Abstract
Lymphatic filariasis continues to be the major cause of clinical morbidity in India and other developing tropical countries. One of the major lacunae in the effective management of clinical filarial cases is the non-availability of a suitable diagnostic test for confirming filaria aetiology in acute, chronic and occult clinical cases where microfilariae (mf) are not usually seen in peripheral circulation. Studies in our laboratory have shown the usefulness of filarial antibody and antigen assays using microfilarial excretory-secretory (mf ES) antigen in detecting microfilaraemic, acute and chronic filarial cases and in confirming filarial aetiology in occult infections. Diethylcarbamazine citrate (DEC) is the drug of choice for lymphatic filariasis. Different regimens of DEC have been explored in the treatment of microfilaraemic cases. Immunomonitoring has shown that the seroconversion of antigen and antibody positivity was found to be very helpful in determining appropriate period of DEC treatment for clinical relief and cure in clinical filarial patients and further they did not have recurrence in most of the cases. Optimal DEC (6mg/kg body wt/day for 21 days each month for 3–12 months) therapy was found to be very effective in acute and atypical clinical manifestations such as asthmatic bronchitis, pulmonary eosinophilia, monoarthritis, recurrent upper respiratory tract infections (URI), pneumonia (super imposed infections) in children and minimal hydrocele, epididymoorchitis, lymphangitis, lymphadenitis, acute abdomen, central serous retinopathy, tenosynovitis, pain and swelling in limbs and joints in adults living in filaria endemic areas.
Similar content being viewed by others
References
World Health Organization. (1994) Lymphatic filariasis Infection & Disease Control Strategies: Report of a WHO/CTD/TDR consultative meeting. 1.
Sharma, R.S. (1996) Filariasis problem in India and the current control strategy. In: NICD (Ed). Revised strategy for control of lymphatic filariasis in India. NICD: Delhi. 10.
Harinath, B.C., Malhotra, A., Ghimikar, S.N., Annadate, S.D., Issacs, V.P. and Bharati, M.S. (1984) Field evaluation of an enzyme immunosorbent assay usingWuchereria bancrofti mf ES antigen for bancroftian filariasis. Bull WHO. 62, 941–44.
Alikhan, A., Parkhe, K.A., Reddy, M.V.R. and Harinath, B.C. (1990) Filarial antigen antibody and circulating immune—complexed antigen levels in bancroftian filariasis by stick ELISA. Natl. Med. J. India. 3, 265–68.
Harinath, B.C. and Reddy, M.V.R. (1997) Diagnosis and immunomonitoring in the successful management of bancroftian filariasis. J. Parasitic. Dis. 21, 41–51.
Patond, K.R., Tandon, V., Harinath, B.C., Narang, P., Srivastava, S.K., Cheirmaraj, K. and Ramarao, B.V. (1992) A clinico epidemiological study of filarial related orthopaedic manifestations Ind. J. Com. Med. 17, 98–101.
Chaturvedi, P., Gawdi, A. and Dey, S. (1990) Occult filariasis infection. Natl. Med. J. India. 3, 7–9.
Chaturvedi, P., Harinath, B.C., Reddy, M.V.R., Advani, B., Gawdi, A., Alikhan, A. and Ramarao, B.V. (1995) Filarial antibody detection in suspected occult filariasis in children in an endemic area. J. Trop. Paed. 41, 243–245.
Reddy, M.V.R., Alli, R., Devi, K.K., Narayan, R., Harikrishnan, R., Cheirmaraj, K. and Harinath, B.C. (1996) Comparative evaluation of microtitre plate peroxidase and stick penicillinase enzyme immunoassays for detection of filarial antibodies usingBrugia malayi microfilarial excretory-secretory antigen. J. Parasitic. Dis. 20, 173–176.
Lalitha, P., Ravichandran, M., Suba, S., Kaliraj, P., Narayanan, R.B. and Jayaraman, K. (1998) Quantitative assessment of circulating antigens in human lymphatic filariasis: a field evaluation of monoclonal antibody based ELISA using blood collected on filter strips. Trop. Med. Int. Health. 3, 41–45.
Dreyer, G., Amaral, F., Noroes, J., Medeiros, Z. and Addiss, D. (1995) A new tool to assess the adulticidal efficacyin vivo of antifilarial drugs for bancrftian filariasis. Trans. Roy. Soc. Trop. Med. Hyg. 89, 225–226.
Malhotra, A. and Harinath, B.C. (1984) Detection and monitoring of microfilarial ES antigen levels by inhibition ELISA during DEC therapy. Ind. J. Med. Res. 79, 194–198.
Ramaprasad, P., Prasad, G.B.K.S. and Harinath, B.C. (1988) Microfilariaemia filarial antibody antigen and immunecomplex levels in human filariasis before, during and after DEC therapy. Acta. Tropica. 45, 245–255.
Lammie, P.J., Eberhard, M.L., Leiva, L.E., Lowrie, R.C.J. and Katz., S.P. (1988) The effect of diethylcarbamazine treatment of bancroftian filariasis on the immunological reactivity of microfilaraemic individuals. Trans. Roy. Soc. Trop. Med. Hyg. 82, 726–729.
Zheng, H.J., Piessens, W.F., Tao, Z., Cheng, W., Wang, S. Cheng, S. Ye, Y., Luo, L., Chen, X., Gan, G. and Piessens, W.F. (1991) Efficacy of ivermectin for control of microfilaraemia recurring after treatment with diethylcarbamazine II. Immunological changes following treatment. Am. J. Trop. Med. Hyg. 45, 175–181.
Day, K.P, Spark, R., Garner, P., Raiko, A., Wenger, J.D., Weiss, N. Michell, G.F., Albar, M.P. and Kazura, J.N. (1991) Serological evaluation of the macrofilariacidal effects of diethylcarbamazine treatment in bancroftian filariasis. Am. J. Trop. Med. Hyg. 44, 528–535.
Kurniawan, A., Atkinson, R., Sartono, E., Partono, F., Yazdanbaksh, M. and Maizels, R. M. (1995) Differential decline of filaria specific IgG1, IgG4 and IgE antibodies inBrugia malayi infected patients after diethyl carbamazine chemotherapy. J. Inf. Dis. 172, 1567–1572.
Padigel, U.M., Reddy, M.V.R., Alikhan, A. and Harinath, B.C. (1995) Immunomonitoring of filarial patients during DEC therapy in an endemic area: a seven year follow up. J Trop. Med. Hyg. 98, 52–56.
Harinath, B.C., Padigel, U.M., Devi, K.K. and Reddy, M.V.R. (1996) Diagnosis and immunomonitoring in management of filariasis in an endemic area. J. Parasitic. Dis. 20, 35–40.
World Health Organization. In: Lymphatic filariasis: (1992) The Disease and its control (Fifth report of the WHO Expert working Committee on Filariasis). WHO. Tech. Rep. Ser. 821, 43–44.
Harinath, B.C., Satish Kumar. and Reddy, M.V.R. (1997)In vitro released antigens in diagnosis and immunomonitoring of filaria and tuberculosis. Ind. J. Clin. Biochem. 12 (Suppl), 8–12.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Harinath, B.C., Reddy, M.V.R., Alli, R. et al. Immunomonitoring followed by optimal dec therapy for successful management of clinical filariasis in an endemic area. Indian J Clin Biochem 14, 100–108 (1999). https://doi.org/10.1007/BF02867907
Issue Date:
DOI: https://doi.org/10.1007/BF02867907