Filariasis & Chickunguniya

FILARIASIS
DEFINITION
• Filariasis is an infectious
disease that is most likely
associated by microscopic
worms known as wuchereria
bancrofti, brugia
malayi, and brugia timori.
• Although this condition is not
really a life-threatening
disease, it can permanently
damage and dysfunction a
person’s lymphatic system.
• It is widely considered as a major cause of
disability and deformity in people who are
living in endemic areas and caused by Aedes
aegypti mosquito bite.
classification
1.Lymphatic Filariasis
• affects the lymphatic system
• can result to a more serious
complication such as enlargement of
body parts
• can cause pain and permanent
disability
2.Subcutaneous Filariasis
• Affects the subcutaneous area of the
skin
3.Serous Cavity Filariasis
• Affects the abdomen’s serious cavity
CLINICAL FEATURES
1. Fever that lasts for days
2. Lymphedema or tissue swelling
3. Elephantiasis or thickening of the body’s tissues
4. Scarring
5. In chronic cases,
• orchitis (inflammation of one or both testicles)
• Hydrocele (Scrotum swelling that occurs when fluid
collects surround testicle)
Diagnostic evaluation
• 1. Circulating filarial antigen (CFA)
• This diagnostic examination determines the presence

of W. bancrofti that is released by infected mosquitos.
It can be performed any time of the day.
• 2. Polymerase chain reaction (PCR)
• This diagnostic exam detects whether the body is

already infected by Filariasis.
Conti…
• 3. Blood smears
• This test can also be helpful in identifying roundworms and
any infection that takes place inside the body. It can be
conducted during selected times of the day, particularly during
at night since roundworms are nocturnal.(awake and active at
night)
• 4. Anti-filarial body tests
• This diagnostic exam determines the rise of IgG levels.
Although this test is essential in determining Filarial entry.
• 5. Ultrasound
• These tests distinguish any presence of worm in the

lymphatic system.
• 6. Skin test
• This test can also determine the presence of filarial

infection. Clients who undergo this test may
experience pain, medical professionals will use a tiny
razor blade to cut a small portion of the skin.
treatment
1. Ivermectine – drug of choice for W. bancrofti
2. Doxycycline – used to reduce tissue swelling
3. Suramin –effective against adult roundworms
4. Diethylcarbamazine (DEC) – treatment for W. bancrofti
5. Albendazole and Flubendazole – eliminate roundworms

easily
6. Hetrazan is the safe and effective drug against filarial

infection.
Nursing management
1. Monitor the client’s vital signs, particularly the temperature.
2. Assess skin color and integrity. Note for wounds, bleeding,
or any skin changes.
3. Assess for any discomfort and pain.
4. Provide wound care.
5. Elevate affected body area to reduce swelling.
6. Administer medications
7. Provide support to perform basic activities.
8. Encourage a range of motion and simple exercises of the
affected extremities to stimulate lymphatic flow.
9. Recognize the client’s self-esteem needs.
10.Provide health teaching and information for continuity of
care.
Control measures
•Early of detection of cases: Cases are detected by
microscopic examination of night blood and means taken
from apparently healthy individuals in endemic areas.
•Specific treatment: Hetrazan is the only safe and

effective drug against filarial infection. The recommended
dose is 6 mg per kg body weight daily for 12 doses, to be
completed in 2 weeks. The drug destroys the micro-filarial
and possible adult worms too.
•Control of mosquitoes: Elimination of mosquito
breeding places such as open drains, and other
collection of standing water is an important long-term
control measure for the control of mosquitoes.
Antilarval measures such as weekly application of
larvicidal oils on all mosquito breeding places are
important temporary measures of mosquito control.
•Health education: Filariasis is a man-made disease;

it is associated with bad drainage and poor
environmental sanitation. Therefore health education
of the general public is very important in dealing with
this problem.
Chikungunya fever
definition
•Chikungunya fever is an
infection caused by
Chikungunya virus. It is
transmitted by Aedes
aegyptior, Aedes albopictus
mosquitoes.
etiology
• 1. Chikungunya virus is an alpha virus that

belongs to the Togaviridae family.
• 2. It spreads by the bite of an infected mosquito.
• 3. The incubation period can be 2-12 days,
• 4. Silent chikungunya virus infections do occur

though rarely.
Risk factors
• 1. Climate; hot, humid or rainy season.

• 2. Pregnant women
• 3. Newborns
• 4.Cardiovascular, neurologic and respiratory
diseases.
• 5. Areas with more collected water.
Clinical features
•1. Sudden onset of high fever,

joint pain and Rashes
•2. Headache
•3. Fatigue and nausea.
•4 Digestive complaints
•5. Conjunctivitis
Diagnostic evaluation
•1. Serological diagnosis(significant increase in the

level of specific IgG Antibodies)
•2.ELISA(Enzyme linked immunosorbent assay) test is

used to detect immunoglobulin (IgM).
•3. RT-PCR test.(Real time reverse transcriptase

polymerase chain reaction.
management
There is no vaccine to prevent or to treat chikungunya virus.
2. Treat the symptoms by the following:

a. Complete bed rest.
b. Drink plenty of fluids to prevent dehydration.
3. Take medicine, such as acetaminophen or paracetamol to

reduce fever and pain.
4. Do not take aspirin and NSAIDs until dengue can be ruled

out to reduce the risk of bleeding.
5. Prevention from mosquito bites for the first week or illness:
a. During the first week of infection, chikungunya virus can
be found in the blood and passed from an infected person to a
mosquito through mosquito bites.
b. An infected mosquito can then spread the virus to other
people.
6. Vector control: The aedes aegypti mosquito should be the

main target of control activities. It requires active community
involvement to keep water storage contained free of
mosquitoes. Another techniques. consisting of aerosol spray
of ultra low volume quantities of malathion.
7. Wear long sleeves and pants.

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FILARIASIS

2. Lymphedema or tissue swelling

3. Elephantiasis or thickening of the body’s tissues

• This diagnostic examination determines the presence

• 2. Polymerase chain reaction (PCR)

• This diagnostic exam detects whether the body is

• These tests distinguish any presence of worm in the

• This test can also determine the presence of filarial

2. Doxycycline – used to reduce tissue swelling

3. Suramin –effective against adult roundworms

4. Diethylcarbamazine (DEC) – treatment for W. bancrofti

5. Albendazole and Flubendazole – eliminate roundworms

6. Hetrazan is the safe and effective drug against filarial

•Specific treatment: Hetrazan is the only safe and

•Health education: Filariasis is a man-made disease;

• 1. Chikungunya virus is an alpha virus that

• 3. The incubation period can be 2-12 days,

• 4. Silent chikungunya virus infections do occur

• 1. Climate; hot, humid or rainy season.

•1. Sudden onset of high fever,

•3. Fatigue and nausea.

•1. Serological diagnosis(significant increase in the

•2.ELISA(Enzyme linked immunosorbent assay) test is

•3. RT-PCR test.(Real time reverse transcriptase

There is no vaccine to prevent or to treat chikungunya virus.

2. Treat the symptoms by the following:

3. Take medicine, such as acetaminophen or paracetamol to

4. Do not take aspirin and NSAIDs until dengue can be ruled

6. Vector control: The aedes aegypti mosquito should be the

7. Wear long sleeves and pants.

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