Cases Of Lymphatic Filariasis Research Articles

The national distribution of lymphatic filariasis cases in Malawi using patient mapping and geostatistical modelling.

In 2020 the World Health Organization (WHO) declared that Malawi had successfully eliminated lymphatic filariasis (LF) as a public health problem. Understanding clinical case distributions at a national and sub-national level is important, so essential care packages can be provided to individuals living with LF symptoms. This study aimed to develop a national database and map of LF clinical cases across Malawi using geostatistical modelling approaches, programme-identified clinical cases, antigenaemia prevalence and climate information. LF clinical cases identified through programme house-to-house surveys across 90 sub-district administrative boundaries (Traditional Authority (TA)) and antigenaemia prevalence from 57 sampled villages in Malawi were used in a two-step geostatistical modelling process to predict LF clinical cases across all TAs of the country. First, we modelled antigenaemia prevalence in relation to climate covariates to predict nationwide antigenaemia prevalence. Second, we modelled clinical cases for unmapped TAs based on our antigenaemia prevalence spatial estimates. The models estimated 20,938 (95% CrI 18,091 to 24,071) clinical cases in unmapped TAs (70.3%) in addition to the 8,856 (29.7%), programme-identified cases in mapped TAs. In total, the overall national number of LF clinical cases was estimated to be 29,794 (95% CrI 26,957 to 32,927). The antigenaemia prevalence and clinical case mapping and modelling found the highest burden of disease in Chikwawa and Nsanje districts in the Southern Region and Karonga district in the Northern Region of the country. The models presented in this study have facilitated the development of the first national LF clinical case database and map in Malawi, the first endemic country in sub-Saharan Africa. It highlights the value of using existing LF antigenaemia prevalence and clinical case data together with modelling approaches to produce estimates that may be used for the WHO dossier requirements, to help target limited resources and implement long-term health strategies.

Bayesian spatial hierarchical mixture models for excess zeros data: review and application to female lymphatic filariasis cases

Bayesian spatial hierarchical mixture models for excess zeros data: review and application to female lymphatic filariasis cases

Elimination of lymphatic filariasis: Where do we stand so far?

Lymphatic filariasis (LF), an asymptomatic, acute, and chronic condition in human beings, is the second most common vector-borne disease after malaria. According to the World Health Organization, there are 120 million LF cases detected in 81 tropical and subtropical countries, and one billion people are at risk. Therefore, the Global Program to Eliminate Lymphatic Filariasis was launched in 2000, with the primary objective of stopping LF transmission among all at-risk groups using mass drug administration (MDA), managing morbidities, and preventing LF-related impairments using a minimum treatment package. Additionally, other programs such as epidemiological assessment including National Filaria Control Program and World Health Organization recommended routine and pre-MDA microfilaremia surveys also implemented to stop the LF transmission. The routine filaria surveys were also carried out in around 2 000-4 000 individuals/month throughout the year whereas pre-MDA surveys were also conducted every year in approximately 4 000 individuals in four fixed and four random sites. Furthermore, the Transmission Assessment Survey was also conducted to check the risk of LF among primary school children. Moreover, potential diagnostic methods, systematic surveillance regimes, the Direct Network Report system, and regular trainings and awareness may be also effective in preventing the recurrence of LF. Hence, this review emphasizes the potential advocacy tools and various strategies as well as procedures for monitoring, which could be impactful in eliminating LF.

Importance of consultations using mobile teams in the screening and treatment of neglected tropical skin diseases in Benin.

Since 2013, the World Health Organization has recommended integrated control strategies for neglected tropical diseases (NTDs) with skin manifestations. We evaluated the implementation of an integrated approach to the early detection and rapid treatment of skin NTDs based on mobile clinics in the Ouémé and Plateau areas of Benin. This descriptive cross-sectional study was performed in Ouémé and Plateau in Benin from 2018 to 2020. Consultations using mobile teams were performed at various sites selected by reasoned choice based on the epidemiological data of the National Program for the Control of Leprosy and Buruli Ulcer. All individuals presenting with a dermatological lesion who voluntarily approached the multidisciplinary management team on the day of consultation were included. The information collected was kept strictly anonymous and was entered into an Excel 2013 spreadsheet and analyzed with Stata 11 software. In total, 5,267 patients with various skin conditions consulted the medical team. The median age of these patients was 14 years (IQR: 7-34 years). We saw 646 (12.3%) patients presenting NTDs with skin manifestations, principally scabies, in 88.4% (571/646), followed by 37 cases of Buruli ulcer (5.8%), 22 cases of leprosy (3.4%), 15 cases of lymphatic filariasis (2.3%) and one case of mycetoma (0.2%). We detected no cases of yaws. This sustainable approach could help to decrease the burden of skin NTDs in resource-limited countries.

Neglected tropical disease: Why we need to prioritize them more

Neglected tropical diseases (NTDs) are those that are commonly found in several low-income countries in Africa, Asia, and Latin America and where people do not have access to hygiene, clean water, or safe ways to dispose of human waste. NTDs comprise a diverse group of diseases that is highly prevalent in tropical countries and is caused by a variety of pathogens, including bacteria viruses, parasites, and fungi. Although there are debates on what is included under NTD, few that are listed are ascariasis, Buruli ulcer, Chagas disease, dracunculiasis, hookworm infection, human African trypanosomiasis, Leishmaniasis, leprosy, lymphatic filariasis (LF), onchocerciasis, schistosomiasis, trachoma, and trichuriasis, though this list. keeps on changing. They are called “neglected,” because they are hardly represented in the global health agenda of the developed countries and are often associated with stigma, blind faith, and social exclusion. The epidemiology of NTDs is quite complex and often related to environmental conditions. Many of them are vector-borne, have a zoonotic origin with well characterized animal reservoirs, and are associated with complex life cycles. All these factors make their public health control challenging. With a population of over 1.3 billion, India accounts for nearly one-half of the world’s prevalent cases of visceral leishmaniasis and one-half of the global incident cases of dengue, one-third, or more of the prevalent cases of leprosy, LF, cysticercosis, and visual impairment due to trachoma. India also accounts for 25% world’s burden of ascariasis and hookworm cases. Unfortunately in India, we don’t have a uniform distribution of neglected diseases. It was found to be very much dependent on the geographical locations as well as biased on the socialeconomic status, with more prevelant amongst the lower income groups. NTDs are not just any regular disease but were reported to cause permanent disabilities, impacting mental health and thereby posing a serious threat to livelihood and standard of living. Challenges in studying NTDThe primary challenge is adequate research funding and efforts. Affecting emerging economies, NTD severely suffers from the limelight that other lifestyle diseases such as cardiovascular, diabetes, and oncology enjoys. There was not much research output from the Western world too as NTD mostly affects the poorer nations. NTD related technologies are not considered profitable. This trend is slowly changing with larger participation from the government to aid in NTD research. We hope that future days will show more effort and awareness toward a better solution.

The Spatial-Temporal Distribution of Chronic Lymphatic Filariasis in Indonesia: A 18-Year Registry-Based Analysis

Lymphatic filariasis (LF) is a vector-borne disease caused by parasitic helminths and constitutes a serious public health issue in tropical regions. According to the World Health Organization (WHO), infected cases in Southeast Asia constitute 50% of the estimated 120 million infections globally. In Indonesia, LF is caused by all filarial species, and in 2018, 236 districts of a total of 514 districts in the entire country were declared as endemic areas. The global program to eliminate filariasis has been running for the last 19 years and has been conducted as a full national initiative for the last eight years in Indonesia. The study describes the surveillance of LF cases and prevalence in Indonesia for the past 17 years (2001–2017)—during the global and national LF elimination programs—using national registry-based data. The data demonstrate that the national program has been largely effective in the areas it has been active the longest, while there are provinces lagging behind in the successful suppression of LF. The high geographical fragmentation of the country, with the associated ecological parameters relating to LF incidence, likely play an important role in maintaining the highly varied incidence rate across Indonesia.

Historical overview and geographical distribution of neglected tropical diseases amenable to preventive chemotherapy in the Republic of the Congo: A systematic review.

Neglected Tropical Diseases amenable to Preventive Chemotherapy (PC-NTDs) affect the poorest populations around the world, especially in Africa. Scientific information on the distribution and level of endemicity of these diseases in the Republic of the Congo (RoC) is scarce in the published literature. We sought to collect all available epidemiological data on PC-NTDs in the RoC to document the historical and current situation and identify challenges in reaching the elimination of NTDs. We searched Medline and Horizon databases for studies published until to July 4th, 2019, on onchocerciasis, lymphatic filariasis, soil-transmitted helminth infections, schistosomiasis, and trachoma in the RoC. Unpublished reports were also reviewed. We included all epidemiological studies containing community data and excluded case reports. Location, prevalence data, and dates of the studies were extracted. We identified 933 records, of which 56 met the inclusion criteria. The articles published before 1960 mainly concerned onchocerciasis and schistosomiasis. Despite a low number over the studied period, since 2005 there has been a steady increase in the number of publications. Most of the studies were cross-sectional and conducted in the general population. Trachoma is endemic in the Sangha and Likouala departments (prevalence of trachomatous inflammation-follicular > 5% in some villages), and further mapping is essential to properly assess the burden of this disease in the country. While the prevalence of soil-transmitted helminths is still high (over 20%) in a large part of Congo, cases of lymphatic filariasis (based on Wuchereria bancrofti antigenaemia and/or microfilaraemia) and onchocerciasis are becoming rare and very focused. To achieve the elimination of PC-NTDs, further intervention is required. Except for trachoma, whose epidemiological situation should be better evaluated, PC-NTDs are endemic in the RoC, and actions to control them have been taken by health authorities. To eliminate PC-NTDs, which are still present in some locations, new mapping surveys are needed, and increased investment in scientific research should be encouraged in the country.

Lymphatic filarial serum proteome profiling for identification and characterization of diagnostic biomarkers.

Lymphatic Filariasis (LF) affects more than 863 million people in tropical and subtropical areas of the world, causing high morbidity and long illnesses leading to social exclusion and loss of wages. A combination of drugs Ivermectin, Diethylcarbamazine citrate and Albendazole is recommended by WHO to accelerate the Global Programme to Eliminate Lymphatic Filariasis (GPELF). To assess the outcome of GPELF, to re-evaluate and to formulate further strategies there is an imperative need for high quality diagnostic markers. This study was undertaken to identify Lymphatic Filarial biomarkers which can detect LF infections in asymptomatic cases and would also serve as indicators for differentiating among different clinical stages of the disease. A combination of Fourier-transform infrared spectroscopy (FT-IR), MMP zymography, SDS-PAGE, classical 2DE along with MALDI-TOF/MS was done to identify LF biomarkers from serum samples of different stages of LF patients. FT-IR spectroscopy coupled with univariate and multivariate analysis of LF serum samples, revealed significant differences in peak intensity at 3300, 2950, 1645, 1540 and 1448 cm-1 (p<0.05). The proteomics analysis results showed that various proteins were differentially expressed (p<0.05), including C-reactive protein, α-1-antitrypsin, heterogeneous nuclear ribonucleoprotein D like, apolipoproteins A-I and A-IV in different LF clinical stages. Functional pathway analysis suggested the involvement of differentially expressed proteins in vital physiological pathways like acute phase response, hemostasis, complement and coagulation cascades. Furthermore, the differentiation between different stages of LF cases and biomarkers identified in this study clearly demonstrates the potential of the human serum profiling approach for LF detection. To our knowledge, this is the first report of comparative human serum profiling in different categories of LF patients.

Prevalensi Wuchereria bancrofti Paska Pemberian Obat Pencegahan Massal Filariasis Limfatik di Wilayah Endemis Rendah Kota Pekalongan

Pekalongan district has completed mass drug administration (MDA) of lymphatic filariasis (LF) for two rounds but still remains positive for microfilariae (Mf rate) &gt; 1%. This study aimed was to assess the prevalence of Wuchereria bancrofti and its association with sociodemographic among the adult community to the incidence of lymphatic filariasis. This study is an analytic study with a cross-sectional design. The prevalence of W. bancrofti was detected by the presence of circulating filarial antigen (CFA) using a filarial test strip (FTS). The study population consisted of an adult group living in ten villages in the Pekalongan district's low-endemic region, with 1804 samples collected from 72 clusters. Statistical analysis was performed to test the difference between variables. There were 13 (0.72%) positive W. bancrofti antigen samples out of 1804 total samples. Males were found to be infected at a higher rate than females (61.5%). The age of subjects infected with W. bancrofti was dominated in the range of 13-50 years as many as 9 people (69.2%). The proportion of positive CFA in Medono village with the highest proportion was 6 people (2.7%). There was no statistically significant difference between gender and age with LF cases, but it is significantly different by sub-district (p-value = 0.041). LF transmission occurred in border areas between high and low endemic LF areas. MDA implementation must be constantly supervised in required to address the elimination target.

Multimodal biomarker discovery for active Onchocerca volvulus infection

The neglected tropical disease onchocerciasis, or river blindness, is caused by infection with the filarial nematode Onchocerca volvulus. Current estimates indicate that 17 million people are infected worldwide, the majority of them living in Africa. Today there are no non-invasive tests available that can detect ongoing infection, and that can be used for effective monitoring of elimination programs. In addition, to enable pharmacodynamic studies with novel macrofilaricide drug candidates, surrogate endpoints and efficacy biomarkers are needed but are non-existent. We describe the use of a multimodal untargeted mass spectrometry-based approach (metabolomics and lipidomics) to identify onchocerciasis-associated metabolites in urine and plasma, and of specific lipid features in plasma of infected individuals (O. volvulus infected cases: 68 individuals with palpable nodules; lymphatic filariasis cases: 8 individuals; non-endemic controls: 20 individuals). This work resulted in the identification of elevated concentrations of the plasma metabolites inosine and hypoxanthine as biomarkers for filarial infection, and of the urine metabolite cis-cinnamoylglycine (CCG) as biomarker for O. volvulus. During the targeted validation study, metabolite-specific cutoffs were determined (inosine: 34.2 ng/ml; hypoxanthine: 1380 ng/ml; CCG: 29.7 ng/ml) and sensitivity and specificity profiles were established. Subsequent evaluation of these biomarkers in a non-endemic population from a different geographical region invalidated the urine metabolite CCG as biomarker for O. volvulus. The plasma metabolites inosine and hypoxanthine were confirmed as biomarkers for filarial infection. With the availability of targeted LC-MS procedures, the full potential of these 2 biomarkers in macrofilaricide clinical trials, MDA efficacy surveys, and epidemiological transmission studies can be investigated.

Lymphatic filariasis elimination in the Dominican Republic: History, progress, and remaining steps.

Lymphatic filariasis (LF) is a mosquito-transmitted parasitic disease that is a leading cause of disability globally. The island of Hispaniola, which the Dominican Republic shares with Haiti, accounts for approximately 90% of LF cases in the Americas region. In 1998, the Dominican Ministry of Public Health created the Program to Eliminate Lymphatic Filariasis (PELF) with the goal of eliminating LF transmission by 2020. Baseline mapping revealed 19 (12% of total) endemic municipalities clustered into three geographic foci (Southwest, La Ciénaga and East), with a total at-risk population of 262,395 people. Beginning in 2002, PELF sequentially implemented mass drug administration (MDA) in these foci using albendazole and diethylcarbamazine (DEC). In total, 1,174,050 treatments were given over three to five annual rounds of house-to-house MDA per focus with a median coverage of 81.7% (range 67.4%–92.2%). By 2018, LF antigen prevalence was less than 2% in all foci, thus meeting criteria to stop MDA and begin post-treatment surveillance (PTS). This success has been achieved against a shifting landscape of limited domestic funding, competing domestic public health priorities, and sporadic external donor support. Remaining steps include the need to scale-up morbidity management and disability prevention services for LF and to continue PTS until LF transmission is interrupted across Hispaniola.

Determination of insecticides diagnostic doses in susceptible Culex quinquefasciatus (Diptera: Culicidae)

Despite Mass Drug Administration cases of Lymphatic filariasis still exist in several developing countries such as, China, India, Indonesia, Malaysia and several Southeast Asian countries. Culex quinquefasciatus is the major vector that is dominant and widespread mosquito distributed in rural and urban areas. This study aimed at determining the diagnostic doses of LC50 and LC90 (lethal concentrations that causes 50% and 90% mortality respectively) of commonly used insecticides in Malaysia for dengue vector control by Malaysian Ministry of Health. The diagnostic LC50 of the Malathion, Pirimiphos methyl, Temephos and Deltamethrin insecticides were determined at 0.019mg/L, 0.0060 mg/L, 0.0011 mg/L and 0.0032 mg/L as well as LC90 0.033 mg/L, 0.012 mg/L, 0.0033 mg/L and 0.0010 mg/ml respectively. It is concluded that various LC50 and LC90 diagnostic doses of these insecticides were effective against the susceptible population of Cx. quinquefasciatus that also carries infective third instar larvae (L3) microfilariae. We recommend the use of these doses for effective control of Cx. quinquefasciatus population and constant monitoring of its susceptibility status will provide more information on the possible resistance that may affect the effort in the elimination of Lymphatic filariasis in affected countries.

Filariasis presenting as isolated asymptomatic unilateral inguinal lymphadenopathy

Filariasis continues to be one of the endemic problems worldwide with 40% of the cases in India. We report a case of lymphatic filariasis in a 3-year-old girl who presented with a non-tender swelling over left inguinal region. Blood sample showed eosinophilia while the excision biopsy was diagnostic of filarial worm. Patient responded well with oral diethylcarbamazine. High index of suspicion of filariasis is indicated when dealing with a swelling of unknown cause even if it is not from an endemic area.

Insecticide resistance and molecular characterization of knockdown resistance (kdr) in Culex quinquefasciatus mosquitoes in Sri Lanka.

Resistance to pyrethroids (PY) and organophosphate (OP) insecticides is widespread among populations of Culex quinquefasciatus, the major vector of lymphatic filariasis (LF). The present study was designed to detect the L1014F kdr (knockdown resistant) mutation among Cx. quinquefasciatus populations in the filarial belt of Sri Lanka. Mosquitoes were reared from field-caught larvae from seven localities where LF is endemic. Susceptibility status of Cx. quinquefasciatus to adulticides, 0.05% deltamethrin, 0.75% permethrin, 5% malathion, and the larvicide temephos was determined using the standard WHO susceptibility tests. A fragment of vgsc gene was amplified and sequenced to identify the responsible kdr mutations. The susceptibility test results revealed less than 90% mortalities for 0.05% deltamethrin, and 0.75% permethrin and temephos. For 5% malathion, all study sites except Maharagama revealed greater than 90% mortality. The L1014F kdr mutation was observed in all studied populations. Although the overall microfilaria rate is less than 1% in the country, there is a high risk of re-emergence of LF in Sri Lanka due to abundant Cx. quinquefasciatus mosquitoes, increased resistant status to currently used insecticides, imported LF cases, higher rates of microfilaria among neighboring countries, and the advancement of tourism.

Case Report: Periorbital Filariasis Caused by Brugia malayi

Brugia malayi is a lymphatic nematode that accounts for approximately 10% of lymphatic filariasis cases worldwide. It is endemic in several countries in South and Southeast Asia. In Thailand, B. malayi is endemic in the southern region. The extralymphatic presentation of B. malayi is rare. Here, we report the case of a woman residing in the central region of Thailand who presented with an erythematous periorbital nodule at the left medial canthal area caused by lymphatic filaria. A viable sexually mature filarial adult was removed from the lesion. The nematode species was identified as B. malayi by histology staining and DNA sequencing of the partial mitochondrial 12S ribosomal RNA (rRNA) gene. As far as we know, this is the first case report of B. malayi presenting with a periorbital nodule that has occurred in a disease non-endemic area of Thailand with possibly a zoonotic origin.

English

Wuchereria bancrofti has been reported to cause 90% of all cases of lymphatic filariasis in Africa. wolbachia endosymbiot infect a wide range of insects and nematodes. This study was conducted in 48 settlements (8 from each division). A total of 2003 mosquitoes was pooled into 120 clusters from the 48 settlements in The Gambia. Polymerase chain reaction (PCR) was used to detect the presence of Wolbachia and filarial nematode and further differentiate Wolbachia into super groups among the positive samples. The level of association between Wolbachia and the genera of anthropophilic mosquitoes in The Gambia was also determined. Microscopic results showed 64.9% Anopheles, 32.0% Culex, 3.0% Aedes. PCR showed that, 34.17% of Wolbachia in the mosquito obtained varied among the three mosquito genera, with highest being among Anopheles. Only Wolbachia super group B was identified in Culex and Aedes. The purpose of this study carried out in The Gambia was to describe the most common mosquito species and to identify, by means of PCR, their association with the Wolbachia bacteria and the presence of nematodes responsible for filiariasis, in order to understand the role that this bacterium plays in the chain of filarial transmission. Key words: Wuchereria bancrofti, Filariasis, Anopheles gambiae, Culex quinquefasciatus, elephantiasis.

The Potential Sources of Transmission and Distribution of Lymphatic Filariasis in Semarang City, Central Java, Indonesia

Lymphatic Filariasis (LF) is a neglected tropical disease caused by filarial worms. Semarang City has an increasing number of LF. The aim of this study was to investigate potential sources of transmission and distribution of LF. It was descriptive research using cross-sectional design. The sample were 28 LF cases. The variables studied were level of knowledge, physical and biological environmental factors, and provision of health service. Data were collected with interview and observation. Data were analysed descriptively and spatially. The results showed that LF cases were distributed in centre of Semarang City, especially in the coastal area. Poor drainage and stagnant water around the houses were potential breeding places for mosquitos, which are suspected as a vector of LF transmission. Physical and biological environmental factors around the houses of LF patient may possibly be sources of distribution and transmission of LF. It was indicated with the existence of mosquito larvae in any habitats.

Epidemiological situations and control strategies of vector-borne diseases in Nepal during 1998–2016

Purpose The purpose of this paper is to investigate epidemiology and control strategies of the four priority vector-borne diseases (VBDs) in Nepal, i.e. malaria, Kala-azar (visceral leishmaniasis), lymphatic filariasis (LF) and dengue fever/dengue hemorrhagic fever. Design/methodology/approach The study was a retrospective design to collect data during 1998–2016 from VBDs endemic districts of Nepal. All data were reviewed and epidemiological information of the four VBDs were analyzed. Findings The number of malaria cases during 1998–2016 of the 13 affected districts was declined from 8,498 to 991 cases with no record of deaths since 2012. The number of cases and deaths in the 12 kala-azar (visceral leishmaniasis) affected districts in 1998 was 1,409 and 42 cases, respectively, but was dramatically decreased in 2016 to 213 and 2 cases, respectively. LF cases of the 61 affected districts in 2011, 2014 and 2016 were 28,855, 30,000 and 33,517 cases, respectively. In total, 25 districts achieved elimination target and the remaining are expected to complete the needful cycles by 2018. Dengue incidence of the 31 affected districts during 2006–2015 was under controlled with reported cases of 642, 356 and 136 cases in 2013, 2014 and 2015, respectively, and only one death in 2015. Implementation of control strategies particularly disease management and community peoples’ awareness significantly reduced the cases and deaths of the target VBDs. Practical implications The results of this study clearly suggest that the current control strategies have been worked effectively. However, in particular of the VBDs, health education in communities in the endemic areas should be adopted for better community participation in the context of the primary health care approach and increase the effectiveness of disease control. Originality/value VBDs, i.e., malaria, kala-azar (visceral leishmaniasis), LF and dengue fever/dengue hemorrhagic fever, are major causes of morbidity and mortality in the least developed countries which include Nepal. Globalization of travel and trading, unplanned urbanization, environmental and climate change are having a significant impact on disease transmission. Therefore, the Ministry of Health of Nepal had brought some changes in strategies based on activities for disease control, vector control, preventive and preparedness for outbreak response. Consequently, the cases and deaths due to malaria, kala-azar (visceral leishmaniasis), lymphatic filaiasis and dengue fever/dengue hemorrhagic fever have been brought down markedly.

Evaluation of Endemic Status of Lymphatic Filariasis in Areas Adjoining to the Endemic District of Bangladesh

In Bangladesh, it was assumed that the endemicity of Lymphatic Filariasis (LF) in areas adjoining to the endemic districts may be related to the endemicity of this districts due to presence of sufficient vectors and extend of microfilaria for it’s chronicity. LF is caused by nematodes (round worms) and mainly transmitted to man by the infected- Culex mosquito. Among the 3 types of thread-like filarial worms; Wuchereria bancrofti is responsible for 90% of the cases. Filariasis is endemic in 34 districts and clinical cases are reported from 51 districts, with high endemicity in the northern part of Bangladesh. This cross-sectional survey study was conducted among 6,100 participants at areas adjoining to the endemic districts of LF to evaluate the endemic status during the period of 1st July 2014 to 30th June 2016. Total 10 sub-districts (upa-zilas) were selected from 5 districts of 4 divisions adjoining to the filaria endemic districts, and then 02 sub-districts (Sub-D) from each district. From each Sub-D, 02 unions (several unions constitute a sub-districts) and 10 ‘spot check site (SCS)’ from these unions were selected randomly. Villages and nearby areas of the ‘SCS’ were publicized previous day of data collection by personnel from Upa-zila Health Complexes (UHC) and audio announce. Average 60 samples were collected from each ‘SCS’ and interviewed participants in the same day. Data were collected by using On Site Filariasis Rapid test cassette for identifying the filarial cases and socioeconomic and demographic data had also been collected by interviewing using questionnaire. The mean age of the participants was 30.03+14.85; female - male ratio of were 1: 0.97 and almost equal numbers (20%-30%) respondents were in each age group (5-15, 16-25, 26-40 and &gt;40 years). Most of the participants were Muslims and two third were married, where 56% were completed primary education or could not read and write and 44% secondary level or above. Nearly three fourth of participants were involved in household/ agricultural works or laborers; others were students, had service and small business and 01% had no work. Two third of participants had no income or could not state and other had monthly income ranges from 1000 to 10,000 taka. Prevalence rate of LF test positive cases was 0.2%; male-female ratio was 1:3, IgG was detected in 83% and rest IgM. Two third of cases were in age group 16-25 years and one fourth in &gt;40 years; only 8.3% were in 5-15 years and no cases were found in age group 26-40 years. All positive cases were Muslim and two third were married, where majority were illiterate or primary and rest of them completed secondary or above. Two third of cases did household or agricultural works and rest were students. Two third had no income or could not state, one fourth had &gt;2000 to 5000 taka and only 8.3% had income 5001–&gt;10000 taka. The highest prevalence rate (2.50/1000 Pop) were found in Naogaon &amp; Gaibandha districts and sub-districts were Niamotpur &amp; Sadullapur (5.0/1000 Pop) and no cases were detected at Singra (Natore), Porsha (Naogaon), Palashbari (Gaibandha). Two third of cases suffered from itching; majority had fever and cough and one third stated breathlessness. Clinical signs edema was seen in feet 41.7% of cases. Few cases 08.3% had reached to health care facilities and 91.7% cases had never sought diagnostic facilities. Adjoining areas of endemic districts of LF are prone to spread this disease. Routine survey of LF cases would be continued in areas adjoining to the endemic district.&#x0D; Bangladesh Med J. 2019 May; 48 (2): 13-19

Human Migration and the Spread of the Nematode Parasite Wuchereria bancrofti.

The human disease lymphatic filariasis causes the debilitating effects of elephantiasis and hydrocele. Lymphatic filariasis currently affects the lives of 90 million people in 52 countries. There are three nematodes that cause lymphatic filariasis, Brugia malayi, Brugia timori, and Wuchereria bancrofti, but 90% of all cases of lymphatic filariasis are caused solely by W. bancrofti (Wb). Here we use population genomics to reconstruct the probable route and timing of migration of Wb strains that currently infect Africa, Haiti, and Papua New Guinea (PNG). We used selective whole genome amplification to sequence 42 whole genomes of single Wb worms from populations in Haiti, Mali, Kenya, and PNG. Our results are consistent with a hypothesis of an Island Southeast Asia or East Asian origin of Wb. Our demographic models support divergence times that correlate with the migration of human populations. We hypothesize that PNG was infected at two separate times, first by the Melanesians and later by the migrating Austronesians. The migrating Austronesians also likely introduced Wb to Madagascar where later migrations spread it to continental Africa. From Africa, Wb spread to the New World during the transatlantic slave trade. Genome scans identified 17 genes that were highly differentiated among Wb populations. Among these are genes associated with human immune suppression, insecticide sensitivity, and proposed drug targets. Identifying the distribution of genetic diversity in Wb populations and selection forces acting on the genome will build a foundation to test future hypotheses and help predict response to current eradication efforts.