Prevention and Treatment

Prevention

Since there is no known vaccine or cure for lymphatic filariasis, the most effective method that exists to control the disease is prevention. A parasite such as W. bancrofti, B. malayi or B. timori can effectively be controlled if either the vector is controlled, or if microfilarial levels in the population are controlled. As such, the effective prevention of lymphatic filariasis rests on population based programs that administer treatment drugs to an large group of people. Drugs that lower the levels of microfilariae in the blood will not only help the individual patient, but will prevent the transmission to another person. For this reason, prevention and treatment are intertwined.

Drug treatments are discussed below. In addition to drug treatments, there are other preventative methods. Controlling the vector with larvacides or insecticide spraying can be effective, depending on the vector population. Insect repellent, screens around houses and bed nets are other protective measures individuals can use to prevent bites from infected mosquito vectors (Reference 25).

Treatment/Management

Educational information, such as the pamphlet above, is important in communicating important management techniques to populations afflicted with elephantiasis (Image 12).

Lymphangitis and other acute symptoms are often treated with antihistamines, analgesics and antibiotics. While these treatments treat the symptoms, other treatments have been effective in treating the microfilariae. Diethylcarbamazine (DEC) is a popular microfilaricide, and has been used in Mass Drug Treatment programs. Such programs have added DEC in small amounts to table salt, and have been hugely successful in China and Tanzania (Reference 26). Another effective way to use DEC is in combination with ivermectin on an annual dosage plan. Ivermectin causes paralysis of the microfilariae, preventing migration. This combination drug therapy has shown better long-term results in reducing microfilariae (Reference 27).

Patients suffering from hydrocoele or other symptoms of scrotal swelling have the option of surgery as a treatment. Surgical methods to treat elephantiasis are currently being researched. However, elephantiasis is generally managed instead of treated. Management of elephantiasis includes wrapping of the infected limbs to prevent further swelling, and daily washing of the limb to prevent bacterial or fungal infection. Such infections can be common and very dangerous for patients with elephantiasis, as their lymphatic system is highly impaired in the afflicted limb. In general, management techniques and treatment options must be delivered to the population through education and counseling programs. Many lymphatic filariasis elimination programs involve an education component (Reference 27).