Filariasis vs Elephantiasis

1. LYMPHATIC
FILARIASIS
DR Suhana Adura Bt Mohamad
Pegawai Kesihatan Vektor
Unit Kawalan Penyakit Bawaan Vektor
Jabatan Kesihatan Negeri Kelantan

2. GPELF 2000
WHO launched the Global Programme to Eliminate Lymphatic
Filariasis in 2000. The recommended elimination strategy has two
components:
(i) to stop the spread of infection (interrupting transmission); and
(i) to alleviate the suffering of affected populations (controlling morbidity).

3. WHAT IS LYMPHATIC FILARIASIS?
• Lymphatic filariasis is caused by the
worms Wuchereria bancrofti
(90%), Brugia malayi, and Brugia
timori. These worms occupy the
lymphatic system, including the
lymph nodes; in chronic cases,
these worms lead to the disease
elephantiasis.
• It is a disfiguring and disabling
disease
• A neglected tropical disease

4. MODE OF TRANSMISSION
• The disease spreads from person to person by mosquito bites
• Vectors : Mansonia spp, Culex, Anopheles, Aedes

5. LIFE CYCLE
OF WB

6. MODE OF TRANSMISSION
• When a mosquito bites a person who has lymphatic filariasis,
microscopic worms (infective microfilaria) circulating in the
person's blood enter and infect the mosquito.
• People get lymphatic filariasis from the bite of an infected
mosquito.
• The microscopic worms pass from the mosquito through the
skin, and travel to the lymph vessels. In the lymph vessels they
grow into adults. An adult worm lives for about 5–7 years. The
adult worms mate and release millions of microscopic worms,
called microfilariae, into the blood.
• People with the worms in their blood can give the infection to
others through mosquitoes.

7. SIGN AND SYMPTOMS
• Lymphatic filariasis infection involves asymptomatic, acute, and
chronic conditions.
• Acute episodes of local inflammation involving skin, lymph nodes and
lymphatic vessels often accompany chronic lymphoedema or
elephantiasis
• The disease usually is not life threatening, but it can permanently damage
the lymph system and kidneys.
• Because the lymph system does not work right, fluid collects and causes
swelling in the arms, breasts and legs (lymphedema). For men, the
genital area also becomes swollen, a condition known as hydrocele.
• It also decreased function of the lymph system make it difficult for the
body to fight germs and infections. These people will have more bacterial
infections in the skin and lymph system. This causes hardening and
thickening of the skin, which is called elephantiasis.

8. LAB DIAGNOSIS
• Rapid Test (Pan-LF/Brugia Rapid) – antibody detection
• Night Blood Survey – Gold Standard (antigen detection)

9. TREATMENT
• Drugs :
• T. DEC (Di-EthylCarbamazine Citrate)
 6 mg/kg body weight
 Day 1 – Day 12
 DOTS
• T. Albendazole
• 400 mg Stat
• Day 1 Only

12. COMPLICATIONS
• Lymphatic filariasis is a leading cause of permanent and
long-term disability worldwide.
• People with the disease can suffer pain, disfigurement,
and sexual disability.
• Many women with visible signs of the disease will never
marry, or their spouses and families will reject them.
• Such body deformities lead to social stigma, as well as
financial hardship from loss of income and increased
medical expenses. The socioeconomic burdens of isolation
and poverty are immense.

13. PREVENTION
• Foot Hygiene (refer to new hope guideline) **
• 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
• Self-Protection (endemic area)
• Avoid Mosquito bite (self-protection)
• Sleep under a mosquito net/insecticide treated mosquito net.
• Use mosquito repellent on exposed skin between dusk and
dawn

14. THANK YOU