Reasons that Make it Challenging to Eliminate Elephantiasis – A Debilitating NTD

Lymphatic filariasis is one of the most common causes of long-term or permanent disability in the world. Sometimes known as Elephantiasis, it is a neglected disease which happens due to a mosquito bite. It is also stigmatised more commonly. The disease damages our lymphatic system and leads to the disfiguring of the limbs. It leads to bizarre swelling of the lower limbs, breasts and genitals. Even after the 10-year continuous distribution of WHO-led drugs to halt its spread, the disease is still endemic in 72 countries. Approximately 1.4 billion people are at risk of lymphatic filariasis and about 120 million people are affected by it.

Causes of lymphatic filariasis

People get infected with the disease due to a mosquito bite. In India, the main vector is Culex quinquefasciatus (mosquito) which spreads Wuchereria bancrofti and has been the most prevailing infection leading to 99.4% of the cases in the country. Wuchereria bancrofti is a microscopic filarial parasitic worm that is transmitted by the mosquito from one person to another during its feeding process. These worms start growing inside the lymphatic system of our bodies and cause gradual damage and disruption.

Lymphatic filariasis

The lymphatic system is part of the immune system. It is responsible for maintaining the body’s fluid levels and protecting the body from pathogens.

The first step to preventing lymphatic filariasis is avoiding contact with mosquitoes in endemic areas. Tropical areas around the world are most prone to lymphatic filariasis due to the common collection of water outdoors and bad sanitary conditions. However, one does not get affected by the diseases with one bite. People who are at greater risk are the ones bitten repeatedly. Research shows that the factors that put people at risk of this disease include short savanna grass areas, closeness to the coast, rainfall and temperature, poverty and poor housing and season.

Living with lymphatic filariasis

People with lymphatic filariasis go through many severe filarial attacks. These involve a fever, peeling skin, and swelling in the affected areas of the body. These attacks involve microbial contamination and may lead to immune reactions due to adult worms. The major symptom of this illness is abnormal swelling in the body parts, followed by peeling skin in the affected area. In women, this swelling more commonly occurs in the arms and legs. On the other hand, it can cause swelling in the scrotum, which is called a hydrocele.

The swelling can affect the lifestyle of people in many ways. It can become a hurdle in clothing and the fit of footwear, affect sexual function and impair mobility. The effects are not only limited to the physical aspects. It can also lead to serious economic issues, and raise social and interpersonal consequences.

Due to the factors such as stigma, discrimination and disability; the victims often lose their jobs, are ignored by their communities and find difficulty in starting new relationships. The ill-treatment, stigma and isolation due to this condition can also ultimately result in mental health conditions.

Factors making it difficult to eliminate the disease

The hurdles coming in the way of eradication are not straightforward. The research in this field has been majorly focused on mass drug administration. The drugs targeted for this disease kill the larval stages of the parasites. But they have little effect on adult worms. These medicines only avoid the disfigurement of the body, that too if taken at an early stage.

There is a lack of cultural engagement in the elimination of this disease and that is where the first barrier arises. Often the disease victims blame their outside invisible forces like ancestral curses, sorcery or witchcraft for their illness. Most of the time, they might even seek solutions from priests, and rituals to fight off dangerous spirits.

One other barrier can be gender dynamics. Women might experience social and financial barriers in seeking treatment.

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