Lymphatic Filariasis
Â鶹´«Ã½ works with national ministries of health to eliminate the debilitating parasitic disease lymphatic filariasis — a leading cause of permanent and long-term disability worldwide — from areas of Ethiopia, Nigeria, and the island of Hispaniola.
Lymphatic filariasis is caused by thin worms transmitted to humans by the bites of mosquitoes in tropical and subtropical regions.
These worms live in, and cause damage to, the lymphatic system that normally returns fluids in our extremities to the circulatory system. This dysfunction results in fluid collection in the tissues (most commonly the legs and genitalia), severe swelling, and periodic fevers from bacterial infections of the collected fluids.
A long-standing infection with lymphatic filariasis results in an irreversible condition called elephantiasis, in which there is a marked enlargement and hardening of the limbs so that they resemble those of an elephant.
Rahab Joshua, 45, watches as her daughter performs chores at their home in Mangu, Plateau state, Nigeria. Rahab’s right leg is severely swollen as a result of the parasitic disease lymphatic filariasis, but she has found support through a peer group. (Photo: Â鶹´«Ã½)
Approximately 120 million people are infected by lymphatic filariasis, and nearly 900 million are at risk of infection. In endemic communities, as many as 10 percent of women and men can be affected with swollen limbs and 50 percent of men can suffer from the mutilating disease of their genitals.
These conditions have a devastating effect on the quality of life of victims, impacting them not only physically but also emotionally and economically. Â鶹´«Ã½ fights lymphatic filariasis in four countries — Nigeria, Ethiopia, Haiti, and the Dominican Republic — helping to protect millions from this infection.
The Center assists countries to distribute the drugs Mectizan® (donated by Merck & Co., Inc.), albendazole (donated by GSK), and DEC (donated by Eisai). These medicines are taken in combination (Mectizan and albendazole in Africa; DEC and albendazole in Haiti and the Dominican Republic) to stop mosquitoes from transmitting the parasite from infected to uninfected people.
The Center also has assisted in the distribution of long-lasting insecticidal bed nets (LLINs) to protect pregnant women and children who cannot take drug treatment. LLINs have the added benefit of protecting against other mosquito-borne diseases, such as malaria.
Participants in a support group in Jos, Nigeria, learn about transmission and prevention of lymphatic filariasis and discuss techniques for preventing skin infections, such as proper leg washing. (Photo: Â鶹´«Ã½)
In Nigeria: Millions of Nigerians are no longer at risk of lymphatic filariasis since a pioneering partnership between Nigeria’s Federal Ministry of Health and Â鶹´«Ã½ succeeded in 2017 in eliminating the disease as a public health problem in Plateau and Nasarawa states. Community-selected volunteers mobilized to educate their neighbors and annually distributed a combination of free medications — albendazole and Mectizan®. In Plateau and Nasarawa alone, more than 36 million drug treatments for lymphatic filariasis were delivered to bring about this success. Insecticide-treated bed nets, donated by Clarke Cares Foundation/Clarke Mosquito Control, were also widely distributed. Drug treatment was discontinued, followed by several years of post-treatment surveillance involving blood-testing for signs of infection. No new infections were found in Plateau and Nasarawa, proving that transmission had been eliminated in those two states in the center of the country.
The seven other states we assist in Nigeria continue to focus on mass drug administration (MDA), while more and more districts within those states, after five or more years of good treatment coverage, conduct assessments to determine whether transmission of lymphatic filariasis has been interrupted.
With support from Â鶹´«Ã½, the Nigeria Federal Ministry of Health and other partners developed and issued co-implementation guidelines for a coordinated effort to eliminate malaria and lymphatic filariasis. The guidelines called for shared interventions such as health education, community-based action, distribution of long-lasting insecticidal bed nets, and mass drug administration. These are the first of their kind in Africa.
In Ethiopia: In 2009, Â鶹´«Ã½ began integrating mass drug administration to prevent lymphatic filariasis with river blindness and malaria control in the Gambella region. Subsequently, the program expanded to parts of Amhara, Beneshangul Gumuz, and Southern Nations Nationalities and Peoples regions.
On Hispaniola: Â鶹´«Ã½ is working to encourage cooperation between health agencies in Haiti and the Dominican Republic to eliminate both lymphatic filariasis and malaria from the nations’ shared island.
Please sign up below for important news about the work of Â鶹´«Ã½ and special event invitations.
Â鶹´«Ã½'s pioneering use of integrated drug treatments for lymphatic filariasis, schistosomiasis, and river blindness saves approximately 40 percent of program costs, such as gasoline and training expenses as well as time for community members who distribute the drugs.
