A pilot project to administer triple drug therapy with the long term aim of eradicating lymphatic filariasis was launched in Nagpur.
Nagpur is one of the five districts in the country and only one in Maharashtra, where this triple drug therapy campaign is being launched.
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Over 40% of worldwide cases are found in India and to eradicate the disease a concerted effort is needed.
Since 2004, two drug therapy for lymphatic filariasis has been in place but the addition of the third drug now will give boost to the overall campaign.
The third drug used in this therapy will help control adult worms of lymphatic filariasis.
Micro filariasis, which is produced by adult worms, is the cause of swollen leg. Previously the adult worms were sterilized by drugs and remained inactive for a year. Now that period will increase to two years.
Commonly known as elephantiasis, is a neglected tropical disease.
Infection occurs when filarial parasites are transmitted to humans through mosquitoes.
Infection is usually acquired in childhood causing hidden damage to the lymphatic system.
The painful and profoundly disfiguring visible manifestations of the disease, lymphoedema, elephantiasis and scrotal swelling occur later in life and can lead to permanent disability.
These patients are not only physically disabled, but suffer mental, social and financial losses contributing to stigma and poverty.
Currently, 856 million people in 52 countries are living in areas that require preventive chemotherapy.
Causes and transmission
Lymphatic filariasis is caused by infection with parasites classified as nematodes (roundworms) of the family Filariodidea. There are 3 types of these thread-like filarial worms:
Wuchereria bancrofti, which is responsible for 90% of the cases
Brugia malayi, which causes most of the remainder of the cases
Brugia timori, which also causes the disease.
Adult worms lodge in the lymphatic vessels and disrupt the normal function of the lymphatic system.
The worms can live for approximately 6–8 years and, during their life time, produce millions of microfilariae (immature larvae) that circulate in the blood.
Mosquitoes are infected with microfilariae by ingesting blood when biting an infected host. Microfilariae mature into infective larvae within the mosquito.
When infected mosquitoes bite people, mature parasite larvae are deposited on the skin from where they can enter the body.
The larvae then migrate to the lymphatic vessels where they develop into adult worms, thus continuing a cycle of transmission.
It is transmitted by different types of mosquitoes for example by the Culex mosquito, widespread across urban and semi-urban areas, Anopheles, mainly found in rural areas, and Aedes, mainly in endemic islands in the Pacific.
Lymphatic filariasis infection involves asymptomatic, acute, and chronic conditions. The majority of infections are asymptomatic, showing no external signs of infection while contributing to transmission of the parasite.
These asymptomatic infections still cause damage to the lymphatic system and the kidneys, and alter the body's immune system.
When lymphatic filariasis develops into chronic conditions it leads to lymphoedema (tissue swelling) or elephantiasis (skin/tissue thickening) of limbs and hydrocele (scrotal swelling). Involvement of breasts and genital organs is common.
Such body deformities often lead to social stigma and sub-optimal mental health, loss of income-earning opportunities and increased medical expenses for patients and their caretakers. The socioeconomic burdens of isolation and poverty are immense.
To eliminate lymphatic filariasis as a public health problem; in 2000, Global Programme to Eliminate Lymphatic Filariasis (GPELF) was launched. In 2012, the WHO neglected tropical diseases roadmap reconfirmed the target date for achieving elimination by 2020.
WHO’s strategy is based on 2 key components:
stopping the spread of infection through large-scale annual treatment of all eligible people in an area or region where infection is present; and
Alleviating the suffering caused by lymphatic filariasis through provision of the recommended basic package of care.
Neglected Tropical Diseases (NTDs), a group of infectious diseases, include: