Intended for healthcare professionals

  1. News & Views
  2. Elimination of...
  3. Elimination of lymphatic filariasis in South East Asia
CCBYNC Open access
Analysis Neglected Tropical Diseases in South Asia

Elimination of lymphatic filariasis in South East Asia

BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.k5198 (Published 22 January 2019) Cite this as: BMJ 2019;364:k5198
  1. Sabine Specht, head of filarial clinical programme1,
  2. T K Suma, professor of internal medicine2,
  3. Belen Pedrique, researcher1,
  4. Achim Hoerauf, professor of microbiology3
  1. 1Drugs for Neglected Diseases initiative, Geneva, Switzerland
  2. 2Filariasis Research Unit, Government T D Medical College, Alappuzha, Kerala, India
  3. 3Institute for Medical Microbiology, Immunology and Parasitology, University Hospital Bonn, Germany
  1. Correspondence to: S Specht sspecht{at}dndi.org

Expanding treatment options alongside ensuring high coverage of mass drug administration can accelerate progress in elimination of lymphatic filariasis, say Sabine Specht and colleagues

Lymphatic filariasis is a tropical disease that affects about 70 million people worldwide.1 It is caused by infection with the parasitic nematodes Wuchereria bancrofti, Brugia malayi, or Brugia timori and is transmitted through mosquitoes. Chronic infection causes lymphatic dysfunction, resulting in progressive, irreversible swelling of the limbs and genitals (box 1). Filarial induced lymphoedema is the second leading cause of disability in the world, accounting for about two million disability adjusted life years lost.1 The associated social stigma often causes mental health problems and poverty because of loss of employment.1

Box 1

Course of lymphatic filariasis

  • Adult filarial parasites reside in the lymphatic vessels of an infected person for up to eight years and produce thousands of first stage larvae (microfilaria)

  • Mosquitoes of the genera Aedes, Anopheles, Culex, and Mansonia ingest microfilaria during blood meals from humans and these develop into an infective larval stage

  • Larvae enter humans through the wound made by a mosquito, where they migrate and settle in the lymphatics to mature into adult worms and complete the cycle

  • Lymphatic dysfunction in response to the parasites provokes severe morbidity, including progressive, irreversible swelling of the limbs (elephantiasis) and genitals (hydrocele) with acute adenolymphangitis or acute secondary bacterial infection

  • Infection often occurs early in childhood in endemic areas, but clinical signs appear much later. Once triggered, symptoms may progress even after the parasites have died, being sustained by opportunistic bacterial and fungal infections

RETURN TO TEXT

The third sustainable development goal calls for elimination of neglected tropical diseases, including filariasis, by 2020. Sixty three per cent of the population at risk of lymphatic filariasis and 50% of the people infected worldwide live in South East …

View Full Text
Back to top