Introduction:

Loa loa filariasis, commonly known as African eye worm, is a parasitic infection caused by the nematode worm Loa loa. This tropical disease is prevalent in rainforest regions of Central and West Africa, where it is transmitted to humans through the bite of infected deer flies or mango flies. In this article, we will explore the causes, symptoms, diagnosis, and treatment of Loa loa filariasis.

1. Causes:

Loa loa filariasis is caused by the parasitic nematode Loa loa, commonly referred to as the African eye worm. Humans become infected when they are bitten by infected deer flies (Chrysops species) or mango flies (Mangoesteen flies - Cordylobia anthropophaga). These flies act as vectors, transmitting the infective larvae of the worm into the human host during the feeding process.

2. Symptoms:

After an infected fly bite, it takes several months for the larvae to mature into adult worms and migrate through the subcutaneous tissues. Common symptoms of Loa loa filariasis include:

• Subcutaneous swelling (calabar swelling): Painful, localized swellings that occur on the arms, legs, or other body parts as the worm migrates beneath the skin.
• Eye involvement: Adult worms may migrate across the conjunctiva (the thin membrane covering the white part of the eye), leading to ocular manifestations. Patients may experience eye pain, redness, and discomfort.

3. Diagnosis:

Diagnosing Loa loa filariasis involves clinical evaluation and laboratory tests. The primary methods of diagnosis include:

• Physical examination: A healthcare professional will assess the presence of characteristic calabar swellings and eye involvement.
• Blood smear examination: Microscopic examination of a blood smear can reveal the presence of microfilariae (larval stages of the worm) circulating in the blood. These are more easily detected during daytime when the microfilariae are most active.

4. Treatment:

The treatment of Loa loa filariasis aims to eradicate the parasitic worms and alleviate symptoms. Common treatment options include:

• Diethylcarbamazine (DEC): This oral medication is the mainstay of treatment for Loa loa filariasis. It effectively kills both adult worms and microfilariae.
• Ivermectin: In some cases, a combination of ivermectin and DEC may be used to treat the infection.

5. Prevention:

Preventing Loa loa filariasis largely involves controlling the transmission of the parasite. This can be achieved through various measures:

• Using insect repellents and protective clothing: When traveling or residing in endemic areas, wearing long-sleeved clothing and using insect repellents can help reduce the risk of fly bites.
• Avoiding outdoor activities during peak fly activity: Deer flies are most active during the daytime, especially around dusk and dawn. Limiting outdoor activities during these times can lower the risk of exposure.

6. Prognosis:

With timely and appropriate treatment, the prognosis for Loa loa filariasis is generally good. Most patients experience resolution of symptoms and elimination of the parasite from the bloodstream. However, recurrent infections can occur if re-exposure to infected flies takes place.

Conclusion:

Loa loa filariasis, also known as African eye worm, is a parasitic infection transmitted through the bites of infected deer flies or mango flies. Early diagnosis and treatment are essential to manage symptoms and prevent complications. Travelers to endemic regions should take preventive measures to avoid exposure to the parasite and reduce the risk of infection.

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