Speaker
Description
Background: Filarial lymphoedema, commonly called elephantiasis, is a long-term and disabling condition caused by parasitic worms transmitted by mosquitoes. With over 15 million people affected worldwide, it causes swelling in the legs and recurrent painful episodes called acute adenolymphangitis (ADL) attacks, characterized by fevers, chills, and lymph node inflammation. These attacks are thought to be triggered by bacterial infections entering through wounds or lesions on the legs. Current knowledge of the skin microbiome, wound infections, and immune response during acute ADL attacks is limited, yet addressing these gaps is essential to improve lower-extremity management and to strengthen the World Health Organization’s Global Programme to Eliminate Lymphatic Filariasis (GPELF) strategy for reducing filariasis-related morbidity
Method: Thus, a longitudinal case-control study is being conducted in the Upper East Region of Ghana, with 200 participants to investigate changes in the skin microbiome, detect potential bacterial species in peripheral blood during ADL attacks, and characterize the corresponding immune profile.
Results: To date, the study has recorded 15 acute ADL attacks (9.6%), but blood cultures so far have been negative for bacteria, fungi, or yeasts. Most attacks occurred following injuries to the lymphoedematous legs. Ongoing assessments are focused on evaluating changes in the skin microbiome in relation to the severity of lymphoedema and the occurrence of acute attacks.
Conclusion: Preliminary findings suggest that leg injuries are the main triggers of ADL attacks in the study population. Insights from this study will inform policies on hygiene-based management and guide the development of targeted antimicrobial strategies, contributing significantly to improved care and antimicrobial stewardship.
Keywords: microbiome, lymphoedema, AMR