5.2. filariasis darah & limfatik
DESCRIPTION
gyuutTRANSCRIPT
![Page 1: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/1.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 1/30
FILARIASIS
BLOOD AND LYMPHATIC SYSTEM
ISNA INDRAWATI
Department of Microbiology-Parasitology
![Page 2: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/2.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 2/30
FILARIA
• Tissue nematodes (round worms)
• Family Filarioidea
• Adult worms live in the lymphatic,subcutaneous tissue & body cavities
• Transmitted by infected biting arthropods
during a blood meal.
![Page 3: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/3.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 3/30
Morphology
• Adult worms : whitish and thread like
• Female : viviparous microfilaria
•
Microfilaria : sheated/ unsheated
![Page 4: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/4.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 4/30
Periodicity of microfilaria:
• the circadian rhythm observed in the
appearance of filarial microfilaria in the
peripheral blood.• Nocturna,
• diurna
• sub periodic
![Page 5: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/5.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 5/30
• Basis of mf periodicity : >> unknown
• Influenced by :
–Circadian rhythm of the host
–p O2 and N2 in the blood
–Strain of parasite
–Feeding habit of the vectors
![Page 6: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/6.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 6/30
lymphatic
FILARIA
non-lymphatic
(sub cutaneous)
Wuchereria bancrofti
Brugia malayi
Brugia timori
Loa-loa
Onchocerca volvulus
Mansonella
NEMATODE
![Page 7: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/7.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 7/30
Global distribution of lymphatic filariasis and
onchocerciasis.
(Adapted from WHO, http://who.int/tdr/)
Source : www.neb.com
![Page 8: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/8.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 8/30
Life cycle
Infected stage
![Page 9: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/9.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 9/30
LYMPHATIC FILARIASIS
![Page 10: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/10.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 10/30
Prevalence (WHO, 2015)
• ± 120 million people are infected withlymphatic filariasis;
• 25 million men have genital disease ( >>>
hydrocele)
• 15 million,(>> women), have lmphoedema or
elephantiasis of the leg.
• ± 66% of those at risk of infection live in theWHO South-East Asia and 33% in the African
Region.
![Page 11: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/11.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 11/30
Geographic distribution
W.bancrofti : 90 % of the cases
B. malayi : most of the remainder cases
B. timori : also causes diseases
![Page 12: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/12.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 12/30
Morphology
•
Adult worms : minute and thread like; whitish,smooth cuticula
• ♂: 40 mm x 0,1 mm, posterior end curved
sharply
• ♀: 80-100mm x 0.2- 0.3 mm
![Page 13: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/13.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 13/30
Species Type/varians Mf periodicity Definitive
host
Wuchereria
bancrofti
Urban type Nocturnal Human
Rural type Nocturnal Human
Brugia malayiantropophilic Nocturnal Human
zoophilic
Subperiodic
Nocturnal
Human,
Monkey, Cat
Brugia timori Nocturnal Human
![Page 14: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/14.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 14/30
![Page 15: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/15.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 15/30
Clinical symptoms
• Males >> females• The incubation period: 8 to 16 months.
(http://www.icm.tn.gov.in/seminar/filariasis.htm)
• >> infected people have no symptoms
• Acute :
•
episodes attacks of local inflammationinvolving the skin, lymph nodes and lymphaticlymphangitis retrograde & lymphadenitis
![Page 16: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/16.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 16/30
• Filarial fever
• Orchitis, epididimitis, funiculitis ( filariasis
bancrofti)
Chronic
• << of persons will develop lymphedema
>> these symptoms years after beinginfected
![Page 17: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/17.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 17/30
Filariasis bancrofti Filariasis brugia
• lymphatic system of
genitalia and breast
• 10 –50% of men suffer
genital damage,• hydrocele or swelling of
the scrotum
•
Chyluria• Elephantiasis of the
entire leg or arm
• Ulcer
• Never affected
lymphatic system of
genitalia and breast• Elephantiasis of lower
part of the extremities
![Page 18: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/18.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 18/30
Clinical symptoms
![Page 19: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/19.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 19/30
Clinical symptoms
![Page 20: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/20.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 20/30
Diagnosis
• Microscopic examination:
–identification of microfilariae in a
blood smear obtained at night (10 pm
–2 am)
Specific diagnosis (species)
•
Serologic enzyme immunoassay tests :antibody IgG4
• DNA probe ( PCR)
![Page 21: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/21.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 21/30
Microfilaria
W. bancrofti
B. malayi
B.timori
http://www.dpd.cdc.gov/dpdx/HTML/Frames/A-F/Filariasis/body_Filariasis_mic1.htm
![Page 22: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/22.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 22/30
Diagnosis( cont’d)
• ultrasonography : allows visualization of adult
worms filarial dance sign (W.b)
• ICT( Immunochromatographic Tes): detection
of circulating filarial antigen detect antigens
released by adult filarial worms may
be positive even in amicrofilaremic individuals
(Filariasis bancrofti)
![Page 23: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/23.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 23/30
The left ICT card displays negative results for LF infection, while the
right card displays positive results
Immuno Chromatographic Test
![Page 24: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/24.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 24/30
Diagnosis (cont’d)
• Biopsy :
• lymphoscintigraphy imaging Of lymphaticsystem
Lymphatic Filariasis
(diagnosis)
![Page 25: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/25.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 25/30
Therapy
•DEC (Diethyl Carbamazine)
• Combination with albendazole
• Surgery :
–The treatment for hydrocele is surgery(hydrocelectomy).
– lymphedema
• lymphedema: patients can be educated aboutbasic principles of care ( such as hygiene,exercise, elevation, and treatment of woundsand infections)
![Page 26: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/26.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 26/30
Tropical pulmonary
eosinophilia
•Etiology : Filarial worms
• typically found in persons living with thedisease in Asia.
•
Men 20 to 40 years old are most commonlyaffected.
• Symptoms : cough, shortness of breath, andwheezing.
• Hypereosinophilia is often accompanied byhigh levels of IgE and antifilarial antibodies.
![Page 27: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/27.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 27/30
Epidemiology
• The Global Goal of Elimination of LymphaticFilariasis as a Public Health problem by The
Year 2020
•strategy :
• (i) to stop the spread of infection
(interrupting transmission); and
• (ii) to alleviate the suffering of affectedpopulations (controlling morbidity).
![Page 28: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/28.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 28/30
• Mass drugs administration (MDA) :
– 6 mg/kg of body weight diethylcarbamazine
citrate (DEC) + 400 mg albendazole;
– Once a year for at least 5 years
– coverage of at least 65% of the total at-risk
population:
![Page 29: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/29.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 29/30
Source: http://www.wpro.who.int/southpacific/pacelf/about/en/
![Page 30: 5.2. Filariasis Darah & Limfatik](https://reader036.vdocument.in/reader036/viewer/2022082209/5695d10e1a28ab9b0294f2ed/html5/thumbnails/30.jpg)
7/21/2019 5.2. Filariasis Darah & Limfatik
http://slidepdf.com/reader/full/52-filariasis-darah-limfatik 30/30
Prevention
• Protecting oneself from being bitten by amosquito:
– sleeping in a bed-net or screened bedroom
– Insecticide spraying
– using mosquito repellent.
• Controlling and reducing mosquito
populations