TROPICAL DESEASE 8

2.1 EPIDEMIOLOGY
- More than 250 million persons throughout the world are
presently infected, and
both the prevalence, and distribution of the disease seems to be increasing in many parts of
Africa, and
Asia.
- The disease primarily affects Africa, Pacific Islands, South-East
Asia from Korea to India fig.9.4
- The West Indies, Central America and South America are also sites
of the disorder.
- B.Malayi infection is limited in distribution to India, Burma,
Thailand, Vietnam, Japan, Malaysia, Indonesia, Borneo, New Guinea,
and Philippines.

2.2 PATHOLOGY
Pathological changes are caused by the adult worm in the
Lymphatics, and the effects are of two types
* Inflammatory, and
* obstructive

2.2.1 INFLAMMATORY
Inflammatory response is thought to be an immediate type of
Hyper-sensitivity reaction to the larvae,
-This is evidenced by infiltration by lymphocytes, plasma cells and eosinophiles.
There is hyperplasia of the endothelium of the lymphatics.
Later there is a granulomatous reaction to the dead and dying adult
Worms, this may end in a reversible lymphatic obstruction.

2.2.2 Repetition of this process produces permanent obstruction.
2.2.3 With the addition of secondary streptococcal
infections, there is further lymphatic obstruction and tissue
becomes edamatous, thickened and fibrotic.
Intensely dilated lymphatic may rupture.


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