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    Filaria-Limf 12

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    Juwita
    This document provides information on filariasis, a tissue nematode infection caused by Wuchereria bancrofti, Brugia malayi, and Brugia timori. It discusses the classification, morphology, life cycle, clinical symptoms, diagnosis, treatment, epidemiology, and the WHO strategy for eliminating lymphatic filariasis, which includes mass drug administration to entire at-risk populations. Over 120 million people are currently infected globally, with W. bancrofti responsible for 90% of cases. Left untreated, filariasis can cause lymphedema and elephantiasis.

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    Filaria-Limf 12

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    Juwita
    27 views30 pages
    This document provides information on filariasis, a tissue nematode infection caused by Wuchereria bancrofti, Brugia malayi, and Brugia timori. It discusses the classification, morphology, life cycle, clinical symptoms, diagnosis, treatment, epidemiology, and the WHO strategy for eliminating lymphatic filariasis, which includes mass drug administration to entire at-risk populations. Over 120 million people are currently infected globally, with W. bancrofti responsible for 90% of cases. Left untreated, filariasis can cause lymphedema and elephantiasis.

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    Filaria-limf 12

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    This document provides information on filariasis, a tissue nematode infection caused by Wuchereria bancrofti, Brugia malayi, and Brugia timori. It discusses the classification, morphology, life cycle, clinical symptoms, diagnosis, treatment, epidemiology, and the WHO strategy for eliminating lymphatic filariasis, which includes mass drug administration to entire at-risk populations. Over 120 million people are currently infected globally, with W. bancrofti responsible for 90% of cases. Left untreated, filariasis can cause lymphedema and elephantiasis.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    27 views30 pages

    Filaria-Limf 12

    Uploaded by

    Juwita
    This document provides information on filariasis, a tissue nematode infection caused by Wuchereria bancrofti, Brugia malayi, and Brugia timori. It discusses the classification, morphology, life cycle, clinical symptoms, diagnosis, treatment, epidemiology, and the WHO strategy for eliminating lymphatic filariasis, which includes mass drug administration to entire at-risk populations. Over 120 million people are currently infected globally, with W. bancrofti responsible for 90% of cases. Left untreated, filariasis can cause lymphedema and elephantiasis.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 30

    FILARIASIS

    TISSUE NEMATODES

    Isna Indrawati Department of Parasitology

    Classification of medical importance:


    Wuchereria bancrofti

    Lymphatic

    Brugia malayi Brugia timori Loa-loa

    Non - lymphatic (subcutaneous)

    Onchocerca volvulus Mansonella (less pathogenic)

    Filariasis lymphatic
    Belongs to superfamily Filaroidea WHO : over 120 million people are currently infected in 73 countries : 66% of those infected live in the WHO South-East Asia Region, 33% in the African Region, 1% in other tropical areas.

    W. bancrofti, which is responsible for 90% of the cases

    Filariasis lymphatic (contd)


    about 40 million disfigured and incapacitated by the disease. altered lymphatic system and the abnormal enlargement of body parts, causing severe disability. commonly known as elephantiasis.

    Countries Endemic for Lymphatic Filariasis in SEAR

    Source : WHO (Last update: 27 April 2006)

    Host & Geographic distribution


    W.bancrofti B. malayi B.timori 2 variant : antropophilic (human ) human zoophilic : human & animal (feline and monkey) Asia Indonesia (NTT)

    Host

    Human

    geograp hic distributi on

    Tropical & subtropical area all over the world

    Morphology
    W.bancrofti B.malayi B.timori
    thread-like worms , creamy white with smooth surface

    F: 65-100x 0.25 F: 55 x 0.16


    mm,

    Adult

    M: 40 x0.1 mm

    mm, M: 22x 0.09 mm

    F: 21-39x 0.1 mm, M: 13-23x 0.08mm

    Habitat

    Female : viviparous Adult : live for 6-8 years (can survive 15 yrs) Adult: lymphatic system Microfilaria : circulate in the blood

    Microfilariae
    W.bancrofti
    Size Head
    tail Body nuclei

    B.malayi
    200-260x 8 L=2xW
    2 nuclei in the end of the tail

    B.timori
    280-310x7 L=3xW
    2 nuclei in the end of the tail

    250-300x 7 Length = width


    No nuclei in the tail Fewer & regular

    Dense and irregular

    Body curved
    Sheath

    flexible
    present, unstained

    Coiled and kinked


    present, stained present, pink/darkly unstained

    Microfilariae
    Live in the blood, sheated Show periodicity released periodically into the peripheral blood from capillary of the lung during certain hours The mechanism not fully understood an adaptation of mf to the feeding habit of vectors Influenced by circadian rhythm, species , oxygen tension between venous and arterial blood

    Periodicity
    Species
    Wuchereria bancrofti Brugia malayi Brugia timori

    Periodicity
    Indonesia: nocturnal Nocturnal ; sub periodic nocturnal; nocturnal

    Vectors
    W.bancrofti Species Urban : Cx.quinquefasciatus Rural : Anopheles & Aedes Life 2 weeks, cycle in stadium I, II, III mosquit oes B.malayi B.timori Antropophil An. barbiic: An. rostris barbirostris zoophilic: Mansonia 10 days, stadium I, II, III

    Clinical symptoms
    cause a broad range of clinical manifestations, most infected people have no symptoms and will never develop clinical symptoms

    Microfilaria : occult filariasis / tropical eosinophilia ( respiration) Adult:


    Acute adenolymphangitis (ADL): Episodes of high fever, painful lymph node, lymphatic inflammation retrograde nature of the lymphangitis

    Clinical symptoms (contd)


    A small percentage of persons will develop lymphedema ( usually after 6 12 months ) >> affects the legs, but can also occur in the arms , exclusively with W.bancrofti : breasts and genitalia. This causes hardening and thickening of the skin, which is called elephantiasis

    Clinical symptoms (contd)


    Wuchereria bancrofti B.malayi & B. timori Acute: ADL Genital lymphatic system: funiculitis, epidydimitis, orchitis Chronic: Elephantiasis of the arms, legs,vulva ,hydrocele, chyluria Acute: ADL

    Elephantiasis of arms & legs Breast & Genitalia involvement is not found in Brugia infection

    Diagnosis
    Clinical symptoms Definitive D/ : detecting mf in blood ( depend on the periodicity of mf) W. Bancrofti : Occasionally mf can be found in hydrocele fluid or chyluria adult worm in biopsy Radio D/ : USG+ Doppler technique may identify motile adult worms in the scrotum (filarial dance)

    Diagnosis (contd)
    Immunological test :
    W. bancrofti : Assays for circulating antigens: the ELISA and the immunochromatographic card test Brugian filarial : antibody-based assay (dipstick test) has been developed

    B. malayi microfilaria

    Microfilaria W bancrofti B timori microfilaria

    Adult Filaria in the tissue

    Therapy
    Drugs :
    DEC(Diethyl carbamazine) Ivermectin Combination DEC with albendazole or Ivermectin

    Surgical approaches : moderately successful for chronic disabilities management

    Epidemiology
    Affects men > women (10 to 50 %t of men and up to 10 % of women) W. Bancrofti : rural type > urban B.malayi & B.timori : only in rural area Indonesia : wide range of prevalence. In Papua up to 70 %

    Strategy WHO
    In 2000: WHO launched its Global Programme to Eliminate Lymphatic Filariasis (GPELF) The goal of the GPELF is to eliminate lymphatic filariasis as a public-health problem by 2020.

    Strategy (contd)
    The strategy is based on two key components: interrupting transmission through mass drug administration (MDA): implemented to cover the entire at-risk population; alleviating the suffering caused by lymphatic filariasis : through morbidity management disability prevention.

    MDA
    Weekly Epidemiological Report : 53 countries are currently implementing mass drug administration WHOr data : 538 million people received treatment LF around the world in 2011.

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