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Infection and disease in lymphatic filariasis: an epidemiological approach

Published online by Cambridge University Press:  06 April 2009

B. T. Grenfell  and
E. Michael
B. T. Grenfell
Affiliation:
Department of Zoology, Cambridge University, Downing Street, Cambridge CB2 3EJ, UK
E. Michael
Affiliation:
Department of Zoology, Cambridge University, Downing Street, Cambridge CB2 3EJ, UK
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Extract

A major question in the study of any parasitic disease is the relationship between infection and clinical disease. The public health importance of lymphatic filariasis has generated a large body of research in this area, both in laboratory studies (Ottesen, 1984,1989; Maizels & Lawrence, 1991) and in the field (Hayashi, 1962; Hairston & Jachowski, 1968; Denham & McGreevy, 1977; Vanamail et al. 1989 b; Bundy, Grenfell & Rajagopalan, 1991; Srividya et al. 1991 b). Despite this, there is still no conclusive explanation for the apparently complex relationship between infection and clinical disease observed in human communities. At least part of the problem may lie in the current impossibility of measuring adult worm burden in vivo (Pichon et al. 1980; Denham & Fletcher, 1987; Das et al. 1990; Grenfell et al. 1990). Although there has recently been significant progress in the development of immuno logical markers for infection status in humans (Ottesen, 1989; Day et al. 1991 a), microfilaraemia is still the most reliable measure of current infection in the field. Studies in endemic areas indicate that, far from there being any simple direct relationship between microfilaraemia and disease status, it is possible to find some individuals with microfilariae in their blood but no disease, and indeed with all other combinations of infection and disease status (Hairston & de-Meillon, 1968; Hairston & Jachowski, 1968; Beaver, 1970; Bryan & Southgate, 1976; Denham & McGreevy, 1977; Pani et al. 1991). Furthermore, the proportions of people in different categories are often observed to vary between endemic areas (Denham & McGreevy, 1977; Day et al. 1991 a).

Type
Lymphatic Filariasis
Information
Parasitology , Volume 104 , Issue S1: Symposia of the British Society for Parasitology Volume 29:Human parasitic disease: the complementory roles of field and laboratory studies , June 1992 , pp. S81 - S90
Copyright
Copyright © Cambridge University Press 1992

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