Sexually Transmitted Diseases - I. I. Mavrov 2005

Parasitic Diseases of the Urogenital System
Filariases

Filariasis encompasses a group of Human and Animal diseases caused by filarial worms (nematodes). Depending on the localization of adult helminths and the species of the pathogen, human filariasis is subdivided into bancroftian filariasis, brugian filariasis, loiasis, onchocerciasis, and dipetalonemiasis.

Etiology. Like other parasitic helminths, filariae have a specific developmental cycle characterized by alternating vertebrate and invertebrate hosts. Adult filariae parasitize the Lymphatic vessels, Tissues, and cavities of humans and mammals. The pathogens of filariasis are transmitted by Blood-sucking Arthropods (mosquitoes, horseflies, blackflies, and biting midges).

Epidemiology and Pathogenesis. Filariasis is widely distributed globally. It is endemic in countries with tropical and subtropical climates (South and Central America, Pacific islands, China, India, etc.). In the countries of the former CIS, filariasis is found in individuals who have arrived already infected from endemic regions.

The disease is characterized by a significant duration. Adult filariae can persist in The Human Body for 20 years or more (Baroyan et al., 1979). In most cases, pathological changes are caused by The Development of allergic reactions to the presence of living or dead filariae, as well as their metabolic products, or by the damage to the lymphatic vessels, their occlusion, and significant proliferation of vessel walls and adjacent Connective Tissue elements. The primary sites of involvement are the inguinal-femoral, iliac, and other retroperitoneal and pelvic Lymph Nodes (Tiktinsky et al., 1985). The resulting lymphostasis leads to enlargement of the Scrotum, Penis, and corona glandis.

Clinical Manifestations. Patients complain of malaise, fatigue, intermittent fever, and chills. The external genitalia are enlarged; the Skin over them is edematous, pasty, and wrinkled. Occasionally, vesicles filled with serous fluid appear on the skin. The penis is frequently almost entirely retracted into the edematous scrotum, impairing urination. Maceration develops in the lower lateral Regions of the scrotum where it comes into contact with the inner thighs. Manifestations include orchitis, epididymitis, funiculitis, hydrocele, Renal Colic, Acute Urinary Retention, and others.

Diagnosis. The main diagnostic method is the detection of filariae in the urine, blood, lymph, or skin biopsies of infected individuals. Clinical and epidemiological findings are taken into account. Epidemiological history can be decisive in cases where filariae cannot be detected.

Treatment. Filariasis therapy involves diethylcarbamazine (banocide, notesin, ditrazine, or hetrazan) or suramin, administered concurrently with antihistamines. Surgical treatment is recommended when indicated.

The primary method of filariasis Prevention is vector control and the treatment of infected individuals. Strict personal hygiene is crucial for those at risk of filariasis infection. Health education among the population greatly facilitates the Structure/175.html">Implementation of mass preventive measures against these diseases.