FILARIASIS

afflicts Filipino living in the endemic areas chronic, debilitating and disfiguring unnoticed and unfamiliar to health workers 45 out of 78 provinces Accdg to Filariasis Control Unit (FCU)- Regions 5, 8, II and CARAGA Marinduque and Sarangani 0.2-100.8 per 1,000- Sulu highest/ Cebu lowest

Infectious Agents Wuchereria bancrofti. Brugia malayi and/or Brugia timori found in blood Life span of adult parasite- 10 years (but a 40-year-life-span has been reported) microfilariae live for about a year at the most Mode of Transmission Through bites of infected female mosquito Aedes poecilius Bites at night

Incubation Period Variable ranges from 8-16 months Asymptomatic Stage Characterized by the presence of microfilariae in the peripheral blood No clinical signs and symptoms of the disease Some remain asymptomatic for years and in some instances for life Others progress to acute and chronic stages Microfilariae rate increase with age and then levels off In most endemic areas including the Philippines, men have higher micronlariae rate than women

Acute Stage Starts when there are already manifestation such as: Lymphadenitis (inflammation of lymph nodes) Lymphangitis (inflammation of lymph vessels) In some cases, the male genitalia is af fected leading to funiculitis, epidydimitis, or orchitis (redness, painful and tender scrotum)

Chronic Stage Develops 10-15 years from the onset of the first attack. Immigrants from areas where Filariasis is not endemic tend to develop this stage more often and much sooner (1 -2 years) than do the indigenous population of endemic areas.

Chronic Signs and Symptoms Hydrocoele (swelling of the scrotum) Lymphedema (temporary swelling of the upper and lower extremities) Elephantiasis (enlargement and thickening of the skin of the lower and/or upper extremities, scrotum, breast) Diagnosis Physical examination is done in the main health center or during scheduled survey bites in the community History taking Observation of the major and minor signs and symptoms

Laboratory examination Nocturnal Blood Examination (NBE) blood are taken from the patient at the patients residence or in the hospital after 8:00 pm Immunochromatographic Test (ICT) it is the rapid assessment method, it is an antigen test that can be done at daytime. Treatment Treatment of cases in endemic communities Compliance Diethylcarbamazine Citrate (DEC) or Hetrazan

Mass Treatment Distribution to all population Endemic and infected or not infected with filariasis in established endemic areas The dosage is 6 mg/kg body weight taken as a single dose per year Surgical Treatment Chronic manifestation such as elephantiasis and hydrocoele can be handled through surgery. This is usually referred to hospitals for management. Mild cases of lymphedema can be treated by lymphovenous anastomosis distal to the site of the lymphatic destruction. Chyluria is operated on by ligation and stripping of the lymphatics of the pedicle of the af fected kidney while hydrocoeles can be managed by inversion or resection of the tunic vaginalis.

Supportive Care For Filariasis Observe personal hygiene Wash area with soap and water Prevention and Control Measures aimed to control the vector Environmental sanitation such as proper drainage and cleanliness of surroundings Spraying with insecticides (may also produce harmful ef fects)

Measures aimed to protect the individual & Families in endemic areas Use of mosquito nets Use of long sleeves, long pants and socks Application of insect repellants Screening of houses Health education