiasis are caused by the body's reaction to the worms eggs, not by the worms themselves. Abdominal pain, diarrhea,blood in the stool, and liver enlargement-intestinal schistosomiasis Bladder cancer, hematuria-urogenital schistosomiasis In children: anaemia, stunting and a reduced ability to learn, Chronic schistosomiasis may affect peoples ability to work and in some cases can result in death.

DIAGNOSIS

Eggs in stool methylene blue-stained cellophane soaked in glycerine or glass slides. Eggs in urine For urogenital schistosomiasis,microscopic blood in urine and this can be detected by chemical reagent strips. History of blood in their urine used to identify high risk of infection, For low transmission areas, serological and immunological techniques may be used

TREATMENT:

This infection is usually treated with the drug praziquantel. If the infection is severe or involves the brain, corticosteroids may be given.

POSSIBLE COMPLICATIONS

Badder cancer

Chronic kidney failure

Chronic liver damage and an enlarged spleen Colon (large intestine) inflammation with bloody diarrhea

Kidney and bladder obstruction

Pulmonary hypertension Repeated blood infections can occur, because bacteria can enter the bloodstream through an irritated colon Right-sided heart failure Seizures

PREVENTION AND CONTROL

Preventive treatment, Snail control, Improved sanitation and health education. The WHO strategy for schistosomiasis control focuses on reducing disease through periodic, targeted treatment with praziquantel. This involves regular treatment of all people in at-risk groups. Treatment should be complemented with health education, as well as access to safe water and good sanitation. A major limitation to schistosomiasis control has been access to praziquantel. Praziquantel is the only available treatment against all forms of schistosomiasis. It is effective, safe and low-cost.

THANK YOU

GROUP MEMBERS

Warris Walayat Litia Chola Nafisah Begum Cessy Cherriyan Chetana Singh Lortakul Suvimand Pet Kris Ruthiachanok Reerattanachart Dusadee Nishant Prajapati Umair Muneer Harold Nkume