Project: Impact of secondary bacterial infection in the development of filarial lymphedema among Ghanaian patients

Acronym SecBILE (Reference Number: TMA2016CDF-1561)
Duration 01/07/2018 - 30/06/2021
Project Topic Filarial infections affect >150 million people in the tropics (Kwarteng, Ahuno et al. 2016). One of major forms to be dealt with in this project is lymphedema caused by Wuchereria bancrofti in Africa. The chronicity and morbidity of lymphatic filariasis (LF) is associated with the longevity of the adult worm (>5 years) and the production of millions of microfilariae (MF), which populate the blood. Existing control programmes by the WHO rely on mass administration of mainly microfilariacidal drugs (MDA) that have the potential to reduce MF loads in infected humans and thus, transmission by the insect vector (Hoerauf 2008). However, several challenges may impede sustainable control and have therefore induced the call to search for alternative and effective approach (Taylor 2002) in understanding the pathogenesis of lymphedema (LE) as well offering possible option of providing support for individuals with this stage of the LF (Hoerauf 2003). In LF, there are additional problems regarding morbidity, which is imposed not by MF, but by adult worms that induce an alteration of the lymphatic vessels where they reside, causing both vessel obstruction and dilatation. This results in lymphatic pathology, where two of the manifestations being hydrocele and lymphedema (Pfarr, Debrah et al. 2009). Furthermore, exogenous bacterial that enter through skin lesions are believed to aggravate lymphedema though secondary infections (Dreyer, Addiss et al. 2006). Therefore, proving the hypothesis of exogenous bacterial being major mediators of lymphedema could lead to complementary chemotherapy approaches against this condition. This is very important because the problem of current WHO control programmes is that although transmission can be targeted with the existing microfilariacidal drugs, morbidity (LE and hydrocele) from which >40 million people suffer, cannot be sufficiently approached by anti-filarial chemotherapy. This is particularly true for Africa, which bears one third of the LF cases, and for which current chemotherapy being used for MDA (Diethylcabamazine, ivermectin and albendazole) shows no or partial macrofilaricidal effect therefore not able to target the adult worms which cause LF pathology (Goebel, Ulmer et al. 2008). Whiles some studies have been conducted in South America by Dreyer’s group, the bacterial which are believed to contribute to lymphedema progression in Ghana remains to be studied (Shenoy, Sandhya et al. 1995).
Network EDCTP2
Call Career Development Fellowships 2016

Project partner

Number Name Role Country
1 Kwame Nkrumah University of Science and Technology Coordinator Ghana