Bancroftian filariasis in a paediatric population: an ultrasonographic study

Area of Science:

• Tropical Medicine
• Parasitology
• Medical Imaging

Background:

• Lymphatic filariasis, caused by Wuchereria bancrofti, is a significant public health concern.
• The precise anatomical location of adult W. bancrofti in children remains poorly understood.
• Understanding worm location is crucial for diagnosis and treatment strategies.

Purpose of the Study:

• To determine the anatomical location of adult Wuchereria bancrofti in children using ultrasound.
• To investigate the association between W. bancrofti infection and clinical signs of filariasis in pediatric populations.
• To evaluate the utility of the filaria dance sign (FDS) in diagnosing lymphatic filariasis in children.

Main Methods:

• Seventy-eight children from Greater Recife underwent ultrasound examinations of superficial lymphatic vessels.
• Ultrasound focused on limbs, scrotal area (boys), and breast area (girls).
• The characteristic 'filaria dance sign' (FDS) indicating adult worm movement was specifically sought.

Main Results:

• The filaria dance sign (FDS) was detected in 14.1% of children.
• In boys, FDS was found in scrotal lymphatic vessels and the inguinal cord; in girls, in a crural lymphatic vessel and axillary lymph node.
• FDS detection was more frequent in boys, older children, and those with microfilaraemia. Diffuse lymphangiectasia was observed in 4 boys.

Conclusions:

• Ultrasound visualization of adult W. bancrofti via FDS is feasible in children.
• The study identifies specific anatomical locations for adult worms in pediatric lymphatic filariasis.
• Ultrasonographic findings correlate W. bancrofti infection with disease manifestations in children, highlighting the role of imaging in diagnosis.