Dr. Tariq Jagnarine
Family Medicine, Endocrinology / Diabetes
Lymphatic Filariasis (LF) is a debilitating disease that can cause swelling in the extremities and genital areas, once it has manifested, it cannot be reversed. About 60,000 people in Guyana are already affected by filaria, and about 90% live in endemic areas, at risk of contracting the disease.
The Ministry of Health, Guyana, in collaboration with the Pan American Institute of Health (PAHO), launched the Mass Drug Administration (MDA) campaign in Guyana since 2017. The annual exercise will see health workers and volunteers visiting homes, workplaces and schools in eight regions. nationwide (1, 2,3,4,5, 6, 7 and 10) to administer the pills.
The American countries agreed to a collective approach to eradicating communicable diseases throughout Latin America and the Caribbean. The Eradication Initiative identifies a wide range of related diseases and conditions, including lymphatic filariasis, as potential candidates for eradication in the Region, and enables countries to pool efforts and resources towards bringing these diseases to ben and ensuring public health.
Phylariasis is a tropical disease caused by parasitic worms that are spread through mosquito bites. The skin becomes thick and hard, similar to elephant skin. Although it is medically known as lymphatic filariasis, the term elephantiasis is commonly used because the symptoms include swelling and enlargement of the arms and legs.
The World Health Organization (WHO) estimates that 120 million people worldwide are affected by filaria.
Causes
The following 3 types of parasitic earthworms cause elephantiasis:
* Wuchereria bancrofti
* Brugia malayi
* Brugia timori
Wuchereria bancrofti worms cause 90 percent of all cases of elephantiasis. Most of the others are caused by Brugia malayi.
TRANSLATION
Mosquitoes are responsible for spreading the parasites that cause filariasis.
* First, mosquitoes are infected with earthworm larvae when taking a blood meal because an infected human.
* The mosquitoes then bite someone else, passing the larvae to their bloodstream.
* Finally, the worm larvae migrate to the lymphatic through the bloodstream and mature into the lymph system.
RISK FACTORS
Elephantiasis can affect anyone who is exposed to the parasites that cause the disease. The risk of exposure is greatest for people who:
* Long-term living in tropical and subtropical regions like Guyana
* Are regularly bitten by mosquitoes
* Living in unsanitary conditions
The regions where these worms are located include:
* Africa
* India
* South America
* Southeast Asia
FILARIA SYMPTOMS
Most infected people will not show symptoms, despite damage to the lymph and kidney system. Those who experience symptoms usually experience swelling in:
* Legs
* Weapons
* Breasts
* Genital organs
* Also, they may have impaired immune function due to damage to their lymph system. They tend to have more bacterial infections on the skin, causing it to become dry, thickened, and itchy with repeated infections.
* Other symptoms during these frequent bacterial infections include fever and cold.
DIAGNOSIS
The Diagnosis is mainly done by taking the following:
* Medical history
* Query symptoms
* Perform a physical exam
* A blood examination would be required to confirm a parasitic infection. In most parts of the world worms are most active at night, so the blood sample must be collected during this time, according to the Centers for Disease Control and Prevention (CDC).
* Alternative tests can be used to detect the parasites, but may show negative results as symptoms can develop years after the initial infection.
* X-rays and ultrasound can also be done to rule out other conditions that may be causing the swelling.
TREATMENTS
People with active infection can take medicines to kill the worms in the blood. These medicines prevent the illness from spreading to others, but do not completely kill all the parasites.
Antidepressants that can be prescribed include:
* Diethylcarbamazine (DEC)
* Ivermectin
* Albendazole
* Doxycycline (option)
Other symptoms can be controlled with:
* Antihistamines
* Analgesics
* Antibiotics
Not everyone with elephantiasis will need medication. This is because they may no longer carry the worms in their system despite the presence of symptoms. People can control the swelling and skin infections in these cases by:
* Gently wash the damaged and damaged skin daily with soap and water
Moisture of the skin
* Raise swollen legs to improve fluid and lymph flow
* Wound disinfection to prevent secondary infections
* Exercise regularly to support the lymphatic system, as directed by a physician
* Wrap the limbs to prevent further swelling
Surgery may be recommended in rare cases to remove damaged lymphatic tissue or relieve pressure in some areas, such as the scrotum.
Some people with filariasis may wish to seek emotional and psychological support in the form of:
* Individual counseling, support groups and online resources
COMPLETED
Without medical treatment, the microscopic parasites can live for years in the lymphatic system, causing destruction and damage. The lymph system is responsible for transporting excess fluid and proteins and fighting infections. Fluid builds up when it is not working properly. Fluid accumulation leads to swelling of the tissue and reduced immune function.
Phylariasis is associated with many physical and emotional complications, including:
* Disability: Phylariasis is a leading cause of permanent disability worldwide. It may be difficult to move the affected parts of the body, which makes it more difficult to work or carry out household tasks.
* Secondary infections: Fungal and bacterial infections are common in those with elephantiasis due to damage to the lymph system.
* Emotional distress: The condition can cause people to worry about their appearance, which can lead to anxiety and depression.
* Job Losses
Stigma and Discrimination
PREVENTION
The best way to prevent filariasis is to avoid mosquito bites. People visiting or living in at-risk countries should:
* Sleep under a mosquito net
* Cover their skin with long sleeves and trousers
* Use insect repellent
* Participate in the mass drug administration campaign by taking your filarial Pills when healthcare workers visit them. These pills include: Diethylcarbamazine (DEC), Ivermectin, Albendazole, they are given a foundation at the height of the person from the age of 2 years. These drugs are not given during pregnancy or people who are seriously ill.
Some of the most common side effects of these include: headache, drowsiness, vomiting, diarrhea, abdominal cramps
TAKEAWAY
Phylariasis is a tropical disease that is spread through mosquito bites. People living in the most affected tropical or subtropical areas are most at risk of infection. However, there is a very low risk of short-term visitors to these regions having filaria or related conditions. People with symptoms of the condition, including swelling and skin thickening, should see their doctor immediately. Symptoms of this disease can be managed through medications, lifestyle changes, and emotional support. To avoid its complications – GET YOUR VILLAGE PILLS!
