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Dreyer, G & Dreyer, P.

RATIONAL FOR MORBITY MANAGEMENT IN BANCROFTIAN FILARIASIS ENDEMIC AREAS.

Revista da Sociedade Brasileira de Medicina Tropical, 33(2):217-221, mar-abr. 2000.

ABSTRACT

Selection of the most appropriate therapy for the patient with bancroftian filariasis requires a knowledge of the diverse clinical characteristics of filarial disease and their pathogenesis.
As a result of new diagnostic tests and clinical advances, our understanding of bancroftian filariasis
has changed rapidly, as have our ideas about treatment. In the past, it was believed that
elephantiasis was caused by an immunologic reaction of the host to the filarial parasite. From this
perspective, elephantiasis was seen as the endpoint of an unalterable relationship between the
host and the parasite, and given the absence of effective medication or procedures, affected
individuals were considered “immunologically predisposed” to this end-stage disease. In the last
few years, however, new evidence has suggested that lymphedema and elephantiasis have another
etiologic agent. Namely, the principal factor in the evolution of lymphedema and elephantiasis is
the involvement of recurrent secondary bacterial infections. Today, it is clear that other forms of
supportive therapy (including education and psychological counseling) are necessary and are
often more important than antiparasitic drugs.