ULTRASONOGRAPHIC EXAMINATION OF HAITIAN CHILDREN WITH LYMPHATIC FILARIASIS: A LONGITUDINAL ASSESSMENT IN THE CONTEXT OF ANTIFILARIAL DRUG TREATMENT

Clinical and subclinical findings of LF in FDS-positive children after three annual cycles of mass treatment for lymphatic filariasis (LF) are demonstrated.

Abstract

To assess the clinical findings associated with detection of adult Wuchereria bancrofti worms on ultrasound, 186 schoolchildren in a filariasis-endemic area of Haiti underwent physical and ultrasonographic examinations. The filaria dance sign (FDS) of adult W. bancrofti was detected in the inguinal and crural lymphatics of 28 (15%) children. FDS detection was more common in older children (P = 0.003) and in those with a history of inguinal lymph node inflammation (P = 0.002) or crural lymphadenopathy on physical exam (P = 0.01). Twenty-five FDS-positive children were reexamined after three annual cycles of mass treatment for lymphatic filariasis (LF). The total number of adult worm nests detected by ultrasound decreased from 29 to 4 (P </=0.0001). FDS and lymphangiectasia were detected in the intrascrotal (N = 3) and inguinal (N = 1) lymphatic vessels of three postpubescent boys. This study demonstrates clinical and subclinical findings of LF in FDS-positive children.