Brugian Filariasis

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Taniawati Supali - One of the best experts on this subject based on the ideXlab platform.

  • An open label, randomized clinical trial to compare the tolerability and efficacy of ivermectin plus diethylcarbamazine and albendazole vs. diethylcarbamazine plus albendazole for treatment of Brugian Filariasis in Indonesia.
    'Public Library of Science (PLoS)', 2021
    Co-Authors: Taniawati Supali, Yenny Djuardi, Michael Christian, Elisa Iskandar, Rahmat Alfian, Roospita Maylasari, Yossi Destani, Adriani Lomiga, Dominikus Minggu, Daphne Lew
    Abstract:

    Improved treatments for lymphatic Filariasis (LF) could accelerate the global elimination program for this disease. A triple drug combination of the anti-filarial drugs ivermectin, diethylcarbamazine (DEC) and albendazole (IDA) has been shown to be safe and effective for achieving sustained clearance of microfilariae (Mf) of the filarial parasite Wuchereria bancrofti from human blood. However, the triple drug combination has not been previously been evaluated for treatment of Brugian Filariasis, which accounts for about 10% of the global LF burden. This hospital-based clinical trial compared the safety and efficacy of IDA with that of the standard treatment (DEC plus albendazole, DA) in persons with Brugia timori infections on Sumba island, Indonesia. Fifty-five asymptomatic persons with B. timori Mf were treated with either a single oral dose of IDA (28 subjects) or with DEC plus albendazole (DA, 27 subjects). Participants were actively monitored for adverse events (AE) for two days after treatment by nurses and physicians who were masked regarding treatment assignments. Passive monitoring was performed by clinical teams that visited participant's home villages for an additional five days. Microfilaremia was assessed by membrane filtration of 1 ml night blood at baseline, at 24h and one year after treatment. IDA was more effective than DA for completely clearing Mf at 24 hours (25/28, 89% vs. 8/27, 30%, P < 0.001). By 12 months after treatment, only one of 27 IDA recipients had Mf in their blood (4%) vs. 10 of 25 (40%) in persons treated with DA (P = 0.002). Approximately 90% of participants had antibodies to recombinant filarial antigen BmR1 at baseline. Antibody prevalence decreased to approximately 30% in both treatment groups at 12 months. About 45% of persons in both treatment groups experienced AE such as fever, muscle aches, lower back, joint and abdominal pain. These were mostly mild and most common during the first two days after treatment. No participant experienced a severe or serious AE. This study showed that IDA was well-tolerated and significantly more effective for clearing B. timori Mf from the blood than DA. Larger studies should be performed to further assess the safety and efficacy of IDA as a mass drug administration regimen to eliminate Brugian Filariasis. Trial Registration: NCT02899936

  • impact of six rounds of mass drug administration on Brugian Filariasis and soil transmitted helminth infections in eastern indonesia
    PLOS Neglected Tropical Diseases, 2013
    Co-Authors: Taniawati Supali, Mark Bradley, Rahmah Noordin, Yenny Djuardi, Paul Rückert
    Abstract:

    Background: The lymphatic filarial parasite Brugia timori occurs only in eastern Indonesia where it causes high morbidity. The absence of an animal reservoir, the inefficient transmission by Anopheles mosquitoes and the high sensitivity to DEC/ albendazole treatment make this species a prime candidate for elimination by mass drug administration (MDA). Methodology/Principal Findings: We evaluated the effect of MDA using DEC and albendazole on B. timori and soil transmitted helminths (STH) in a cross-sectional study of a sentinel village on Alor Island annually over a period of 10 years. Pre-MDA the microfilaria (MF) prevalence was 26% and 80% of the residents had filaria-specific IgG4 antibodies. In 2010, 34 months after the 6 th round of MDA, MF and antibody rates were only 0.17% and 6.4%, respectively. The MDA campaign had also a beneficial effect on STH. Baseline prevalence rates for Ascaris, hookworm and Trichuris were 34%, 28%, and 11%, respectively; these rates were reduced to 27%, 4%, and 2% one year after the 5 th round of MDA. Unfortunately, STH rates rebounded 34 months after cessation of MDA and approached pre-MDA rates. However, the intensity of STH infection in 2009 was still reduced, and no heavy infections were detected. Conclusions/Significance: MDA with DEC/albendazole has had a major impact on B. timori MF and IgG4 antibody rates, providing a proof of principle that elimination is feasible. We also documented the value of annual DEC/albendazole as a mass de-worming intervention and the importance of continuing some form of STH control after cessation of MDA for Filariasis.

  • Infections in Eastern Indonesia
    2013
    Co-Authors: Taniawati Supali, Paul Rückert, Mark Bradley, Rahmah Noordin, Yenny Djuardi, Universiti Sains Malaysia
    Abstract:

    Impact of six rounds of mass drug administration on Brugian Filariasis and soil-transmitted helmint

  • detection of brugia parasite dna in human blood by real time pcr
    Journal of Clinical Microbiology, 2006
    Co-Authors: Gary J Weil, Kerstin Fischer, Taniawati Supali
    Abstract:

    Brugian Filariasis (caused by the nematodes Brugia malayi and B. timori) is an important cause of disability in Southeast Asia. Improved diagnostic tests are needed for Filariasis elimination programs (to identify areas of endemicity and to monitor progress) and for diagnosis of the disease in infected individuals. We have developed and evaluated two real-time PCR assays for detecting Brugia DNA in human blood and compared the results of these assays to those of “gold standard” assays. One assay uses a TaqMan probe (TaqM) to amplifiy a 320-bp “HhaI repeat” DNA sequence. The other assay uses a minor groove binding probe (MGB) and modified nucleotides in primers (Eclipse MGB) to amplify a 120-bp fragment of the HhaI repeat. This assay detects 22 copies of the target sequence, and it is more sensitive than the TaqM assay. Both assays were evaluated with human blood samples from two different areas of endemicity. The MGB assay was as sensitive as membrane filtration and microscopy for the detection of B. malayi infection in 57 blood samples recovered at night from patients in Sulawesi, Indonesia. The MGB assay also detected parasite DNA in 17 of 31 (55%) of microfilaria-negative day blood samples from these subjects. This test was more sensitive than the conventional and the TaqM PCRs (and was almost as sensitive as night blood membrane filtration) for the detection of infection in 52 blood samples recovered at night from individuals in an area of B. timori endemicity on Alor Island, Indonesia, where microfilaria-positive individuals had low densities after mass treatment. Thus, the Eclipse MGB real-time PCR assay is a sensitive means of detecting Brugia parasite DNA in human blood.

  • impact of two rounds of mass drug administration using diethylcarbamazine combined with albendazole on the prevalence of brugia timori and of intestinal helminths on alor island indonesia
    Filaria Journal, 2005
    Co-Authors: Tim Oqueka, Taniawati Supali, Is Suhariah Ismid, Paul Rückert, Mark Bradley
    Abstract:

    Annual mass drug administration (MDA) using diethylcarbamizine (DEC, 6 mg/kg) combined with albendazole (alb, 400 mg) is recommended by the Global Programme to Eliminate Lymphatic Filariasis (GPELF). This strategy has been shown to be efficient in the of control bancroftian Filariasis, but data on Brugian Filariasis as well as on the positive side effects on intestinal helminths are lacking. The effect of one selective treatment and two rounds of MDA using DEC and alb on the prevalence and intensity of Brugia timori infection were studied on Alor island using a cross-sectional and a cohort approach. Before the campaign and ten months after each treatment cycle microfilariae (mf) were assessed by filtration of night blood. Before and ten months after MDA, stool samples were collected and the prevalence of intestinal helminths were determined. In all, the mf-rate dropped from 26.8% before any treatment to 3.8% following the second MDA. Almost all mf-positive, treated individuals showed very low mf densities. The crude prevalence of hookworm dropped from 25.3% to 5.9%. The reduction of prevalence of Ascaris lumbricoides (32.3% to 27.6%) and Trichuris trichiura (9.4% to 8.9%) was less pronounced. Within a cohort of 226 individuals, which was examined annually, the prevalence of A. lumbricoides dropped from 43.8% to 26.5% and of T. trichiura from 12.8% to 6.6%. The results indicate that this MDA approach reduces not only the mf prevalence of B. timori but also the prevalence of hookworm and to a lesser extent also of A. lumbricoides and T. trichiura. The MDA using DEC and alb as recommended by GPELF is extremely effective for areas with Brugian Filariasis. The beneficial effect of MDA on intestinal helminths may strengthen the national programme to eliminate lymphatic Filariasis in Indonesia and may set resources free which are otherwise used for deworming campaigns of schoolchildren.

Gary J Weil - One of the best experts on this subject based on the ideXlab platform.

  • a multicenter evaluation of a new antibody test kit for lymphatic Filariasis employing recombinant brugia malayi antigen bm 14
    Acta Tropica, 2011
    Co-Authors: Gary J Weil, Kurt C Curtis, Peter U Fischer, Patrick J Lammie, Hayley Joseph, Wayne Melrose, Norbert W Brattig
    Abstract:

    Antibody tests are useful for mapping the distribution of lymphatic Filariasis (LF) in countries and regions and for monitoring progress in elimination programs based on mass drug administration (MDA). Prior antibody tests have suffered from poor sensitivity and/or specificity or from a lack of standardization. We conducted a multicenter evaluation of a new commercial ELISA that detects IgG4 antibodies to the recombinant filarial antigen Bm14. Four laboratories tested a shared panel of coded serum or plasma samples that included 55 samples from people with microfilaremic Wuchereria bancrofti or Brugia infections and 26 control samples. Qualitative results were identical in all four test sites. In addition, each laboratory tested samples from their own serum banks. The test detected antibodies in 32 of 36 samples (91%) from people with Brugian Filariasis and in 96 of 98 samples (98%) from people with Bancroftian Filariasis. Specificity testing showed that many serum or plasma samples from patients with other filarial infections such as onchocerciasis had positive antibody tests. Specificity was otherwise excellent, although 3 of 30 samples from patients with ascariasis and 4 of 51 with strongyloidiasis had positive antibody tests; it is likely that some or all of these people had previously lived in Filariasis-endemic areas. Antibody test results obtained with eluates from blood dried on filter paper were similar to those obtained with plasma tested at the same dilution. This test may be helpful for diagnosing LF in patients with clinical signs of Filariasis. It may also be a useful tool for use in LF endemic countries to monitor the progress of Filariasis elimination programs and for post-MDA surveillance.

  • detection of brugia parasite dna in human blood by real time pcr
    Journal of Clinical Microbiology, 2006
    Co-Authors: Gary J Weil, Kerstin Fischer, Taniawati Supali
    Abstract:

    Brugian Filariasis (caused by the nematodes Brugia malayi and B. timori) is an important cause of disability in Southeast Asia. Improved diagnostic tests are needed for Filariasis elimination programs (to identify areas of endemicity and to monitor progress) and for diagnosis of the disease in infected individuals. We have developed and evaluated two real-time PCR assays for detecting Brugia DNA in human blood and compared the results of these assays to those of “gold standard” assays. One assay uses a TaqMan probe (TaqM) to amplifiy a 320-bp “HhaI repeat” DNA sequence. The other assay uses a minor groove binding probe (MGB) and modified nucleotides in primers (Eclipse MGB) to amplify a 120-bp fragment of the HhaI repeat. This assay detects 22 copies of the target sequence, and it is more sensitive than the TaqM assay. Both assays were evaluated with human blood samples from two different areas of endemicity. The MGB assay was as sensitive as membrane filtration and microscopy for the detection of B. malayi infection in 57 blood samples recovered at night from patients in Sulawesi, Indonesia. The MGB assay also detected parasite DNA in 17 of 31 (55%) of microfilaria-negative day blood samples from these subjects. This test was more sensitive than the conventional and the TaqM PCRs (and was almost as sensitive as night blood membrane filtration) for the detection of infection in 52 blood samples recovered at night from individuals in an area of B. timori endemicity on Alor Island, Indonesia, where microfilaria-positive individuals had low densities after mass treatment. Thus, the Eclipse MGB real-time PCR assay is a sensitive means of detecting Brugia parasite DNA in human blood.

R K Shenoy - One of the best experts on this subject based on the ideXlab platform.

  • Lymphoscintigraphic evidence of lymph vessel dilation in the limbs of children with Brugia malayi infection.
    The Journal of communicable diseases, 2008
    Co-Authors: R K Shenoy, T K Suma, Kumaraswami, G. Dhananjayan, N. Rahmah, G. Abhilash, C. Ramesh
    Abstract:

    Lymphatic Filariasis (LF) is targeted for global elimination by the year 2020. It was earlier believed that LF is mostly a disease of adults. Recent studies indicate that in endemic countries filarial infection starts mostly in childhood even though the disease manifestations occur much later in life. The initial damage to the lymph vessels where the adult worms are lodged is dilation, thought to be irreversible even with treatment. Most of these studies relate to bancroftian Filariasis. Studies that address this early pathology in Brugian Filariasis in humans are scarce. We report here for the first time, the lymphatic abnormalities seen on lymphoscintigraphy (LSG) in children with Brugia malayi Filariasis. LSG was performed in 100 children aged between 3-15 years, who were enrolled in the study either because they were microfilaremic; had present or past filarial disease or were positive for antifilarial IgG4 antibodies. Inguinal and axillary lymph nodes were imaged in most children. Dilated lymph vessels were visualized in 80 children and this pathology was evenly distributed in all the three study groups. Lymph vessels dilation was seen even in three year old children. The implications of these findings for management of LF and control programmes are discussed.

  • multicentre laboratory evaluation of brugia rapid dipstick test for detection of Brugian Filariasis
    Tropical Medicine & International Health, 2003
    Co-Authors: Neli Rahmah, R K Shenoy, Thomas Nutma, K Gilmou, Rick M Maizels, Maria Yazdanbakhsh, N. Weiss, Erliyani Sartono
    Abstract:

    A multicentre evaluation of the Brugia Rapid dipstick test was performed using 1263 serum samples in four international laboratories i.e. T.D. Medical College (TDMC India) National Institutes of Health (NIH USA) Swiss Tropical Institute (STI Switzerland) and Leiden University Medical Centre (LUMC Netherlands). In comparison with microscopy the dipstick demonstrated sensitivities of 97.2% (70 of 72) at TDMC 91.6% (175 of 191) at LUMC and 100% (six of six) at STI. Sera of chronic patients showed a positivity rate of 11.3% (19 of 168) and 61.2% (71 of 116) at TDMC and LUMC respectively. All 266 sera of non-endemic normals from STI NIH and LUMC tested negative with the dipstick. At LUMC sera of ‘endemic normals’ (amicrofilaraemics with no clinical disease) from an area with approximately 35% microfilaria positivity showed 60.8% positive results (31 of 51) thus demonstrating the likelihood of many cryptic infections occuring in this population. Specificities of the test with Onchocerca volvulus sera were 98.8% (80 of 81) and 100% (10 of 10) at the NIH and STI respectively; while specificity with Loa loa sera at the NIH was 84.6% (44 of 52). At the STI the dipstick test also demonstrated 100% specificity when tested with 75 sera from various protozoan and helminthic infections. (authors)

  • specificity and sensitivity of a rapid dipstick test brugia rapid in the detection of brugia malayi infection
    Transactions of The Royal Society of Tropical Medicine and Hygiene, 2001
    Co-Authors: Neli Rahmah, R K Shenoy, S Taniawati, Oon Hua Lim, Vasanthapuram Kumaraswami, Khairul A Anua, Lokma S Hakim, M Noo I Hayati, T E Cha, M Suharni
    Abstract:

    A total of 753 serum samples from 6 institutions in 3 countries (Malaysia, Indonesia and India) were used to evaluate an immunochromatographic rapid dipstick test, Brugia Rapid, for diagnosis of Brugia malayi infection. The samples comprised sera from 207 microfilaria-positive individuals and 546 individuals from filaria non-endemic areas. The latter consisted of 70 individuals with soil-transmitted helminth infections, 68 with other helminth infections, 238 with protozoan infections, 12 with bacterial and viral infections and 158 healthy individuals. The dipstick is prepared with a goat anti-mouse antibody control line and a B. malayi recombinant-antigen test line. First, the dipstick is dipped into a well containing diluted patient serum, thus allowing specific anti-filarial antibody in the serum to react with the recombinant antigen. Then the dipstick is placed into an adjacent well containing reconstituted anti-human IgG4-gold. After 10 min, development of 2 red-purplish lines denotes a positive result and one line indicates a negative reaction. The overall results of the evaluation showed 97% sensitivity, 99% specificity, 97% positive predictive value and 99% negative predictive value. Brugia Rapid is thus a promising diagnostic tool for detection of B. malayi infection, and would be especially useful for the Brugian Filariasis elimination programme.

  • a recombinant antigen based igg4 elisa for the specific and sensitive detection of brugia malayi infection
    Transactions of The Royal Society of Tropical Medicine and Hygiene, 2001
    Co-Authors: Neli Rahmah, R K Shenoy, Vasanthapuram Kumaraswami, Boon Huat Lim, Khairul A Anuar, Lokman S Hakim, P Chotechuang, K Kanjanopas, C P Ramachandran
    Abstract:

    An IgG4 ELISA based on a novel recombinant antigen was evaluated for detection of Brugia malayi infection, using 2487 sera from various institutions: 2031 samples from Universiti Sains Malaysia, 276 blinded sera from 2 other institutions in Malaysia, 140 blinded sera from India and 40 blinded sera from Thailand. These sera were from various groups of individuals, i.e., microfilaraemics, chronic patients, endemic normals, non-endemic normals and individuals with other parasitic and bacterial infections. Based on a cut-off optical density reading of 0.300, the IgG4 ELISA demonstrated specificity rates of 95.6-100%, sensitivity rates of 96-100%, positive predictive values of 75-100% and negative predictive values of 98.9-100%. These evaluation studies demonstrated the high specificity and sensitivity of this test for the detection of active B. malayi infection. Thus, the IgG4 ELISA would be very useful as a tool in diagnosis and in elimination programmes for Brugian Filariasis.

  • A rapid dipstick test for serological diagnosis of Brugian Filariasis: evaluation results
    2001
    Co-Authors: N. Rahmah, R K Shenoy, Erliyani Sartono, V Kumaraswami, H Lokman, Anuar Khairul, Hayati Nor, M Yazdanbakhsh, Tb Nutman, Taniawati Supali
    Abstract:

    A total of 753 serum samples from six institutions were used to evaluate an immunochromatographic rapid dipstick test (Brugia Rapid) for diagnosis of Brugia malayi infection.The samples comprised of sera from 207 microfilaria positive individuals and 546 individuals from filaria non-endemic areas.The latter consisted of 70 individuals with soil-transmitted helminthic infections, 68 individuals with other helminthic infections, 238 individuals with protozoan infections, 12 individuals with bacterial and viral infections and 158 healthy individuals. The dipstick is lined with goat anti-mouse antibody (control line) and a B. malayi recombinant antigen (test line).First, the dipstick is dipped into a well containing diluted patient sera, thus allowing specific anti-filarial antibody in the serum to react with the recombinant antigen.Then the dipstick is placed into an adjacent well containing reconstituted anti-human IgG4-gold.After 10 minutes, development of two red-purplish lines denotes a positive result and one line indicates a negative reaction. The overall results of the evaluation showed 91% sensitivity, 99% specificity, 97% positive predictive value and 99% negative predictive value. Brugia Rapid is thus a promising diagnostic tool for detection of B. malayi infection,and would be especially useful for the Brugian Filariasis elimination programme

Norbert W Brattig - One of the best experts on this subject based on the ideXlab platform.

  • a multicenter evaluation of a new antibody test kit for lymphatic Filariasis employing recombinant brugia malayi antigen bm 14
    Acta Tropica, 2011
    Co-Authors: Gary J Weil, Kurt C Curtis, Peter U Fischer, Patrick J Lammie, Hayley Joseph, Wayne Melrose, Norbert W Brattig
    Abstract:

    Antibody tests are useful for mapping the distribution of lymphatic Filariasis (LF) in countries and regions and for monitoring progress in elimination programs based on mass drug administration (MDA). Prior antibody tests have suffered from poor sensitivity and/or specificity or from a lack of standardization. We conducted a multicenter evaluation of a new commercial ELISA that detects IgG4 antibodies to the recombinant filarial antigen Bm14. Four laboratories tested a shared panel of coded serum or plasma samples that included 55 samples from people with microfilaremic Wuchereria bancrofti or Brugia infections and 26 control samples. Qualitative results were identical in all four test sites. In addition, each laboratory tested samples from their own serum banks. The test detected antibodies in 32 of 36 samples (91%) from people with Brugian Filariasis and in 96 of 98 samples (98%) from people with Bancroftian Filariasis. Specificity testing showed that many serum or plasma samples from patients with other filarial infections such as onchocerciasis had positive antibody tests. Specificity was otherwise excellent, although 3 of 30 samples from patients with ascariasis and 4 of 51 with strongyloidiasis had positive antibody tests; it is likely that some or all of these people had previously lived in Filariasis-endemic areas. Antibody test results obtained with eluates from blood dried on filter paper were similar to those obtained with plasma tested at the same dilution. This test may be helpful for diagnosing LF in patients with clinical signs of Filariasis. It may also be a useful tool for use in LF endemic countries to monitor the progress of Filariasis elimination programs and for post-MDA surveillance.

Shenoy R K - One of the best experts on this subject based on the ideXlab platform.

  • Relevance of Anti-BmR1 IgG4 antibodies in children from an area endemic for Brugia malayi infection in Kerala, India
    Indian Society for Malaria and Other Communicable Diseases, 2009
    Co-Authors: Shenoy R K, Suma T K, Rahmah N., Thaslim A X, Gopu R B
    Abstract:

    Brugian Filariasis prevalent mostly in South-East Asian countries including India contributes to a small but significant proportion of the socioeconomic burden due to lymphatic Filariasis. Along with bancroftian Filariasis, Brugian Filariasis has been targeted for elimination globally. The lack of a reliable daytime diagnostic test has been seen as an important barrier to the successful implementation and monitoring of elimination programmes in brugia endemic areas. We evaluated an anti- BmRI-IgG4 antibody test namely, 'Brugia Rapid' in a large study meant to understand the clinical and pathological manifestations of Brugian Filariasis in children. We found the test superior to traditional night blood screening for microfilaraemia. Although an antibody detection test, we found it to be a reliable indicator of Brugian infection. Among the 100 children studied extensively, 94% of the microfilaraemics, 86% of those showing filarial dance sign indicating presence of, live adult worms and 78% having abnormal lymphatics on lymphoscintigraphy were IgG4 positive. Coupled with its advantages like ease of use any time of the day, high sensitivity and specificity, this test may be the ideal tool to assist programme managers in their efforts to eliminate lymphatic Filariasis where Brugian infections are found

  • Lymphoscintigraphic Evidence of Lymph Vessel Dilation in the Limbs of Children with Brugia malayi Infection
    'Advanced Research Publications', 2008
    Co-Authors: Shenoy R K, Suma T K, Rahmah N., Dhananjayan G, Abhilash G, Ramesh C
    Abstract:

    Lymphatic Filariasis (LF) is targeted for global elimination by the year 2020. It was earlier believed that LF is mostly a disease of adults. Recent studies indicate that in endemic countries filarial infection starts mostly in childhood even though the disease manifestations occur much later in life. The initial damage to the lymph vessels where the adult worms are lodged is dilation, thought to be irreversible even with treatment. Most of these studies relate to bancroftian Filariasis. Studies that address this early pathology in Brugian Filariasis in humans are scarce. We report here for the first time, the lymphatic abnormalities seen on lymphoscintigraphy (LSG) in children with Brugia malayi Filariasis. LSG was performed in 100 children aged between 3-15 years, who were enrolled in the study either because they were microfilaremic; had present or past filarial disease or were positive for antifilarial IgG4 antibodies. Inguinal and axillary lymph nodes were imaged in most children. Dilated lymph vessels were visualized in 80 children and this pathology was evenly distributed in all the three study groups. Lymph vessels dilation was seen even in three year old children. The implications of these findings for management of LF and control programmes are discussed

  • A qualitative study of the perceptions, practices and socio-psychological suffering related to chronic Brugian Filariasis in Kerala, southern India
    'Maney Publishing', 2003
    Co-Authors: Suma T K, Shenoy R K
    Abstract:

    Lymphatic Filariasis is a major health problem in many parts of the tropical world. Although the disease itself is rarely fatal, the disability caused by the swollen extremities, the acute attacks of adenolymphangitis and the consequent sufferings of those afflicted are considerable. The economic burden imposed by lymphatic Filariasis is not fully quantified and information on the social and psychological problems caused by the disease is scanty. Semi-structured interviews were therefore used, in southern India, to assess the perceptions, practices and sociopsychological problems of 127 patients with Brugian Filariasis. The patients were aware of the causative factors and the precautions to be taken to prevent progression of the disease. However, depression and loss of job opportunities were common in the study population. Patients also complained that the disease eroded their standing in the community and diminished their prospects of marriage. Awareness of these factors will be of help in planning suitable disability-management packages, including the rehabilitation of those who find it difficult to carry on with their existing jobs because of the severity of their disease

  • A Qualitative Study on the Feasibility and Benefits of Foot Hygiene Measures Practiced by Patients with Brugian Filariasis
    Indian Society for Malaria and Other Communicable Diseases, 2003
    Co-Authors: Shenoy R K, Suma T K
    Abstract:

    Disability alleviation is an important component of Global Programme for Elimination of Lymphatic Filariasis'. In Brugia malayi infection the disability is largely due to acute attacks of adenolymphangitis (ADL), which frequently prevent patients from attending their normal activities, causing much suffering and economic loss. The foot care programme has been shown to reduce the frequency and severity of these episodes. In the present study we used semi-structured interviews to evaluate the impact of the foot care in 127 patients with Brugian Filariasis. They were previously trained in this procedure and were advised to practice it regularly, unsupervised. All except one could recollect the various components of foot hygiene and were practicing it regularly. They were aware of the factors causing ADL attacks and were able to avoid them. Majority (95.2%) expressed their happiness with the relief provided by foot care, which prevented or reduced the ADL episodes. The motivation was such that they transmitted this knowledge to others suffering in the community and even physically helped them to carry out foot care. This study fully endorses the advocacy of foot care programme as an easy to carry out, effective, sustainable and economically feasible ,procedure to prevent acute ADL attacks

  • Efficacy and sustainability of a footcare programme in preventing acute attacks of adenolymphangitis in Brugian Filariasis
    'Wiley', 2002
    Co-Authors: Suma T K, Shenoy R K
    Abstract:

    Lymphatic Filariasis is associated with considerable disability related to the intensity and frequency of acute adenolymphangitis (ADL) attacks. The global programme for elimination of lymphatic Filariasis emphasizes the need to combine transmission control with alleviation of disability. Footcare aimed at the prevention of secondary bacterial infections is the mainstay of disability alleviation programmes. We evaluated the efficacy and sustainability of an unsupervised, personal footcare programme by examining and interviewing 127 patients who had previously participated in a trial that assessed the efficacy of diethylcarbamazine, penicillin and footcare in the prevention of ADL. During the trial period these patients had been educated in footcare and were supervised. During the unsupervised period, which lasted 1 year or longer, 47 patients developed no ADL, and ADL occurred less frequently in 72.5%. Most patients were practising footcare as originally advised, unsupervised and without cost, which proves that such a programme is sustainable and effective. keywords Brugian Filariasis, acute adenolymphangitis, footcar

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