DOI: http://dx.doi.org/10.18203/2349-2902.isj20200562

Incidence of filariasis in clinically diagnosed primary vaginal hydrocele

Mahendra Bendre, Shrreya Akhil, Srujan Kondreddy

Abstract


Background: Lymphatic filariasis is caused by a mosquito-borne parasite affecting roughly 100 million people round the world. There is consensus that hydrocele is the most frequent clinical manifestation of bancroftian filariasis. In endemic areas, about 40% of men are suffering from testicular hydrocele. With this background, the present study was aimed to find the incidence of filariasis in clinically diagnosed primary vaginal hydrocele.

Methods: A hospital based prospective, cross-sectional study was conducted with 60 patients diagnosed clinically as primary vaginal hydrocele coming to the department of surgery, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune, to assess the incidence of filariasis.

Results: Anti-filarial antibody and circulating filarial antigen in serum were detected in 5 (8.3%). Out of 60 patients and anti-filarial antibody was detected in hydrocele fluid of 2 (3.3%) patients. 2 patients out of these 5 showed microfilaria in peripheral blood smear and eosinophilic infiltrates in histopathological examination of sac.

Conclusions: In 5 out of 60 cases both anti-filarial antibody and circulating filarial antigen in serum are positive thus proving that incidence of filarial hydrocele is 8% in clinically diagnosed primary vaginal hydrocele which is supposed to be idiopathic. Even though these cases have presented as clinically primary vaginal hydrocele, they are found to be filarial hydrocele after analysis of serum and hydrocele fluid. So, it is advised that all cases of clinically diagnosed primary vaginal hydroceles should be investigated for filariasis and if not, may lead to recurrence in these cases.


Keywords


Anti-filarial antibody, Circulating filarial antigen, Filariasis, Hydrocele

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References


World Health Organization. Global programme to eliminate lymphatic filariasis. Wkly Epidemiol Rec. 2005;80:202-12.

Michael E, Bundy DAP, Grenfell BT. Re-assessing the global prevalence and distribution of lymphatic filariasis. Parasitology. 1996;112(4):409-28.

Thambugala RL. The radical cure of hydrocele of the tunica vaginalis: the technique of excision of the sac. Brit J Surg. 1971;58(7):517-8.

Gratama S. The pathogenesis of hydrocele in filarial infection. Trop Geogr Med. 1969;21(3):254-68.

Wijers DJB. Bancroftian filariasis in Kenya. I. Prevalence survey among adult males in the coast province. Ann Trop Med Parasitol. 1977;71(3):313-31.

Pani SP, Balakrishnan N, Srividya A, Bundy DA, Grenfell BT. Clinical epidemiology of bancroftian filariasis. Effect of age and gender. Trans R Soc Trop Med Hyg. 1991;85(2):260-4.

Sivam NS, Jayanthi S, Ananthakrishnan N, Elango A, Yuvaraj J, Hoti SL, et al. Tropical vaginal hydroceles. Are they all filarial in origin? Southeast Asian J Trop Med Public Health. 1995;26(4):739-42.

Sabesan S, Palaniyandi M, Das PK, Michael E. Mapping of lymphatic filariasis in India. Ann Trop Med Parasitol. 2000;94(6):591-606.

Sabesan S, Vanamail P, Raju KH, Jambulingam P. Lymphatic filariasis in India: Epidemiology and control measures. J Postgrad Med. 2010;56(3):232.

National Vector Borne Disease Control Programme, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India. Available at: http://www.nvbdcp.gov.in/filariasis-new.html Accessed on 13 January 2010.

Kar SK, Mania J. Filarial hydrocele and its treatment with DEC. Progress in Lymphology. XIV.: Proceedings of the XIV International Congress of Lymphology: Washington DC: 1993: 364.

Bernhard P, Magnussen P, Lemnge MM. A randomized, double-blind, placebo-controlled study with diethylcarbamazine for the treatment of hydrocoele in an area of Tanzania endemic for lymphatic filariasis. Trans R Soc Trop Med Hyg. 2001;95:534-6.

Albrecht W. Holtl W, Aharinejad S. Lord's procedure - the best operation for hydrocele. J Urol. 1991;68:187-9.

Das S, Tuerk D, Amar AD, Sommer J. Surgery of male genital lymphedema. J Urol. 1983;129(6):1240-2.

Ku JH, Kim ME, Lee NK, Park YH. The excisional, plication and internal drainage techniques: a comparison of the results for idiopathic hydrocele. BJU international. 2001;87(1):82-4.

Mathieu E, Dorkenoo A, Otogbe FK, Budge PJ, Sodahlon YK. A laboratory-based surveillance system for Wuchereria bancrofti in Togo: a practical model for resource-poor settings. Am J Trop Medi Hyg. 2011;84(6):988-93.

Uttah EC. Prevalence of endemic Bancroftian filariasis in the high altitude region of south-eastern Nigeria. J Vector Borne Dis. 2011;48(2):78-84.

Meyrowitsch DW, Simonsen PE, Garred P, Dalgaard M, Magesa SM, Alifrangis M. Association between mannose-binding lectin polymorphisms and Wuchereria bancrofti infection in two communities in North-Eastern Tanzania. Am J Trop Med Hyg. 2010;82(1):115-20.

Nicolas L. New tools for diagnosis and monitoring of bancroftian filariasis parasitism: The Polynesian experience. Parasitol Today. 1997;13:370-5.

Bhumiratana A, Siriaut C, Koyadun S. Evaluation of a single oral dose of diethylcarbamazine 300 mg as provocative test and simultaneous treatment in Myanmar migrant workers with Wuchereria bancrofti infection in Thailand. Southeast Asian J Trop Med Public Health. 2004;35:591-8.

Rao KV, Eswaran M, Ravi V, Gnanasekhar B, Narayanan RB, Kaliraj P, Jayaraman K, et al. The Wuchereria bancrofti orthologue of Brugia malayi SXP1 and the diagnosis of bancroftian filariasis. Mol Biochem Parasitol. 2000;107(1):71-80.

Baskar LK, Srikanth TR, Suba S, Mody HC, Desai PK, Kaliraj P, et al. Development and evaluation of a rapid flow-through immuno filtration test using recombinant filarial antigen for diagnosis of brugian and bancroftian filariasis. Microbiol Immunol. 2004;48(7):519-25.

Ambily VR, Pillai UN, Kanaran PP. Immunological diagnosis of lymphatic filariasis in dogs of Kerala, India using filarial antibody detection immunospot test. J Immunol Tech Infect Dis. 2014;3:2.

Rocha A, Braga C, Belém M, Carrera A, Aguiar-Santos A, Oliveira P, et al. Comparison of tests for the detection of circulating filarial antigen (Og4C3-ELISA and AD12-ICT) and ultrasound in diagnosis of lymphatic filariasis in individuals with microfilariae. Mem Inst Oswaldo Cruz. 2009;104(4):621-5.

Goel RS, Verma NS, Mullan SA, Ashdown AC. Detection of filarial antigen and antibody in serum and hydrocele fluid of 100 patients of hydrocele. Intern J Urol. 2006;13:565-8.

Mahaboob S. Retrosepctive study of sac eversion with minimal separation: surgical experiance of 25 years for hydrocele. Asian Pac J Health Sci. 2015;2(1):18-21.

Khandelwal R, Agnihotri N, Pandey S. Unanticipated cytodiagnosis of filariasis: A Study of 16 cases. Int J Med Res Rev. 2018;6(03):166-76.

Singh AK, Agarwal L, Lakhmani K, Sengupta C, Singh RP. Detection of anti-filarial antibody among hydrocele patients living in an endemic area for filariasis. J Family Med Prim Care. 2016,5(3):553-7.

Shah AP, Mulla SA. Circulating filarial antigen in serum and hydrocele fluid from individuals living in an endemic area for bancroftian filariasis. Indian J Med Microbiol. 2007;25(3):253-5.

Rocha A, Lima G, Medeiros Z, Aguiar-Santos A, Alves S, Montarroyos U, et al. Circulating filarial antigen in the hydrocele fluid from individuals living in a bancroftian filariasis area – Recife, Brazil: Detected by the monoclonal antibody Og4C3-assay. Mem Inst Oswaldo Cruz. 2004;99(1):101-5.

Dandapat MC, Mohapatro SK, Mohanty SS. The incidence of Filaria as an aetiological factor for testicular hydrocele. Br J Surg. 1986;73(1):77-8.

Mishra S, Achary KG, Mandal NN, Tripathy A, Kar SK, Bal MS. Hydrocele fluid: Can it be used for immunodiagnosis of lymphatic filariasis? J Vector Borne Dis. 2014;51(3):188-93.