Overview
ELEPHANTISIASIS is one of the neglected tropical diseases(NTDs). It is also referred to as lymphatic filariasis. Lymphatic filariasis is caused by a parasitic micro-organism known as filarial worms, which are transmitted through mosquito bites.
Elephantiasis causes swelling of limbs, breasts and genitals. Most of the affected individuals do not present symptoms, and if they do, it is usually after a many years. Adult filarial worms can live for about 5-7 years in human body, causing severe damage that remains even after they die.
Key Facts & Statistics
What are the key facts and statistics that surround elephantiasis?
- Almost 1.5% of the total world population suffer from lymphatic filariasis. These translates to about 120 million individuals globally.
- Elephantiasis is most common in tropical and subtropical regions, including Africa and South East Asia. It is very rare in the US.
- Filariasis results in a weakened immune system.
- More than 60% of people with the condition do not have severe symptoms.
Risk Factors
What are the risk factors associated with elephantiasis?
- This disease can affect persons of any age, whether young or old.
- It affects both sexes, men and women.
- Most common risk factors are:
- Living in unhygienic conditions.
- Frequent exposure to mosquitoes that carry parasites responsible for elephantiasis.
- Living or spending much time in tropics and subtropics.
Causes
What causes Elephantiasis?
Filarial worms are responsible for this condition:
- Wuchereria bancrofti causes 90% of all infections
- Brugia malayi and Brugia timori are responsible for the remaining cases.
Brugia malayi is one of the types of nematode worm which cause human filariasis. They are spread by blood- sucking insects. The worms then invade the human lymphatic system to produce thousands of larvae that spread around the body. Repeated infection causes lymph vessels to become inflamed and fluid to accumulate, which can lead to an enormous enlargement of parts of the body (elephantiasis). Treatment is usually with anthelmintic drugs.
These parasites are spread from infected to uninfected people through mosquito bites.
Filariasis, a parasitic infection, if untreated develops to elephantiasis.
Signs & Symptoms
What are the signs and symptoms of elephantiasis?
- Lymphedema
- Hydrocele in men(fluid build-up in the scrotum)
- Edema
- Inflammation
What parts/ organs of the body are affected by this condition?
Elephantiasis can affect several body parts such as:
- Upper and lower limbs
- Scrotum
- Breast
- Vulva
- Penis
- Face
Diagnostic Procedures & Tests
What are the procedures and tests for diagnosing elephantiasis?
They include:
- Patient history taking. This involves obtaining medical history, signs and symptoms and previous history of travel to tropics and subtropics.
- Microscopic blood tests. Laboratory blood testing is conducted to check for presence of filarial parasites. With filarial worms being nocturnal parasites, it is best practice to draw blood at night.
Blood sample of patient negative tested for filariasis. - Antibody tests. These are conducted to check for antibodies against the infection.
- X-rays and ultrasounds to rule out other conditions with similar presentation.
Treatment and Management
Is there a cure for lymphatic filariasis?
There lacks a vaccine or cure for this condition.
But, drugs can be used to kill the worms and help in preventing spread of infection to other people.
Treatment can also reduce symptoms and their severity.
How is elephantiasis treated?
The following are treatment strategies for elephantiasis:
- Anti-parasitic drugs such as albendazole and ivermectin.
- Surgery to remove dead worms from bloodstream or remove fluid that has accumulated in the scrotum(if filariasis has caused hydrocele)
- Elephantiasis management. This involves procedures that aid in management of swelling such as elevation or compression garments.
Note that anti-parasitic drugs can lead to severe side effects, such as:
- Muscle ache
- Joint pain
- Fever
- Dizziness
- Nausea
Therefore, your healthcare practitioner needs to keenly monitor these drugs and their effects.
Complications
What are the complications of elephantiasis?
As disease progresses, damage and insult done to the lymphatic system makes the body unable to fight off infections.
Due to weakened immune response, the patient is likely to develop:
- Frequent bacterial infections
- Tropical pulmonary eosinophilia syndrome
- Thick skin
- Fluid retention
Prevention
How do we prevent elephantiasis?
Elephantiasis is spread through mosquito bites. Prevention methods include:
- Sleeping under insecticide-treated mosquito nets.
- Smearing mosquito repellants on the skin.
- Wearing long-sleeved shirts and long trousers when approaching swampy and bushy areas.
- Clearing stagnant water and other areas that support mosquito breeding.
- Taking medications such as diethylcarbamazine(DEC), ivermectin and albendazole as a preventive measure before travelling to regions that are prone to elephantiasis.