Clinical correlates of filarial infection in Haitian children: an association with interdigital lesions.
To assess clinical findings associated with Wuchereria bancrofti infection, 192 school children in a filariasis-endemic area of Haiti underwent physical and ultrasonographic examinations and testing for circulating filarial antigen (CFA). The CFA-positive children were more likely than CFA-negative children to have severe interdigital lesions (> or = 1 macerated lesion with involvement of > or = 4 toe web spaces) (P < 0.0001) and inguinal (P = 0.003) or crural (P = 0.004) lymph node pathology. In multivariate analysis, CFA positivity remained a significant predictor for severe interdigital lesions (P = 0.006) and inguinal lymph node pathology (P = 0.05). Ultrasound detected adult worms and lymphangectasia (diameter = 2.0-4.0 mm) in 11 (10.8%) CFA-positive children. Among CFA-positive children, ultrasonographic detection of adult worms was associated with inguinal (P = 0.01) and crural (P = 0.004) lymph node pathology and advanced pubertal stage (sexual maturity rating = 3-5) (P = 0.02). This is the first study to associate interdigital lesions with filarial infection in children.
Fox
LeAnne M
LM
Epidemic Intelligence Service, Epidemiology Program Office, and Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3724, USA. lfox@bu.edu
Wilson
Susan F
SF
Addiss
David G
DG
Louis-Charles
Jacky
J
Beau de Rochars
Madsen V
MV
Lammie
Patrick J
PJ
D000293:Adolescent; D000328:Adult; D000818:Animals; D000947:Antigens, Helminth / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D004605:Elephantiasis, Filarial / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000469:parasitology / Q000473:pathology*; D005260:Female; D006205:Haiti / Q000453:epidemiology; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D015999:Multivariate Analysis; D014034:Toes / Q000000981:diagnostic imaging / Q000469:parasitology / Q000473:pathology*; D014463:Ultrasonography; D014958:Wuchereria bancrofti / Q000302:isolation & purification
D000947:Antigens, Helminth