Prevention of acute adenolymphangitis in brugian filariasis: comparison of the efficacy of ivermectin and diethylcarbamazine, each combined with local treatment of the affected limb

Shenoy, R. K.; Suma, Takeshi; Rajan, K.; Kumaraswami, V.

doi:10.1080/00034983.1998.11813316

Cited by 61 publications

(61 citation statements)

References 9 publications

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“…Occasionally they present with filarial lymphangitis caused by death of the adult worms in the lymphatics, either spontaneous or after treatment with the antifilarial drug DEC. In such situations dilated, inflamed and tender lymphatic channels stand out as cords ("string sign") seen and palpated either by the side of the chest or inguinal region (Shenoy et al 1998). Rarely chyluria and tropical pulmonary eosinophilia are also reported in children (Witt and Ottesen, 2001).…”

Section: Clinical Features Of Lf Disease In Childhoodmentioning

confidence: 99%

“…Any local precipitating 'entry lesions' like injury and bacterial or fungal infection should be treated with local antibiotic or antifungal ointments or with systemic antibiotics where needed. Proper and regular practice of 'local hygiene' measures of the affected limbs are effective in preventing ADLA attacks (Shenoy et al 1998). This is aimed at prevention of fungal and bacterial infections and has become the mainstay for disability alleviation in GPELF (Ottesen, 2000).…”

Section: Management Of Lf Infection and Disease In Childrenmentioning

confidence: 99%

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Lymphatic filariasis in children: Clinical features, infection burdens and future prospects for elimination

Shenoy

Bockarie

2011

Parasitology

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S U M M A R YLymphatic filariasis (LF), a common parasitic infection in tropical countries, causes lymphoedema of limbs, hydrocele and acute attacks of dermato-lymphangio-adenitis. Recent advances in diagnosis have helped to recognize that LF infection is often acquired in childhood. Newly available diagnostic techniques like sensitive antigen and antibody assays, Doppler ultrasonography and lymphoscintigraphy have helped to understand the subclinical pathology caused by this infection, which was hitherto generally believed to be irreversible. Recent studies indicate that drugs used in the mass drug administration (MDA) programme under GPELF are capable of reversing the sub-clinical lymphatic damage in children and provide benefits other than interruption of transmission. Albendazole and ivermectin used in MDA are effective against soil-transmitted helminthic infections common in children in LF endemic areas. Thus MDA had other 'beyond LF' benefits in treated children including increased appetite, weight gain, greater learning ability and concentration, better school attendance and prevention of anaemia. MDA should no longer be viewed as a measure for interrupting transmission alone. Recent findings of reversibility of early lymphatic pathology in treated children indicate that both MDA and 'foothygiene' measures are effective strategies in preventing and managing morbidity. Programme managers should effectively utilize this information to strengthen their advocacy efforts to achieve high and sustainable coverage in MDA.

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Section: Clinical Features Of Lf Disease In Childhoodmentioning

confidence: 99%

Section: Management Of Lf Infection and Disease In Childrenmentioning

confidence: 99%

Lymphatic filariasis in children: Clinical features, infection burdens and future prospects for elimination

Shenoy

Bockarie

2011

Parasitology

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“…Such repeated attacks later perpetuate and worsen the lymphedema leading to elephantiasis. This in turn favors more such attacks due to lack of local hygiene and a vicious cycle is thus established [4,24]. Advanced stages of lymphedema are characterized by increasing dilation and tortuosity of the lymphatics, endothelial proliferation, formation of new lymph channels, and obstructive changes and dermatosclerosis with nodular and warty changes.…”

Section: Introductionmentioning

confidence: 99%

Clinical and Pathological Aspects of Filarial Lymphedema and Its Management

Shenoy

2008

Korean J Parasitol

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109

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Lymphatic filariasis, transmitted by mosquitoes is the commonest cause of lymphedema in endemic countries. Among 120 million infected people in 83 countries, up to 16 million have lymphedema. Microfilariae ingested by mosquitoes grow into infective larvae. These larvae entering humans after infected mosquito bites grow in the lymphatics to adult worms that cause damage to lymphatics resulting in dilatation of lymph vessels. This earliest pathology is demonstrated in adults as well as in children, by ultrasonography, lymphoscintigraphy and histopathology studies. Once established, this damage was thought to be irreversible. This lymphatic damage predisposes to bacterial infection that causes recurrent acute attacks of dermato-lymphangio-adenitis in the affected limbs. Bacteria, mainly streptococci gain entry into the lymphatics through 'entry lesions' in skin, like interdigital fungal infections, injuries, eczema or similar causes that disrupt integrity of skin. Attacks of dermato-lymphangio-adenitis aggravates lymphatic damage causing lymphedema, which gets worse with repeated acute attacks. Elephantiasis is a late manifestation of lymphatic filariasis, which apart from limbs may involve genitalia or breasts. Lymphedema management includes use of antifilarial drugs in early stages, treatment and prevention of acute attacks through 'limb-hygiene', antibiotics and antifungals where indicated, and physical measures to reduce the swelling. In selected cases surgery is helpful.

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“…Elephantiasis is a late manifestation of lymphatic filariasis, which apart from limbs may involve genitalia or breasts. 4 In addition presents with its consequent sequel 5,6 i.e -elephantiasis and necrosis is increasing progressively in spite of the commonly prescribed Di ethyl carbamazine citrate in dose of 2mg/kg every 8 hours which only relieve toxic phase i.e-pyrexial phase but fails to relieve lymph edema 7,8,9 In addition current therapeutic added in its treatment i.e.-Ivermectine also fails to alleviate lymph edema which in turn causes mucin deposit and elephantiasis posing encumbrance even in natural routine activity…”

Section: Introductionmentioning

confidence: 99%