Page 197 - Learnwell EVS
P. 197
ariasis
– Doxycycline P O , w h en ad m inistered as a prolong ed treatm ent, elim inates th e m ajority
of m acrofilariae and red uces lym ph oed em a: 2 0 0 m g / d ay for 4 w eeks m inim um .
It is
contra-ind icated in ch ild ren < 8 years and preg nant or breast-feed ing w om en.
– Diethylcarbamazine P O as a sing le d ose (4 0 0 m g in ad ults; 3 m g / kg in ch ild ren) m ay
be
an alternativ e but elim inates a v ariable proportion of ad ult w orm s (up to 4 0 % ) and
dLooaeslonaomt reilcierovfeilasryiaml lopatdom> s2;0a0pr0olmongf/emd trleaantmd inenptreisgnnoanmt aonrde berffeeacstitv-feetdh inang swingolme en.
d ose th erapy. In ad d ition, D E C is contra-ind icated in patients w ith onch ocerciasis or
– I v erm ectin (w eak or absent m acrofilaricid al effect) and albend azole sh ould not be
used for th e treatm ent of ind iv id ual cases (no effect on sym ptom s).
– In th e case of confirm ed or probable co-infection w ith O. volvulus: treat onch ocerciasis
first (see pag e 1 5 7 ), th en ad m inister d oxycycline.
Control/prevention of inflammatory manifestations and infectious complications
– A cute attacks: bed rest, elev ation of th e affected lim b w ith out band ag ing , cooling of
th e affected lim b (w et cloth , cold bath ) and analg esics; antibacterial or antifung al
cream if necessary; antipyretics if fev er (paracetam ol) and h yd ration.
extrem ity , com fortable footw ear, im m ed iate attention to second ary bacterial/ fung al
– P rev ention of episod es of lym ph ang itis and lym ph oed em a: h yg iene of th e affected
8
infections and w ound s.
– E stablish ed lym ph oed em a: band ag ing of th e affected lim b by d ay, elev ation of th e
affected extrem ity ( after rem ov al of th e band ag e) w h en at rest, sim ple exercises
(flexion-extension of th e feet w h en recum bent or uprig h t, rotation of th e ankles); skin
h yg iene, as abov e.
Surgery
M ay be ind icated in th e treatm ent of ch ronic m anifestations: ad v anced lym ph oed em a
(d iv ersion-reconstruction), h yd rocoele and its com plications, ch yluria.
8 Wash at least once daily (soap and water at room temperature), paying special attention to folds and interdigital
areas; rinse thoroughly and dry with a clean cloth; nail care.
162
– Doxycycline P O , w h en ad m inistered as a prolong ed treatm ent, elim inates th e m ajority
of m acrofilariae and red uces lym ph oed em a: 2 0 0 m g / d ay for 4 w eeks m inim um .
It is
contra-ind icated in ch ild ren < 8 years and preg nant or breast-feed ing w om en.
– Diethylcarbamazine P O as a sing le d ose (4 0 0 m g in ad ults; 3 m g / kg in ch ild ren) m ay
be
an alternativ e but elim inates a v ariable proportion of ad ult w orm s (up to 4 0 % ) and
dLooaeslonaomt reilcierovfeilasryiaml lopatdom> s2;0a0pr0olmongf/emd trleaantmd inenptreisgnnoanmt aonrde berffeeacstitv-feetdh inang swingolme en.
d ose th erapy. In ad d ition, D E C is contra-ind icated in patients w ith onch ocerciasis or
– I v erm ectin (w eak or absent m acrofilaricid al effect) and albend azole sh ould not be
used for th e treatm ent of ind iv id ual cases (no effect on sym ptom s).
– In th e case of confirm ed or probable co-infection w ith O. volvulus: treat onch ocerciasis
first (see pag e 1 5 7 ), th en ad m inister d oxycycline.
Control/prevention of inflammatory manifestations and infectious complications
– A cute attacks: bed rest, elev ation of th e affected lim b w ith out band ag ing , cooling of
th e affected lim b (w et cloth , cold bath ) and analg esics; antibacterial or antifung al
cream if necessary; antipyretics if fev er (paracetam ol) and h yd ration.
extrem ity , com fortable footw ear, im m ed iate attention to second ary bacterial/ fung al
– P rev ention of episod es of lym ph ang itis and lym ph oed em a: h yg iene of th e affected
8
infections and w ound s.
– E stablish ed lym ph oed em a: band ag ing of th e affected lim b by d ay, elev ation of th e
affected extrem ity ( after rem ov al of th e band ag e) w h en at rest, sim ple exercises
(flexion-extension of th e feet w h en recum bent or uprig h t, rotation of th e ankles); skin
h yg iene, as abov e.
Surgery
M ay be ind icated in th e treatm ent of ch ronic m anifestations: ad v anced lym ph oed em a
(d iv ersion-reconstruction), h yd rocoele and its com plications, ch yluria.
8 Wash at least once daily (soap and water at room temperature), paying special attention to folds and interdigital
areas; rinse thoroughly and dry with a clean cloth; nail care.
162
