title: Lymphatic filariasis and onchocerciasis.
abstract: Lymphatic filariasis and onchocerciasis are parasitic helminth diseases that constitute a serious public health issue in tropical regions. The filarial nematodes that cause these diseases are transmitted by blood-feeding insects and produce chronic and long-term infection through suppression of host immunity. Disease pathogenesis is linked to host inflammation invoked by the death of the parasite, causing hydrocoele, lymphoedema, and elephantiasis in lymphatic filariasis, and skin disease and blindness in onchocerciasis. Most filarial species that infect people co-exist in mutualistic symbiosis with Wolbachia bacteria, which are essential for growth, development, and survival of their nematode hosts. These endosymbionts contribute to inflammatory disease pathogenesis and are a target for doxycycline therapy, which delivers macrofilaricidal activity, improves pathological outcomes, and is effective as monotherapy. Drugs to treat filariasis include diethylcarbamazine, ivermectin, and albendazole, which are used mostly in combination to reduce microfilariae in blood (lymphatic filariasis) and skin (onchocerciasis). Global programmes for control and elimination have been developed to provide sustained delivery of drugs to affected communities to interrupt transmission of disease and ultimately eliminate this burden on public health.
authors.affiliation: Liverpool School of Tropical Medicine, Liverpool, UK. mark.taylor@liv.ac.uk
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Taylor
authors.forename: Achim
authors.initials: A
authors.lastname: Hoerauf
authors.forename: Moses
authors.initials: M
authors.lastname: Bockarie
mesh_terms: D017954:Africa South of the Sahara; D000367:Age Factors; D015766:Albendazole / Q000627:therapeutic use; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000969:Antinematodal Agents / Q000627:therapeutic use*; D001766:Blindness / Q000469:parasitology; D009033:Culicidae; D003872:Dermatitis / Q000469:parasitology; D003879:Dermatologic Agents / Q000627:therapeutic use; D004049:Diethylcarbamazine / Q000627:therapeutic use; D004318:Doxycycline / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004605:Elephantiasis, Filarial / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology / Q000635:transmission; D005369:Filaricides / Q000627:therapeutic use; D016905:Gram-Negative Bacterial Infections / Q000150:complications; D006099:Granuloma / Q000469:parasitology; D006801:Humans; D007194:India; D007559:Ivermectin / Q000627:therapeutic use; D008199:Lymphadenitis / Q000469:parasitology; D008205:Lymphangitis / Q000469:parasitology; D008209:Lymphedema / Q000469:parasitology; D018942:Macrolides / Q000627:therapeutic use; D009855:Onchocerciasis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology / Q000635:transmission; D015995:Prevalence; D013559:Symbiosis; D020577:Wolbachia / Q000187:drug effects
chemical_list: D000900:Anti-Bacterial Agents; D000969:Antinematodal Agents; D003879:Dermatologic Agents; D005369:Filaricides; D018942:Macrolides; D007559:Ivermectin; D015766:Albendazole; D004318:Doxycycline; C027837:moxidectin; D004049:Diethylcarbamazine