Elephantiasis is the common name for the lymphatic disorder “Lymphatic Filariasis” (CDC I n.d). This disease is a filarial parasitic infection found in humans mainly transmitted by mosquitoes. The distinctive nature of this disease is the unusual swelling especially in the limbs and genitals due to unusual collection of the watery fluid causing severe pain and extremely disfiguring symptoms. The skin becomes dark, thickened with pebbly appearance and ultimately may become ulcerated. Though the infection occurs in the childhood, the clinical manifestations are visible only the later part of the life (WHO n.d). Two different kinds of elephantiasis are recognized. They are:
Filarial elephantiasis: It is mainly caused by the parasitic infection of three species of filarial worms namely: Wuchereria bancrofti, Brugia malayi, and Brugia timori transmitted by the bite of Culex, Aedes, Anopheles or Mansonia mosquito species (CDC II n.d ). Secondary skin infections, existence of symbiotic bacteria and body’s response to worms (Dorothy et al 2011) are also the sources of filarial elephantiasis.
Nonfilarial elephantiasis or podoconiosis: is the inflammation of the lymphatic system triggering various secondary infections. According Desta et al. (2003) this condition is mainly prevalent in Ethiopia where continuous contact with specific particles such as alkali metals, red clay, etc., present in the soil embed in the lymphatic tissues and engender irritating effects. Ultimately it traumatizes the tissue making it vulnerable to streptococcal infection.
According WHO (n.d), presently over 1.3 billion people in 81 countries are threatened by this disease and approximately 65% of those infected live in the South-East Asia Region, 30% in the African Region, and the remainder in other tropical areas. Further in one third of the infected population elephantiasis has resulted in disfigurement. People who are directly exposed to parasitic contacts like mosquito bites, living in unhygienic disease prevalent regions are prone to greater risk. Additionally walking barefoot in unhygienic environments in disease prevalent regions also contributes to nonfilarial elephantiasis (Dorothy et al 2011). The end result of this disease is serious body disfigurement. Hence various treatment strategies such as usage of anti-parasitic drugs namely diethylcarbamazine [DEC], antibiotics such as doxycycline and chemotherapy (CDC III n.d) helps in eradicating the causal parasites. The limited contact of selected soils that provoke podoconiosis reduces its manifestation (Desta et al 2003). However, with the intervention of advanced medical surgery, the disfigured tissues are removable. Medical workers insist that the most effective method to prevent the disease is mainly through suppression of transmission. Using insecticide sprays or mosquito nets protect people in endemic regions by controlling mosquito breeding as well as bites. However patients suffering from chronic disabilities like elephantiasis, lymphoedema, or hydrocele are recommended to maintain personal hygiene and be cautious about aggravation and further secondary infections of their diseases (WHO n.d). Further all medical practitioners campaigning disease prevention as first step in disease control is recommendable. Next, the primary role of pharmacists is the provision of information on the best preventive techniques, execution of strategies that eliminate or destroy parasites and ensure accessibility of the best possible alternative therapy treatment for secondary infections. Development of national and international strategies and policies particularly focusing on public education, good hygiene which relates to effective prevention, treatment and management of the disease and increased supply of antifilarial drugs in high risk and the endemic regions (Raju et al 2010) would be the most important intervention. Nonetheless, the earlier the treatment is initiated; the better is the prognosis (Dorothy et al 2011).
References
CDC I. “Parasites – Lymphatic Filariasis”. Frequently Asked Questions (FAQs). Web.
CDC II. “Parasites – Lymphatic Filariasis”. Epidemiology & Risk Factors. Web.
CDC III. “Parasites – Lymphatic Filariasis”. Treatment. Web.
Borton, Dorothy et al. “Lippincott’s guide to infectious diseases”. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins ( 2011): p 104.
Desta K, Ashine M, and Davey G. “Prevalence of podoconiosis (endemic non-filarial elephantiasis) in Wolaitta, Southern Ethiopia”. Tropical Doctor 32, (2003): 217–220.
Kucherlapati Raju, et al. “Lymphatic filariasis in India: epidemiology and control measures”. Journal of Postgraduate Medicine 56(3) (2010): 232-238.
World Health Organization (WHO). “Lymphatic filariasis.”. Fact sheet No.102. Web.
“Lymphatic filariasis. Fact sheet No.102.” WHO.int. Web.