DOCSLIB.ORG

Coumarin) BMJ: First Published As 10.1136/Bmj.307.6911.1037 on 23 October 1993

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Coumarin) BMJ: First Published As 10.1136/Bmj.307.6911.1037 on 23 October 1993 Treatment offilarial lymphoedema and elephantiasis with 5,6-benzo-oL-pyrone (coumarin) BMJ: first published as 10.1136/bmj.307.6911.1037 on 23 October 1993. Downloaded from J R Casley-Smith, C T Wang, Judith R Casley-Smith, Cui Zi-hai Abstract drugs that have been studied do this by increasing both Objective-To study efficacy of treatment the numbers of macrophages and their normal pro- of ifiarial lymphoedema and elephantiasis with teolysis per cell.' These drugs thereby provide another 5,6-benzo-a-pyrone. path by which protein and its osmotically held water Design-Randomised, double blind, placebo con- can be removed from the tissues. Removing the excess trolled study with matching for grade and duration of protein also reduces the chronic inflammation, which disease, age, and sex. Treatment was given for 367 results from the simple chronic accumulation of excess days, and subjects were followed up for another plasma proteins and the consequent excess fibrosis.''0 year. All benzopyrones have similar effects on high protein Setting-A town in Shandong Province, China. oedemas, most can be taken orally, they are of low Subjects-104 men and women with chronic toxicity, and their actions persist for several days.' unilateral filarial lymphoedema or elephantiasis of The cheapest and simplest is 5,6-benzo-ot-pyrone the leg: 64 were randomised to benzopyrone and 40 (coumarin). This is available in large amounts of high to placebo. By the end of the study 19 patients had purity, and has been tested in more clinical trials than dropped out of the treatment group and two out of any other.' While its chemical name is coumarin and it the placebo group. is the parent molecule of the dicoumerol anticoagu- Interventions-Two 200 mg tablets of 5,6-benzo- lants, it has no anticoagulant activity itself.' The ac-pyrone or two placebo tablets given daily. benzopyrones have no relation to the benzopyrenes Main outcome measures-Volumes ofthe affected and have a different chemical structure. and normal legs estimated every three months, and Various benzopyrones have been shown to reduce daily listing ofany side effects. human postmastectomy, primary, and other lympho- Results-Benzopyrone reduced oedema for all edemas' 11-1" and to improve the results obtained with grades oflymphoedema during the year oftreatment physical treatment.20 They also decrease the incidence (pWO.001) and the follow up year (p=0.026). During of secondary acute inflammation by removing the treatment the mean monthly reductions in leg "incubation medium" for bacteria.' "'1-37-'9 However, volume were 0.62% (95% confidence intervals 04% the effects of these drugs on the massive lymphoedema to 0.85%), 1.1% (0.71% to 1.6%), and 16% (0.89% to and elephantiasis caused by filariasis had not been 2 33%) ofthe volume ofthe normal leg for grades 1, 2, studied. A trial was therefore conducted of 5,6-benzo- and 3-5 (elephantiasis) oflymphoedema respectively. a-pyrone on filarial lymphoedema and elephantiasis in Ping-Yi County, Shandong, China. A similar trial During follow up the mean monthly reductions were http://www.bmj.com/ 0.18% (0-01% to 0 35%), 0-54% (0-27% to 0.820/6), was conducted simultaneously in India.2' In India and 0-87% (0.51% to 1.2%). At the end ofthe trial the reinfestation with filariae is frequent,2' but in total reduction in oedema was 100%, 95%, and 45% Shandong, where bancroftian filariasis used to be for grades 1, 2, and 3-5. Symptoms and complications endemic, a campaign of mass treatment with diethyl- were considerably reduced, including attacks of carbamazine and other measures have reduced the secondary acute inflammation, while side effects prevalence of microfilaraemia to 0 01%, compared were minor and disappeared after one month. In the with 20-30% 30 years ago.22 While many patients still had elephantiasis, the lack of reinfestation permitted placebo group there were no changes in the severity on 5 October 2021 by guest. Protected copyright. oflymphoedema. evaluation of the effectiveness of the drug after its Conclusions-5,6 - benzo - a - pyrone reduces the administration ceased. oedema and many symptoms of filarial lympho- edema and elephantiasis. It has few side effects, and its relatively slow action makes it ideal for use Patients and methods without compression garments. Altogether 104 patients were chosen who had Henry Thomas chronic lymphoedema or elephantiasis in one leg and Laboratory, University of one apparently normal leg. The patients were initially Adelaide, Box 498 GPO, SA Introduction divided into eight groups of 13, each group being 5001, Australia 45 suffer from filarial matched as closely as possible for grade of lympho- J R Casley-Smith, reader Over million people lympho- Judith R Casley-Smith, edema and elephantiasis, including hydrocele.'-3 An edema, duration of the disease, age, and sex (in chairman ofLymphoedema equal number are asymptomatic but are infested with decreasing order of importance). Random number Association ofAustralia filariae. Such patients often have damaged lymphatic tables were then used to assign the patients to treat- systems and are likely to develop lymphoedema and ment with benzopyrone or placebo. At the Chinese Shandong Institute of elephantiasis.45 Effective treatments for lymphoedema ethics committee's insistence, randomisation was Parasitic Disease, Jining, and elephantiasis are now available,' 6-9 but patients in weighted to assign more people to the treatment than Shandong 272 133, China developing countries can seldom afford them. Of to placebo: 64 patients received treatment and 40 C T Wang, director these, the first choice is adequate physical treatment.6 received placebo. Blood specimens were taken from Ciu Zi-hai, research medical This is non-invasive and gives large, rapid, and lasting the patients, and, although blood films revealed no officer reductions of swelling, but compression garments are microfilariae, diethylcarbamazine 6 mg/kg/day was Correspondence and essential. These are impractical in hot, wet, or dirty given to each patient for 12 days before the trial as a reprint requests to: conditions such as paddy fields. precaution. No other treatment was used (including no Dr J R Casley-Smith. The benzopyrone group of drugs have many actions compressive bandaging) except that antibiotics were but all appear to reduce all forms of acute and chronic given for any bacterial infections. For the next 367 days BMJ 1993;307:1037-41 high protein oedema in animals and humans. Those the treatment group received 400 mg 5,6-benzo-ox- BMJ VOLUME 307 23 OCTOBER 1993 1037 pyrone a day (as two 200 mg tablets) while the other thick and coarse), grade 4 (grade 2 or 3 with frequent group received placebo. Village doctors gave the warts and papillomas), and grade 5 (grade 4 with a tablets to the patients each day and ensured that they true elephantoid appearance, an enormously thickened were swallowed so that patient compliance was 100%. and leathery skin and all the usual limb curvatures When this was completed the patients were followed obliterated). Thus grades 2 to 5 are all included in the up for a further year. International Society for Lymphology grade 2, with BMJ: first published as 10.1136/bmj.307.6911.1037 on 23 October 1993. Downloaded from While receiving tablets, the patients were asked grades 3 to 5 being elephantiasis. daily about possible side effects of the drug. The Statistical analysis-The volumes of the patients' patients were also examined every three months, apparently normal legs did not change significantly during which the circumferences of both legs of each during the trial and were used as controls. Although patient were measured at five points, at 10 cm intervals such legs often have abnormal lymphatic systems,45 from the heel. The volume ofeach leg was estimated as their use as controls still reduces SE/mean compared the sum of four truncated cones,23 which gives a value with the use of other subjects as controls."' 1719 A value almost identical with that from water displacement.24 for the oedema in each patient's affected leg was The patients were also examined clinically and asked provided by calculating the volume of the patient's about possible symptoms and complications during the oedematous leg as a percentage of the volume of the previous three months. Features such as the condition normal leg. The results were analysed by means of an of the skin, hair growth, and ulcers were noted, as was unbalanced repeated measures model with structured the frequency and severity of secondary acute inflam- covariance matrices (BMDP version five), with group- Treatment Benzopyrone mation (because of confusion in terminology, the ing factors of treatment, grade of disease (three levels), --- Placebo Intemational Society for Lymphology recommends and time, and individual linear regressions were Grade of lymphoedema that this neutral term be used for any acute inflammation calculated against time. Paired t tests were used to * Grades 3-5 of the affected tissues6). Each clinical feature was assess the significance of the differences between * Grade2 catagorised as severe, moderate, mild, slight, or none. individuals' initial and final values from zero and 170- A Grade I In addition, all the patients had chest radiographs and between the treatment and placebo groups for the 160- electrocardiograms taken and complete blood and individual grades. urine examinations made. Ten patients in each group The results ofthe clinical examination were reported 1~.50! -~ - - were tested for bleeding and coagulation times and for as remained bad (severe or moderate), remained good 140- liver and kidney function. (mild to none), worsened (started as good and became Classification of lymphoedema and elephantiasis-The bad), or improved (started as bad and became good). 130- Intemational Society for Lymphology classifies They were analysed with X2 tests ofhomogeneity, using 120 lymphoedema as grade 1 (pitting of skin and oedema Yates's correction if required.
Load more

Recommended publications
  • PROGRESS Against Neglected Tropical Diseases
    PROGRESS SHEET Significant progress towards the elimination and eradication of neglected tropical diseases has been made in the last decade. Development of public-private partnerships, drug donations from major pharmaceutical companies, increased country and international agency commitment, and effective intervention strategies have led to dramatic declines in rates of infection from these debilitating diseases. Over the last five years, neglected tropical diseases (NTDs)— Elimination Program for the Americas (Merck & Co.), a group of debilitating infectious diseases that contribute to Global Programme to Eliminate Lymphatic Filariasis extreme poverty—have been the focus of increased attention. (GlaxoSmithKline, Merck & Co.), International Trachoma Countries, supported by a variety of global initiatives, have Initiative (Pfizer), Children Without Worms (Johnson & made remarkable headway in combating NTDs—including Johnson), and the WHO Program to Eliminate Sleeping diseases such as leprosy, lymphatic filariasis (elephantiasis), Sickness (Bayer, sanofi-aventis) to provide treatment for those onchocerciasis (river blindness), schistosomiasis (snail fever), NTDs. For schistosomiasis control, praziquantel has been and trachoma—and guinea worm may be the next disease provided via WHO by Merck KGaA and by MedPharm to the eradicated from the planet. Schistosomiasis Control Initiative. Drugs for leprosy control are provided free by Novartis. Global Progress This collection of programs and alliances has been successful in bringing together partners to address NTDs, but there The prospects for reducing the enormous burden caused are others who also provide support to national programs by NTDs have changed dramatically in just the past few fighting these diseases. years, in part due to the growing recognition of the linkages between the fight against these debilitating diseases and The Carter Center spearheads efforts with theCenters for progress towards the United Nations Millennium Disease Control (CDC), WHO, and UNICEF to eradicate guinea Development Goals (MDGs).
    [Show full text]
  • Effect of Water Resource Development and Management on Lymphatic Filariasis, and Estimates of Populations at Risk
    Am. J. Trop. Med. Hyg., 73(3), 2005, pp. 523–533 Copyright © 2005 by The American Society of Tropical Medicine and Hygiene EFFECT OF WATER RESOURCE DEVELOPMENT AND MANAGEMENT ON LYMPHATIC FILARIASIS, AND ESTIMATES OF POPULATIONS AT RISK TOBIAS E. ERLANGER, JENNIFER KEISER, MARCIA CALDAS DE CASTRO, ROBERT BOS, BURTON H. SINGER, MARCEL TANNER, AND JÜRG UTZINGER* Swiss Tropical Institute, Basel, Switzerland; Department of Geography, University of South Carolina, Columbia, South Carolina; Water, Sanitation and Health, World Health Organization, Geneva, Switzerland; Office of Population Research, Princeton University, Princeton, New Jersey Abstract. Lymphatic filariasis (LF) is a debilitating disease overwhelmingly caused by Wuchereria bancrofti, which is transmitted by various mosquito species. Here, we present a systematic literature review with the following objectives: (i) to establish global and regional estimates of populations at risk of LF with particular consideration of water resource development projects, and (ii) to assess the effects of water resource development and management on the frequency and transmission dynamics of the disease. We estimate that globally, 2 billion people are at risk of LF. Among them, there are 394.5 million urban dwellers without access to improved sanitation and 213 million rural dwellers living in close proximity to irrigation. Environmental changes due to water resource development and management consistently led to a shift in vector species composition and generally to a strong proliferation of vector populations. For example, in World Health Organization (WHO) subregions 1 and 2, mosquito densities of the Anopheles gambiae complex and Anopheles funestus were up to 25-fold higher in irrigated areas when compared with irrigation-free sites.
    [Show full text]
  • Neglected Tropical Diseases: Equity and Social Determinants
    Neglected tropical diseases: equity and social determinants 1 8 Jens Aagaard-Hansen and Claire Lise Chaignat Contents Water, sanitation and household-related factors 147 Environmental factors . 147 8.1 Summary . 136 Migration . 148 8.2 Introduction . 136 Sociocultural factors and gender . 148 Neglected tropical diseases. 136 Poverty as a root cause of NTDs. 148 Equity aspects of neglected tropical diseases . 138 8.6 Implications: measurement, evaluation Methodology . 138 and data requirements . 150 8.3 Analysis: social determinants of Risk assessment and surveillance. 150 neglected tropical diseases . 139 Monitoring the impact . 150 Water and sanitation. 139 Knowledge gaps . 151 Housing and clustering . 140 Managerial implications and challenges . 152 Environment . 141 8.7 Conclusion . 152 Migration, disasters and conflicts . 141 Sociocultural factors and gender . 142 References . 153 Poverty . 143 Table 8.4 Discussion: patterns, pathways and Table 8.1 Relationship of the 13 NTDs to entry-points . 144 the selected social determinants and the five 8.5 Interventions . 146 analytical levels. 145 1 The authors would like to acknowledge the valuable input of reviewers (especially Susan Watts and Erik Blas), and Birte Holm Sørensen for her comments regarding the potential of social determinants as indicators of multiendemic populations. Also thanks to staff members of the WHO Department of Neglected Tropical Diseases for their support and advice. Neglected tropical diseases: equity and social determinants 135 8.1 Summary Consequently, poverty should be addressed both in gen- eral poverty alleviation programmes for NTD-endemic The neglected tropical diseases (NTDs) are very het- populations and more particularly by ensuring afford- erogeneous and consequently the analysis of inequity able treatment.
    [Show full text]
  • A Cross-Sectional Study of the Filarial And
    Sangare et al. Parasites & Vectors (2018) 11:18 DOI 10.1186/s13071-017-2531-8 RESEARCH Open Access A cross-sectional study of the filarial and Leishmania co-endemicity in two ecologically distinct settings in Mali Moussa Brema Sangare1, Yaya Ibrahim Coulibaly1*, Siaka Yamoussa Coulibaly1, Michel Emmanuel Coulibaly1, Bourama Traore1, Ilo Dicko1, Ibrahim Moussa Sissoko1, Sibiry Samake1, Sekou Fantamady Traore1, Thomas Bruce Nutman2, Jesus Gilberto Valenzuela3, Ousmane Faye4, Shaden Kamhawi3, Fabiano Oliveira3, Roshanak Tolouei Semnani2 and Seydou Doumbia1 Abstract Background: Filariasis and leishmaniasis are two neglected tropical diseases in Mali. Due to distribution and associated clinical features, both diseases are of concern to public health. The goal of this study was to determine the prevalence of co-infection with filarial (Wuchereria bancrofti and Mansonella perstans)andLeishmania major parasites in two ecologically distinct areas of Mali, the Kolokani district (villages of Tieneguebougou and Bougoudiana) in North Sudan Savanna area, and the district of Kolondieba (village of Boundioba) in the South Sudan Savanna area. Methods: The prevalence of co-infection (filarial and Leishmania) was measured based on (i) Mansonella perstans microfilaremia count and/or filariasis immunochromatographic test (ICT) for Wuchereria bancrofti-specific circulating antigen, and (ii) the prevalence of delayed type hypersensitivity (DTH) responses to Leishmania measured by leishmanin skin test (LST). Results: In this study, a total of 930 volunteers between the age of 18 and 65 were included from the two endemic areas of Kolokani and Kolondieba. In general, in both areas, filarial infection was more prevalent than Leishmania infection with an overall prevalence of 15.27% (142/930) including 8.7% (81/930) for Mansonella perstans and 8% (74/ 930) for Wuchereria bancrofti-specific circulating antigen.
    [Show full text]
  • Skin and Wound Care in Lymphedema Patients: a Taxonomy, Primer, and Literature Review
    LITERATURE REVIEW Skin and Wound Care in Lymphedema Patients: A Taxonomy, Primer, and Literature Review Caroline E. Fife, MD, FACCWS; Wade Farrow, MD, FACCWS, CWSP; Adelaide A. Hebert, MD, FACCWS; Nathan C. Armer, MEd; Bob R. Stewart, EdD; Janice N. Cormier, MD, MPH, FACS; and Jane M. Armer, PhD, RN, FAAN, CLT INTRODUCTION ABSTRACT As part of a systematic review to evaluate the level of evidence of BACKGROUND: Lymphedema is a condition of localized contemporary peer-reviewed lymphedema literature in support protein-rich swelling from damaged or malfunctioning of the second edition of a Best Practices document, publications lymphatics. Because the immune system is compromised, on skin care and wounds were retrieved, summarized, and eval- there is a high risk of infection. Infection in patients with uated by teams of investigators and clinical experts. A joint pro- lymphedema may present in a variety of ways. ject of the American Lymphedema Framework Project and the OBJECTIVE: The goals of this review were to standardize the International Lymphoedema Framework, the objectives are to terminology of skin breakdown in the context of lymphedema, provide evidence of the best practices in lymphedema care and synthesize the available information to create best practice management and to increase lymphedema awareness in the recommendations in support of the American Lymphedema United States and worldwide. Framework Project update to its Best Practices document, and create recommendations for further research. BACKGROUND DATA SOURCES: Publications on skin care and wounds were Lymphedema is a disfiguring condition that can result in signifi- retrieved, summarized, and evaluated by a team of investigators cant impairment in quality of life and function.1 The skin cons- and clinical experts.
    [Show full text]
  • Genital Manifestations of Tropical Diseases J Richens
    12 Sex Transm Infect: first published as 10.1136/sti.2003.004093 on 30 January 2004. Downloaded from TROPICAL MEDICINE SERIES Genital manifestations of tropical diseases J Richens ............................................................................................................................... Sex Transm Infect 2004;80:12–17. doi: 10.1136/sti.2003.004093 Genital symptoms in tropical countries and among bine medical subject headings for individual infections with the headings genital diseases, returned travellers can arise from a variety of bacterial, male and genital diseases, female, exploding the protozoal, and helminthic infections which are not usually latter terms to include all their subheadings. sexually transmitted. The symptoms may mimic classic Genital tuberculosis cases are conveniently indexed in Medline under the heading tubercu- sexually transmitted infections (STIs) by producing losis, male genital, and tuberculosis, female ulceration (for example, amoebiasis, leishmaniasis), wart- genital. All abstracts were screened and the full like lesions (schistosomiasis), or lesions of the upper genital text of individual articles read for all reviews and case series. References in articles were examined tract (epididymo-orchitis caused by tuberculosis, leprosy, for to check for further pertinent articles. and brucellosis; salpingitis as a result of tuberculosis, Individual case reports were not read unless they amoebiasis, and schistosomiasis). A variety of other genital emphasised special features not previously reported or included useful reviews of the symptoms less suggestive of STI are also seen in tropical literature. The references selected are those that countries. These include hydrocele (seen with filariasis), reflect the greatest experience in a specific area which can be no less stigmatising than STI, haemospermia or which describe important new developments or observations.
    [Show full text]
  • A Review of Neglected Tropical Diseases: Filariasis Anish Chandy1*, Alok Singh Thakur1, Mukesh Pratap Singh1, Ashish Manigauha2
    Asian Pacific Journal of Tropical Medicine (2011)581-586 581 Contents lists available at ScienceDirect Asian Pacific Journal of Tropical Medicine journal homepage:www.elsevier.com/locate/apjtm Document heading doi: A review of neglected tropical diseases: filariasis Anish Chandy1*, Alok Singh Thakur1, Mukesh Pratap Singh1, Ashish Manigauha2 1School of Pharmacy, Chouksey Engineering College, Bilaspur , Chattishgarh, India 2NRI College of Pharmacy, Bhopal, India ARTICLE INFO ABSTRACT Article history: Filariasis is result of parasitic infection caused by three specific kinds of round worm. Lymphatic Received 11 February 2011 filariasis is found in under developed region of South America, Central Africa, pacific and Received in revised form 11 April 2011 Caribbian. It has been found for centuries, with main symptoms as elephant like swelling of Accepted 15 June 2011 the arms, legs and genitals. It is estimate that 120 millions peoples in the world have lymphatic Available online 20 July 2011 filariasis. The spread of diseases and the challenge encountered in its management are discussed along with a review on drugs against filariasis in this article. Detail on clinical effect of drugs on Keywords: the infection, safety profile, status in clinical practices and drug resistances are also covered. Filariasis Parasite Treatment Pathophysiology Drugs Ivermectin 2000BC 1. Introduction the disease may have been found as early as . A statue of Pharaoh Mentuhotep 栻 depicts swollen limbs, a characteristic of elephantiasis, which is a symptom of Filariasis is a disease caused by parasitic worms called heavy lymphatic filariasis infection. Artifacts from the filariae. Filariae are microscopic roundworms that dwell Nok civilization in West Africa also show scrotal swelling, in the blood and tissues of humans.
    [Show full text]
  • Lymphatic Filariasis and the Role of Nursing Interventions
    Clinical REVIEW Lymphatic filariasis and the role of nursing interventions Rebecca Penzer Lymphoedema in the resource rich countries of the world is usually associated with cancer or venous disease. In the developing world, however, large numbers of people (1.2 billion) (Dean, 2001) are at risk of developing lympoedema because they live in areas where the infected mosquitos take frequent blood meals from humans. This article seeks to explore the relationship between mosquitos, lymphatic filariasis and the associated lymphoedema and to discuss the relevant nursing interventions which can have a positive impact on literally millions of individuals. blood meal from a human (which it Once in the blood stream, the Key words does by sticking its probiscus into the parasite make its way to the lymphatic superficial blood supply) it picks up system where it grows: male adult Lymphatic filariasis microfilariae (mf) which are circulating worms growing to 4cm in length and Lymphoedema near the surface of the skin. Once in females up to 10cm (Scott, 2000). The Skin care the mosquito, mf undergo a number worms live tangled together in ‘nests’ Nursing interventions of developmental stages which take in the lymphatics, these can be seen place in the flight muscles of the pulsating on an ultrasound scan. At mosquito. Having undergone these adulthood, the worms mate and the stages, the mf migrate back to the female releases further microfilariae mouth parts of the mosquito. On the into the lymphatics. These immature Lymphatic filariasis and the mosquito parasites migrate to the superficial In the tropical countries of Africa, blood vessels where the mosquito Central America and Asia, mosquitos Dermatolymphang- picks them up on taking a blood meal are the vector for parasites which ioadenitis, often referred and, thus, the disease is transmitted.
    [Show full text]
  • A Brief Overview of Vector-Borne Iilness Clinical Manifestations Of
    A Brief overview of Vector-Borne IIlness N5290 The Science of Nursing in the Community Jill Gallin, CPNP Assistant Professor of Clinical Nursing Columbia University Global Distribution of Schistosomiasis in Africa and the Americas: S. mansoni, S. intercalatum Global Distribution of Schistosomiasis in Africa and Asia: S. haematobium, S. japonicum, S. mekongi Clinical manifestations of Shistosomiasis • Severe enlargement of liver and spleen • Intestinal involvement – Abdominal pain – Bloody diarrhoea – fatigue 1 Shells of various snail intermediate hosts of Child infected with Shistosomiasis schistosomiasis Distribution of lymphatic filariasis The life cycle of schistosome parasites in Africa and the Americas Distribution of lymphatic filariasis in Asia Clinical Manifestations of Lymphatic Filariasis • Elephantiasis- hyprtrophy, edema and fibrosis esp. in lower extremeties • Vector breeds in organically polluted water 2 Distribution of onchocerciasis in Africa Distribution of onchocerciasis in the Americas Clinical Manifestations of onchocerciasis A victim of river blindness (onchocerciasis) (River Blindness) • Long term exposure to infected black fly bites causes blindness • Affects river valley communities Aerial view of an abandoned village in an area affected by onchocerciasis in West Africa Blackfly, feeding 3 Distribution of old world and new world visceral leishmaniasis Visceral leishmaniases: Kalazar • Parasite affects the internal organs and the disease is likely to be fatal • Arid, warm environment • Zoonosis: human disease with
    [Show full text]
  • Lymphatic Filariasis and Chemotherapeutic Targets B Sharma* Department of Biochemistry, University of Allahabad, Allahabad, UP, India
    nalytic A al & B y i tr o s c i h e m m Sharma, Biochem Anal Biochem 2014, 3:1 e Biochemistry & i h s c t r o i y DOI: 10.4172/2161-1009.1000e147 B ISSN: 2161-1009 Analytical Biochemistry Editorial Open Access Lymphatic Filariasis and Chemotherapeutic Targets B Sharma* Department of Biochemistry, University of Allahabad, Allahabad, UP, India Lymphatic filariasis (LF) is one of the four important tropical timori rarely affects the genitals. Those who develop the chronic stages diseases (LF, Oncocerciasis, Chagas disease and leprocy) as identified of elephantiasis are usually amicrofilaraemic, and often have adverse by WHO. It is an infectious disease caused by lymph dwelling nematode immunological reactions to the microfilariae, as well as the adult parasites and transmitted by mosquitoes. It is one of the oldest and worms. The diagnosis of LF is done by identifying microfilariae in most debilitating of all the neglected tropical diseases. Elimination of blood using staining of thin and thick blood film smears suing Giemsa LF as public health problems is urgently required as it causes morbidity stain or by Polymerase chain reaction (PCR) and antigenic assays. resulting into economic loss of developing countries. According to the LF treatment includes a combination of two medicines such as WHO report, LF is commonly known as elephantiasis occurring in albendazole and ivermectin (in Sub-Sahara Africa) or albendazole with over 140 million people are currently infected, with about 40 million diethylcitrate (DEC) with an idea to sharply kill and clear Mf from disfigured and incapacitated by the disease.
    [Show full text]
  • Neglected Tropical Diseases
    Department for International Development Single Departmental Plan - Results Achieved by Sector in 2018 Neglected Tropical Diseases Number of people receiving treatment or care for one or more neglected tropical diseases (disaggregated by type of intervention received). 1. Results: In 2018 DFID reached 140.6 million people through our neglected tropical diseases (NTD) programmes. Table 1: Number of people reached by intervention type Intervention Type Number of People Reached1 Preventive chemotherapy2 139,055,529 Other preventive measures3 2,653,286 Morbidity management4 52,854 Curative treatment5 10,909 In 2018 out of the total people reached by DFID’s NTD interventions, 98% received preventative chemotherapy1, 0.04% morbidity management3, 0.01% curative treatment4, and 2% other types of preventative measure2. 1 The total figure has been adjusted to avoid double counting individuals who may have received more than one intervention type therefore the sum of the intervention types is greater than the total. 2 Preventive chemotherapy is the treatment of entire populations at risk of infection (regardless of whether or not they are infected) to treat infection and prevent ongoing transmission. 3 Other preventive measures can be used to prevent the spread of NTDs, for example water filters are used to prevent infection by Guinea Worm due to drinking contaminated water. 4 Morbidity management is the provision of surgery and self-care training to address the disabling consequences of infection with lymphatic filariasis, or surgery to prevent blindness due to trachoma. 5 Curative treatment is where individuals receive a diagnosis and, if infected, treatment to cure the disease. 1 Figure 1: NTD results by gender In 2018 DFID reached 69.8 million females and 69.6 million males through our NTD programmes, the gender of 1.3 million beneficiaries were not identified.
    [Show full text]
  • Podoconiosis, Non-Filarial Elephantiasis, and Lymphology
    168 Lymphology 43 (2010) 168-177 PODOCONIOSIS, NON-FILARIAL ELEPHANTIASIS, AND LYMPHOLOGY G. Davey Brighton & Sussex Medical School, University of Sussex, Falmer, Brighton, United Kingdom ABSTRACT HISTORY Several recent reviews of podoconiosis From the time of the Roman Empire, already exist in journals and on public access travelers recorded anecdotes about people websites. After briefly covering the historical with progressive swelling of the feet. A more and epidemiological background, this detailed reference to ‘swollen legs’ appears in narrative review will therefore attempt the Tibetan translations of a fourth century explicitly to link podoconiosis with revelation originally recorded in Sanskrit as lymphology, examining gaps in what is known the second book of rGyud-bzhi (the ‘four of pathogenesis and identifying the areas of tantras’). However, it was not until c.905 research in which input from lymphologists is that the Persian physician Rhazes first most required. Finally, prevention and distinguished elephantiasis ‘of the Greeks’ treatment will be described and the need for (lepromatous leprosy) from that ‘of the operational research to optimize community- Arabs’ (most probably non-filarial based interventions outlined. elephantiasis) (1). In the 1770s, the adventurer James Bruce Keywords: podoconiosis, elephantiasis, gave a graphic description of the elephan- lymphedema, soil tiasis he saw in Gondar, northern Ethiopia: “The chief seat of this disease is from the Podoconiosis is a type of lower limb bending of the knee downwards to the ankle; tropical elephantiasis distinct from lymphatic the leg is swelled to a great degree, becoming filariasis (LF). It is a geographically localized one size from bottom to top, and gathered disease, clinically distinguished from LF into circular wrinkles...
    [Show full text]