What are the Filarial Diseases?
Lymphatic filariasis (Elephantiasis)
Over 120 million infected 
40 million disfigured or incapacitated  More than 1.4 billion people at risk 
More than 25 million men with genital disease 
More than 15 million people with lymphoedema or elephantiasis of the leg 
DALYs estimated at 2.8 million worldwide 
Onchocerciasis (River Blindness)
Over 37 million infected 
About 169 million at risk 
6.5 million suffer from severe itching or dermatitis
270 000 are blind 
DALYs estimated at nearly 600,000 worldwide 
Lymphatic filariasis (Elephantiasis) affects over 120 million people living in tropical areas of the world. About 80% of people at risk live in the following 10 countries: Bangladesh, Democratic Republic of Congo, Ethiopia, India, Indonesia, Myanmar, Nigeria, Nepal, Philippines, and the Republic of Tanzania.
Onchocerciasis (River blindness) is almost exclusively confined to West and Central Africa, although there are localized infections in Yemen and some South American countries.
Loiasis (Loa loa infection) occurs in the rain forest and swamp areas of West Africa and in Central Africa.
Onchocerciasis (River blindness), Lymphatic filariasis (Elephantiasis) and Loiasis (Loa loa infection) are all caused by parasitic filarial nematode worms that are transmitted between humans by blood-sucking insects.
Onchocerciasis is caused by Onchocerca volvulus, transmitted by the bite of an infected female blackfly; lymphatic filariasis is caused by Wuchereria bancrofti (90% of cases), Brugia malayi (most of the remainder) and Brugia timori, and is transmitted by various mosquito species; Loa loa worms are transmitted by the bites of Mango flies or by Deer flies (Chrysops spp.).
Filarial diseases are the most devastating of the neglected tropical diseases in terms of social and economic impact. Families and communities have to bear the brunt of long-term healthcare, coupled with loss of productivity and earnings due to the incapacity to work. The disabling and disfiguring effects on the individual lead to social stigmatization and isolation.
Filarial disease is not particularly life-threatening, but Onchocerciasis and Lymphatic filariasis cause long-term suffering and chronic disease with life-long disabilities in millions of people worldwide, such as blindness, severe itching and dermatitis (onchocerciasis), and swollen limbs and genitals (lymphatic filariasis). Loiasis is usually considered asymptomatic but can cause localized swellings associated with localized and generalized itching.
Patient Treatments Needs
Programs for the treatment and control of filarial diseases through mass drug administration (MDA) have been in place for over 20 years. However current treatments target the juvenile worm (microfilariae) and need to be repeated for 5 years in the case of lymphatic filariasis, and for 12-15 years in the case of onchocerciasis. Therefore, there is an unmet medical need for a drug that can kill the adult worms (macrofilaricide). A new, safe, short-course macrofilaricidal drug could be used in individual patient treatment and to help the elimination effort in MDA programmes and ideally also in patients with Loa loa co-infection.
 WER 13 September 2013, vol. 88, 37 (pp. 389–400) Global programme to eliminate lymphatic filariasis: progress report for 2012
 Global Burden of Disease 2012: http://www.who.int/entity/healthinfo/global_burden_disease/GHE_DALY_WHOReg6_2000_2012.xls
 WHO, “Weekly epidemiological record Relevé épidémiologique hebdomadaire Meeting of for Disease Eradication –,” no. June, pp. 197–208, 2007.
 WHO, “Africa Programme for Onchocerciasis Control: progress report, 2013-2014,” Wkly. Epidemiol. Rec., no. 49, pp. 545–560, 2014.
 Onchocerciasis – river blindness Fact sheet N°95
 Zouré HGM, Wanji S, Noma M, Amazigo UV, Diggle PJ, et al. (2011) The Geographic Distribution of Loa loa in Africa: Results of Large-Scale Implementation of the Rapid Assessment Procedure for Loiasis (RAPLOA). PLoS Negl Trop Dis 5(6): e1210
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