Academic journal article Negro Educational Review

The Socioeconomic Impact of Lymphatic Filariasis in Tropical Countries

Academic journal article Negro Educational Review

The Socioeconomic Impact of Lymphatic Filariasis in Tropical Countries

Article excerpt

Abstract

Lymphatic filariasis (LF) is an endemic parasitic disease and a major cause of acute and chronic morbidity and incapacitation with devastating public health and socio-economic consequences. It exacerbates poor conditions of afflicted persons and endemic communities through reduced or lost labour supply and productivity. Stigmatisation and discrimination are byproducts of LF that lead to reduced prospects of both marriage and a normal sexual life. LF causes absenteeism from school and poor academic performance. Socio-economic factors and the cost of treatment for LF are presented. Additionally, our discussion includes the description of a two-drug combination introduced in endemic communities to suppress circulating microfilariae and interrupt spread of the disease. An argument is also made for collective support of the current Global Programme for the elimination of lymphatic filariasis as a public health problem and obstacle to socioeconomic development.

Introduction

Filariasis is a group of human and animal infectious diseases caused by nematode parasites (round worms) of the order filariidae, commonly called filariae. Female worms transmit active embryos called microfilariae (MF) into their selected host. Upon entering into the skin MF migrate to the lymphatic system and develop into mature adults. In the lymphatic system, the adult worms provoke a variety of clinical manifestations which include periodic recurring episodes of localized inflammation, tenderness, and pain of the affected lymph and or vessel, often accompanied by fever and commonly referred to as acute adenolymphangitis (ADL). Other manifestations include lymphoedema and elephantiasis of the limbs, genitals, breast; hydrocoele; vulval/labial oedema; and chyluria. Genital complications are seen only in bancroftian filariasis. Hydrocoele and swelling of the testis are the most common symptoms, followed by elephantiasis of the legs, scrotum, arm, vulva, and breast in descending order of frequency (Pani, Balakrishnan, Srividya, Bundy, & Grenfell, 1991). The majority of infected persons once thought to be asymptomatic (without visible clinical manifestations) are now recognised as having serious internal hidden renal, genital, and lymphatic damage. A large number also suffer from a progressive lung disease called tropical pulmonary eosinophilia (TPE), caused by an inflammatory reaction against MF in the lungs (Evans, Gelband, & Vlassoff, 1992; Kumaraswani, 2000; WHO, 1992, 1994).

There are more than 50 filariae parasites known to infect mammals, birds, reptiles, and amphibians. Only eight of these are common parasites of man; they are Wuchereria bancrofti, Brugia malayi, Brugia timori, Onchocerca volvulus, Loa loa, Mansonella perstans, Mansonell streptocerca, and Mansonella ozzardi. Of these, the adults of W. bancrofti, B. malayi, and B. timori reside in the nodes and vessels of the lymphatic system and can induce pathological complications. Hence they are collectively referred to as lymphatic filarial parasites, causing lymphatic filariasis (LF)-a disease of the tropics; i.e., an infection caused by a parasitic worm that lives in the lymph system (Directors of Health Promotion and Education, 2005).

A large body of information about the socio-cultural and economic aspects of LF has emerged since the mid-1980s. This information has not been combined, principally because of the rapidity at which new information and policies are independently generated from studies conducted in different parts of the world. However, with the global alliance to eliminate LF as a public health problem and obstacle to socioeconomic development, it becomes imperative to integrate data from these studies for a better understanding of the dynamics of LF and its management. Our goal herein is to show how this disabling disease has exacerbated the poor conditions of afflicted persons and endemic communities. We begin by describing the burden of LF, followed by a discussion of how health programmes and medications have been introduced into endemic communities and used as potential means of eliminating LF Additionally, we examine the socioeconomic consequences of LF on labour and productivity. …

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