Journal Article

Lymphatic filariasis and onchocerciasis

Hoerauf, Achim, Taylor, Mark J, Bockarie, Moses

2010

Overview

Lymphatic filariasis and onchocerciasis are parasitic helminth diseases that constitute a serious public health issue in tropical regions. The filarial nematodes that cause these diseases are transmitted by blood-feeding insects and produce chronic and long-term infection through suppression of host immunity. Disease pathogenesis is linked to host inflammation invoked by the death of the parasite, causing hydrocoele, lymphoedema, and elephantiasis in lymphatic filariasis, and skin disease and blindness in onchocerciasis. Most filarial species that infect people co-exist in mutualistic symbiosis with Wolbachia bacteria, which are essential for growth, development, and survival of their nematode hosts. These endosymbionts contribute to inflammatory disease pathogenesis and are a target for doxycycline therapy, which delivers macrofilaricidal activity, improves pathological outcomes, and is effective as monotherapy. Drugs to treat filariasis include diethylcarbamazine, ivermectin, and albendazole, which are used mostly in combination to reduce microfilariae in blood (lymphatic filariasis) and skin (onchocerciasis). Global programmes for control and elimination have been developed to provide sustained delivery of drugs to affected communities to interrupt transmission of disease and ultimately eliminate this burden on public health.

• Publisher: Elsevier Ltd,Elsevier,Elsevier Limited
• Subject: Africa South of the Sahara / Age Factors / Albendazole - therapeutic use / Animals / Anti-Bacterial Agents - therapeutic use / Antinematodal Agents - therapeutic use / Biological and medical sciences / Blindness - parasitology / Chronic illnesses / Community / Culicidae / Dermatitis - parasitology / Dermatologic Agents - therapeutic use / Diethylcarbamazine - therapeutic use / Disease / Diseases caused by nematodes / Doxycycline - therapeutic use / Drug Therapy, Combination / Elephantiasis, Filarial - complications / Elephantiasis, Filarial - diagnosis / Elephantiasis, Filarial - drug therapy / Elephantiasis, Filarial - epidemiology / Elephantiasis, Filarial - physiopathology / Elephantiasis, Filarial - transmission / Filariases / Filaricides - therapeutic use / General aspects / Gram-Negative Bacterial Infections - complications / Granuloma - parasitology / Helminthic diseases / Humans / India / Infectious diseases / Internal Medicine / Ivermectin - therapeutic use / Lymphadenitis - parasitology / Lymphangitis - parasitology / Lymphatic filariases / Lymphatic system / Lymphedema - parasitology / Macrolides - therapeutic use / Malaria / Medical sciences / Nematoda / Nematodes / Onchocerciasis - complications / Onchocerciasis - diagnosis / Onchocerciasis - drug therapy / Onchocerciasis - epidemiology / Onchocerciasis - physiopathology / Onchocerciasis - transmission / Onchocercosis / Parasites / Parasitic diseases / Prevalence / Skin diseases / Survival / Symbiosis / Tropical diseases / Vascular endothelial growth factor / Vector-borne diseases / Wolbachia / Wolbachia - drug effects / Worms