Global Programme to Eliminate Lymphatic Filariasis: A review

Wuchereria bancrofti vespid, Immune response, Serum immune complexes diagnosis, Diethylcarbamazine (DEC), Wolbachia in filarial parasites, Interdigital skin lesions, Urban Filariasis, Doxycycline, mass drug administration program, Filarial Lymphedema Care, Detection of filarial parasites, Albendazole, research abstracts

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Global Programme to Eliminate Lymphatic Filariasis: A review

Postby patoco » Mon Feb 19, 2007 8:59 am

Morbidity management in the Global Programme to Eliminate Lymphatic Filariasis: A review of the scientific literature.

Addiss DG, Brady MA.
ABSTRACT: The Global Programme to Eliminate Lymphatic Filariasis (GPELF) has two major goals: to interrupt transmission of the parasite and to provide care for those who already suffer the devastating clinical manifestations of the disease (morbidity control). This latter goal addresses three filariasis-related conditions: acute inflammatory episodes; lymphoedema; and hydrocele. Current lymphoedema management strategies in filariasis-endemic areas are based on the central role of acute inflammatory episodes, known as acute dermatolymphangioadenitis (ADLA), in lymphoedema progression. Simple intervention packages that are currently in use have resulted in dramatic reductions in ADLA rates, decreased chronic inflammation in the dermis and subdermis, and improved quality of life. During the past decade, the socioeconomic impact of ADLA and lymphoedema in filariasis-endemic areas has received increased attention. Numerous operational research questions regarding how best to optimize, scale up, monitor, and evaluate lymphoedema management programmes remain to be answered. Of the clinical manifestations targeted by the GPELF, hydrocele has been the focus of least attention. Basic information is lacking on the effectiveness and complications of hydrocele surgery and risk of post-operative hydrocele recurrence in filariasis-endemic areas. Data on the impact of mass administration of antifilarial drugs on filarial morbidity are inconsistent. Several studies report reductions in acute inflammatory episodes, lymphoedema, and/or hydrocele following mass drug administration, but other studies report no such association. Assessing the public health impact of mass treatment with antifilarial drugs is important for programme advocacy and morbidity control strategies. Thus, although our knowledge of filariasis-related morbidity and its treatment has expanded significantly in recent years, much work remains to be done to address the needs of more than 40 million persons worldwide who suffer from these conditions.

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