A recent PNLMTN-CP Secretariat report on tropical disease training in Côte d’Ivoire, or Ivory Coast notes that 74 out of 83 health districts are affected by Lymphatic filariasis or elephantiasis, prompting one media source to write: Elephantiasis is ravaging in Côte d’Ivoire (computer translated).
According to the report, an estimated 21 million people, or 84 percent of the population is at risk for the mosquito-borne parasitic disease.
There are three species of parasites that cause lymphatic filariasis–Wuchereria bancrofti; which is more widely distributed; Asia, Africa, India, South America and some Caribbean Islands and Brugia malayi and B. timori which are more restricted to parts of Asia.
These parasites are transmitted by several species of mosquito; Culex, Anopheles, Aedes and Mansonia depending on the geographic area.
When the mosquito takes a blood meal on a person, it injects parasitic larvae onto the skin, where it penetrates the bite wound.
After which in time the larvae develop into adults (females can be up to 100 mm in length) and reside in the lymphatic system of the upper or lower limbs or groin (all species). With W. bancrofti, in human males the adult worms may end up in the lymphatic channels of the spermatic cord.
Here the adult male and female worms mate and produce eggs (microfilariae) which circulate in the blood and lymph. The microfilariae only appears in blood at certain times; Wuchereria at night, Brugia during the day.
Most infections are asymptomatic. Any disease present may be due to immune response. If the infection persists the chronic stages of disease develop.
It will then go into an inflammatory stage where lymphadema, orchitis and hydrocele occur.
The obstructive stage of the disease is called elephantiasis. In this stage, which may take years, there is a blockage of lymph flow due to masses of worms. Tissue becomes fibrotic and skin thickens.
Enlarged legs, arms, mammory glands and genitalia are classic appearances of elephantiasis.
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