MY CURIOSITY WITH LYMPHATIC FILARIASIS (ELEPHANTIASIS)

Elephantiasis of leg due to filariasis. Luzon, Philippines. Image Credit: CDC

It is often admissible the idiom — curiosity killed the cat! While this is often cited to discourage adventurous investigation and experimentation, silence is voiced about the possible problems curiosity helped the cat solve before its demise, or the illumination the cat received from its endless inquisitiveness.

Walking as a kid on the streets of Kaduna, Nigeria, I constantly asked myself and anyone that cared to listen — ‘why are there so many people on the roads with swollen legs’? Alas, no one gave a concrete answer; the best I got was, ‘they are poor’. Little I found it hard to understand the relationship between poverty and swollen limbs. It was not until my third year in medical school that I got some answers to the questions my soul had earnestly yearned for. In one of the microbiology lectures, I finally understood what baffled me as a child; it was lymphatic filariasis! I learnt about the cause, disease progression, prevention and management. It was very distressing to know that such a dilapidating disease with grave economic, social and psychological consequences was highly preventable and easily treatable. While I was utterly disappointed as I could not wrap my head around such insouciance from the Government, it was unbeatable that almost everyone was culpable in the morbidity and mortality suffered from the disease.

Neglected tropical diseases (NTDs) are a group of diseases caused by bacteria, protozoa, parasites and viruses. They include diseases such as Schistosomiasis, Oncocerciasis, Lymphatic Filariasis, Fascioliasis, Leishmaniasis, Dracunculiasis, Leprosy etc. They are essentially diseases of the poor as their effects are more felt in developing countries or the poor regions of developed countries. As such, ‘NTDs’ and ‘poverty’ are not mutually exclusive; they affect the poor and trap them in poverty by making them handicap, thereby impeding productivity. Neglected tropical diseases affect about 1 billion people in the world and are hence, diseases of global health significance! It is especially interesting that measures such as vector control, improving water, sanitation and hygiene could help prevent these NTDs.

As a Nigerian, it strikes differently knowing that my country is estimated to have the highest burden of lymphatic filariasis (also known as elephantiasis) in the world, and even more heart-wrenching that it is one of the most debilitating neglected tropical diseases (NTDs). I have seen countless children on the streets being snatched from the solace and effervescence of childhood by NTDs; several others, who despite their illnesses, are subjected to begging for alms on highways. A vivid example is that of Kunle; an 11-year old boy who I see daily under the bridge of Ikeja in Lagos State, Nigeria. Kunle does not have the luxury of a home or the deserved opportunity of getting an education. He brandishes his 12-kg right arm at road users and pedestrians in the hope that they would gift him a dollar or less for his daily sustenance. With tears, I listened to the story of Kunle and I could not imagine the pains hidden behind the weight of his large, right upper limb.

The global efforts to combat NTDs have recorded significant strides in recent years. However, to foster the eradication of NTDs on a global scale, every government, health agency, group, and human has a role to play. While governments need to continue partnering with leading health agencies and private organizations on campaigns such as massive drug administration, individuals must play their part in raising awareness about these diseases, ensure sanitation of their surroundings and cooperate with relevant authorities. Everyone must take responsibility and pick up arms in the fight against NTDs. Until NTDs are seen from a personalized lens, communal efforts would only continue to scratch the surface!

Personally, I have determined to undertake the task of mitigating the burden of infectious diseases such as the neglected tropical diseases on low and middle income countries. While I hope to prevent further deaths and handicap from the disease of my age-long curiosity, it is hard to imagine the numbers who will fall if I fail to inspire like minds to pick a cue from the cat.

Co-author: Mary T. Amure

Dentist and public health enthusiast who is passionate about infectious diseases and their relevance to global health