Prevalence of lymphatic nodule in a bancroftian endemic population

Prevalence and clinical manifestation of lymphatic nodule in natural course of bancroftian filariasis was evaluated in a representative population of 2837 of a defined endemic community of Orissa. Detailed clinical and parasitological examination of study subjects revealed high disease (35.6%) and mf rate (15.8%) and mean microfilariae density (GM: 15.3 +/- 5.1 per 60 mm3 of blood) in the community. Lymphatic filarial nodule was manifested in 216 (7.6%) subjects in different spectrum of filarial infection including endemic normals and asymptomatic mf carriers. Significant proportion of cases with acute filarial disease in the community manifested nodule. Significant proportion of cases with nodule had microfilaraemia (33.3%) as compared to that of community. However highest frequency of nodule was observed amongst microfilaraemics with lowest density of microfilaraemia in the community (P < 0.05.). This possibly indicates microfilariae clearance from circulation as a consequence of death of adult parasite. The above observations suggest that lymphatic nodules may manifest as an early and/or the only clinical sign of bancroftian filariasis. This might have been mediated through either the attempt of the immuno-competent host to kill the adult parasite in a similar fashion that is effected through DEC or by death of the mature parasite in its natural process of attrition.