Influence of seasonal variation on reported filarial attacks among people living with lymphedema in Ghana

Abstract

Background Lymphatic Filariasis (LF) is a vector-borne neglected tropical disease caused by the filarial nematode parasites that can lead to the disfiguring swelling of the limbs (lymphedema or elephantiasis for late stage) and/or genitalia (hydrocele) in men. Growing evidence suggests that not only are filarial lymphedema patients confronted with huge societal stigma and discrimination, but also experience acute filarial attacks accompanied by swelling of the affected part(s), fever, wounds and peeling of the skin of affected limbs(s). However, the extent to which seasonal variation influence filarial attacks among people with lymphedema was highly speculated without empirical evidence and was thus investigated. Methods In light of this, a cross-sectional study where 142 (70.4% females and 29.6% males) lymphedema patients were recruited from 8 established Wuchereria bancrofti endemic communities in the Ahanta West District, Ghana was carried out to investigate the prevalence and seasonal variation (rainy/wet and dry seasons) of acute filarial attacks. Chi-square test was used to test for association between frequency of attacks and seasonality. The STROBE guidelines for reporting cross-sectional studies was adopted. Results The average lymphedema leg stage was 2.37 and 2.33 for left and right legs, respectively, while mossy lesions, sores and ulcers were observed among 33.1% of patients with late stage disease (elephantiasis). It was found that 97 (68.3%) of the study participants experience filarial attacks during the wet season and 36 (25.4%) reported the incidence of filarial attacks during both seasons (wet and dry) while 9 (6.3%) of the study participants did not experience any attack at all. Conclusions Findings from the present study show compelling evidence that the frequency and the prevalence of filarial attacks is significantly increased during wet seasons compared to the dry season. Electronic supplementary material The online version of this article (10.1186/s12879-019-4084-2) contains supplementary material, which is available to authorized users.

Morbidity management and surveillance of lymphatic filariasis disease and acute dermatolymphangioadenitis attacks using a mobile phone-based tool by community health volunteers in Ghana

“…In this study lymphedema cases recorded were significantly higher in females than in males, which is consistent with many reported cases in literature [27][28][29][30]. However, the cases identified among the various age groups as well as the districts were not different.…”

Multi-parasite infection in an immigrant from Ghana: potential for new epidemic foci

“…Despite of it, the patient history, and the clinical symptoms of clinical features let us a suspect of an acute parasitic infection, which was confirmed by serological tests. The results obtained by the serological tests confirmed the actual epidemiological state of Ghana [7,8].…”

Financial burden reportedly impact quality of life among Lymphatic Filariasis Pathology Patients in Ghana

“…Experienced research scientists performed the leg staging of the study participants. The WHO seven-stage system for grading of lymphedema was used as the standard for grading legs of the patients as previously described in 5 . The Committee of Human Research and Publications and Ethics, School of Medical Sciences, Kwame Nkrumah University of Science and Technology provided ethical clearance for this study.…”

“…LF has varied form of manifestations such as hydrocele, lymphedema and elephantiasis 4 . Individuals suffering from lymphatic lariasis experience repeated larial attacks known as adenolymphangitis (ADL), which hinders patients from actively participating in both social and economic activities [5][6][7] . Krishna et al 2005, identi ed ADL as the primary cause of disabilities among LF patients 8 .…”