Working together to fight filariae in Uganda
Prof. Eisaku Kimura, center-right
During October and November in 2014, an investigation on lymphatic filariasis was carried out in the Gulu District and surrounding areas in the northern part of Uganda. While a popular method of diagnosing lymphatic filariasis is to observe the microfilariae produced by female filariae under microscope, microfilariae appear in the blood stream only at night and therefore we had to take blood samples starting from 8:30 p.m. Villages in endemic areas do not have a supply of electricity and so we collected drops of blood from fingertips under paraffin lamps. The investigation during October and November coincided with the rainy season, and often we would experience sudden changes from clear starlit skies to heavy rains. Prepared for these conditions, the villagers trudged along the rough paths and gathered in the appointed place. Deep in the darkness, they waited patiently without complaint and endured the pain of drawing blood. More than 1,000 people cooperated for this investigation.
With the progression of the global program to eliminate filariasis, the infected population in Uganda is decreasing due to mass drug administration. In order to gain an accurate assessment on the rate of reduction, it is necessary to repeatedly obtain blood samples. Thus, even in areas with low rates of infection, it requires taking blood from hundreds of villagers in order to identify several infected individuals. Furthermore, in order to make sure there are no infected individuals and that lymphatic filariasis has been eliminated in Uganda, it is necessary to draw blood from tens of thousands of people. A joint effort is underway on a global scale, with people taking medicine and cooperating with blood sampling for their communities even if they believe they are not infected. I sincerely appreciate their support and cooperation throughout the investigation.
The transmission of lymphatic filariasis can be prevented with proper treatment. With support from the pharmaceutical industry, hundreds of millions of people now have access to medicines against lymphatic filariasis. In the past, this was merely a dream. Unfortunately, the symptoms of lymphatic filariasis such as elephantiasis and scrotal swelling do not disappear even after deworming. During the investigation, many elephantiasis patients came to see me, seeking treatment for their swollen legs. The condition is known to deteriorate by bacterial infections through the skin, but I found patients are still living barefoot. I sincerely hope for further progress in global collaboration beyond the communities and sectors so that we can break the vicious cycle of disease and poverty.