الفهرس 
Historical BackgroundOnly 14 pages are availabe for public view
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Abstract
Introduction: Human lymphatic filariasis is caused mainly by Wuchereria bancrofti which results in considerable suffering and debilitating clinical disease. In endemic areas one can find some asymptomatic microfilaraemic individuals, others symptomatic and amicrofilaraemic, and a few with both microfilaraemia and disease. Lymphoedema of the extremities can be grossly disfiguring and complicated by recurrent episodes of acute adenolymphangitis. Antigen tests have sensitivities of 95% or higher in untreated subjects. Aim of work: Clinical and laboratory diagnosis of lymphatic filariasis (with special concern to lymphoedema cases) as a considerable burden to the patients and to the community. Subjects and methods: The study included 45 lymphoedema patients. History was taken lying stress on duration and acute adenolymphangitis attacks (ADLA). Clinical assessment was done for filarial lesions. Blood examination was done for microfilaraemia by direct smear, Knott’s concentration and filtration. Antibodies and antigen detection by ELISA also was done. Doppler Ultrasound was performed on limbs. Results: - There was significant difference between extensions of lymphoedema and age of patients. -There was a significant trend between grade and extension of lymphoedema. - All lymphoedema patients were susceptible for ADLA attacks. -Potential entry lesions were detected in most of cases. -About 33% of cases showed eosinophilia. - Microfilaraemia was detected in four cases. -Antibodies detection revealed that 60% of cases were positive for IgG, 4.44% were IgM +ve. - Positive cases for filarial antigenaemia were 64.4%. - Antigen level mean was significantly higher in patients than the controls and 13.3% of the patients were high antigenaemic. - Males had significantly higher mean of antigen titre than females. - Antigen titre was significantly higher in microfilaraemics than amicrofilaraemics. - ADLA attacks/year, eosinophil count and antigen titre were significantly decreased after treatment. Conclusion: - Cases of early lymphoedema or just ADLA from endemic area should be treated as filariasis until proved otherwise for prevention of complication. -ADLA attacks which are very significant risk for the progression and complication of the condition. -Antigen detection is very important tool for diagnosis of filariasis. -There was significant negative trend between lymphoedema grade and antigen titre. Recommendations: -The detection of filarial antigenaemia has shown that active infection may be much common in children. So, they are important target during any control programmes. -Mass drug administration of diethylcarbamazine or ivermectin (+albendazole) to the whole endemic area without differentiation between infected or not due to the presence of large category of endemic normals (cryptic infection) and ultralow microfilaraemic cases who are very critical for transmission of the parasite. -Vector control should be included in the transmission control programmes.