– as re-mapping campaign for filaria begins in Region Six

LIFE has not been the same for Ann (not real name), a resident of Rose Hall Town, Corentyne, Berbice, who discovered she had Lymphatic Filariasis (LF) or filaria 19 years ago.

“One night I took ill and I started to get some pain and start trembling with fever. In the morning, my feet started to swell, I went to a private doctor and got an injection but it was no help. I then went to New Amsterdam Hospital and they give me a card to come back in the night to do a test but before that I started to treat it [feet] with other things like Bengay and other topical treatments and so and it went down a little but after a while when it returned I went for the test, that’s when I tested positive for filaria. Then it make one swelling and never went back down.”

This is how Ann described the situation when she first discovered she had the disease. Like her, there are many others who may be infected but they realise too late when the condition becomes chronic and physical/external symptoms manifest. At this stage, the effects of the disease are irreversible.

Filaria, according to the World Health Organisation (WHO) is caused by infection with parasites classified as nematodes (roundworms) of the family Filariidae.

There are three types of these thread-like filarial worms: Brugia timori, Brugia malayi and Wuchereria bancrofti. The latter is most commonly responsible for the disease in Guyana and across the world.

Locally, the condition is usually described or referred to as ‘bigfoot’ (elephantiasis, the thickening of skin/tissue of the limb – as in the case of Ann) and ‘goadie’ (hydrocele or scrotal swelling in males).

As the local names suggest, there is widespread stigma and discrimination against the 36 million people worldwide with manifestations of the chronic disease; not to mention the lifelong effects in trying to lead a normal life.

For Ann, she has been blessed with a supportive family whom she had to care for and nurture. At the time of her diagnosis, her five children were between the ages of two and 12.

“Throughout the past 19 years, it has been tough, I always have to wear long clothes and slippers ‘cause if people see it open they stare. I am not ashamed about it.”
She admits that while she is now aware of the disease because she is a victim, prior to becoming a victim, she knew nothing about lymphatic filariasis or its symptoms.

SMALL BUT DANGEROUS
“My family used to say none of our generation never get this, where I get it from. Then you won’t believe a small thing like a mosquito would do this much harm and changes to a person’s body. At certain time when it gets worse, I would feel a pain and then the worms would come out, it’s a very painful process,” she said.

Having accepted her condition and trying her best to cope with the disease, Ann is hoping for a cure but has become an advocate in her home and community for clean surroundings and preventative methods as she does not want another person to become a victim of the disease.

Her passion for prevention and sanitation is shared by Marvin Dindial, Regional Environmental Health Officer of Region Six. He believes hygiene plays an important role in the process and is a strong advocate for prevention.

Dindial and the team from the Vector Control Unit noted that a lot has been done to address the disease by the Pan American Health Organisation (PAHO) and the Ministry of Public Health, but feels that if everyone is more conscious of their environment and try to keep it clean; there will be less filaria cases.

“Basically these things are transferred by mosquitoes and sanitation plays a very important part in mosquito breeding; so as public health inspectors, we are pivoted on the ideology that source reduction is key and we try to reduce, remove or eliminate the sources of infection and this comes back to the basis of lot inspection and our department is very emphatical on lot inspection – we visit, inspect and advise on breeding grounds of mosquitoes. When we enforce the lot inspection, we try to guide and educate persons on the risk of not only filariasis alone, but other diseases that could really affect human health,” he said.

The Ministry of Public Health has partnered with PAHO, the US Centre for Disease Control (CDC) and other stakeholders to conduct a nationwide survey/re-mapping exercise on the prevalence of lymphatic filariasis in keeping with the national plan for the elimination of the disease.

MAPPING EXCERCISE
As a result, from October 1, the mapping exercise began in Regions One, Two, Six, Seven, Eight and Nine. In the 2001 survey, Regions Three, Four, Five and 10 have been identified as having the highest prevalence of filariasis.

As such, the second round of the Mass Drug Administration (MDA) campaign has begun on Monday in some of those regions.

Clarence Charles, a public health inspector who is also part of the mapping team in Region Six, explained that the mapping exercise targets children between the ages of 6-14 and requires taking a sample of blood to determine if and how many children are infected with the disease. In addition to testing for filaria, screening will also be done for malaria.

The results are usually ready in approximately 10 minutes and persons tested positive are referred to a healthcare facility. The data compiled also helps to map out the prevalence and concentration of the disease so that mass drug distribution and treatment can be strategically done.

Charles said it is expected that 10 teams of four will fan out across the length and breadth of Region Six over the next six weeks to try to complete the exercise on students whose parents have given consent for the samples to be taken.

However, work on this project began since the beginning of the year with awareness/education drive in schools and training.