Developments in lymphatic filariasis research

Abstract

Lymphatic Filariasisedited by T.B. Nutman, Imperial College Press, 2000. £30.00 (283 pages) ISBN 1 86094 059 5The book Lymphatic Filariasis is part of the series Tropical Medicine: Science and Practice edited by G. Pasvol and S.L. Hoffman. Lymphatic Filariasis is a comprehensive book, which consists of ten chapters written by 13 internationally well recognized scientists working in the field of lymphatic filariasis. Emphasis is on clinical and laboratory diagnosis, immunology in addition to treatment and control. This book is particularly helpful for readers who are medically oriented, and is recommended for graduate students and scientists involved in teaching and research of parasitic diseases. Many new developments in lymphatic filariasis research, especially recent insights in lymphatic pathology and the new strategies for treatment are summarized in this book. Hence, it is a must have for those working or involved in filariasis control programmes. This book covers almost all aspects of lymphatic filariasis, except for entomology and ecology of the infection. The editor mentioned in the preface that dramatic advances have been made during recent years. Therefore, frequent revisions will be needed to include the current research progress. With a lymphatic filariasis elimination programme under way, which aims to eliminate lymphatic filariasis as a public health problem by the year 2020, such updates will be essential to reflect the future status of lymphatic filariasis.Minor points to be criticized include the repetitions between the chapters: for example, four chapters mention the estimated prevalence of lymphatic filariasis (128 million cases) in their first paragraphs. Lymphatic filariasis is caused by three different filarial species, therefore the morphological description for each developmental stage should pay more attention on the examined species. Furthermore, different strains of Brugia malayi have been described, which differ in their degree of anthropophily, their periodicity and their mosquito vectors, and only few of these strains can be maintained for several generations in laboratory rodents. Some statements appear contradictory and need clarification. For example, it is cited that, ‘in bancroftian filariasis, recurrent attacks of fever associated with lymphadenitis are less frequently seen as in brugian filariasis,’ whereas four pages further, it is stated that, ‘the frequency of acute attacks is generally higher in bancroftian filariasis as compared to brugian filariasis’. In the chapter on the diagnosis, it should be noted that microfilariae of Brugia timori are significantly longer than those of B. malayi and cannot, therefore, be summarised within one group. Although not recommended for routine treatment of filariasis, it should be mentioned that the use of antibiotics to target the Wolbachia endobacteria in filarial parasites could be a promising new strategy for chemotherapy. The observation that worms and microorganisms can cause lymphatic disease is probably a new and noteworthy issue for some readers. However, most underlying studies have been performed on Wuchereria bancrofti and need to be confirmed for Brugia. One important tool to study is the localisation of adult worms in humans by ultrasound, which, so far, has only been reported for W. bancrofti. The authors describe, ‘fundamental differences in the pathogenesis of lymphoedema and hydroceles’. Because no hydroceles are found in brugian filariasis, the authors should stress that also differences in the pathogenesis of bancroftian and brugian filariasis have to be postulated.The form and the layout of the book are good, but it contains only a few colour images of low quality. Apart from a few gaps in biological aspects of the infection and some minor inaccuracies, the book gives a comprehensive overview of lymphatic filariasis.