Lymphatic filariasis increases tissue compressibility and extracellular fluid in lower limbs of asymptomatic young people in Central Myanmar

Journal Publication ResearchOnline@JCU
Douglass, Janet;Graves, Patricia;Lindsay, Daniel;Becker, Luke;Mason, Jesse;Aye, Ni Ni;Win, San San;Wai, Tint;Win, Yi Yi;Gordon, Susan
Abstract

When normal lymphatic function is hampered, imperceptible subcutaneous edema can develop and progress to overt lymphedema. Low-cost reliable devices for objective assessment of lymphedema are well accepted in clinical practice and research on breast-cancer related lymphedema but are untested in populations with lymphatic filariasis (LF). This is a cross-sectional analysis of baseline data in a longitudinal study on asymptomatic, LF antigen-positive and -negative young people in Myanmar. Rapid field screening was used to identify antigen-positive cases and a group of antigen-negative controls of similar age and gender were invited to continue in the study. Tissue compressibility was assessed with three tissue tonometers, and free fluids were assessed using bio-impedance spectroscopy (BIS). Infection status was confirmed by Og4C3 antigen assay. At baseline (n= 98), antigen-positive cases had clinically relevant increases in tissue compressibilityat the calf using a digital Indurometer (11.1%, p = 0.021), and in whole-leg free fluid using BIS (9.2%, p = 0.053). Regression analysis for moderating factors (age, gender, hydration) reinforced the between-infection group differences. Results demonstrate that sub-clinical changes associated with infection can be detected in asymptomatic cases. Further exploration of these low-cost devices in clinical and research settings on filariasis-related lymphedema are warranted.

Journal

Tropical Medicine and Infectious Disease

Publication Name

Tropical Medicine and Infectious Disease

Volume

2

ISBN/ISSN

2414-6366

Edition

N/A

Issue

4

Pages Count

14

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Publisher

MDPIAG

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Publisher Location

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Date

N/A

EISSN

N/A

DOI

10.3390/tropicalmed2040050