Q: I am a 50 years old male suffering from Bancroftian filariasis. Can it be treated permanently by drugs or surgery?

A:Bancroftian filariasis is a parasitic (filarial) infection caused by Wuchereria bancrofti. Adult worms are present in the lymphatics of the patient, and microfilaria can be present in the blood.

The medical treatment is dependant on isolation of microfilariae or presence of filarial antigens in blood. Hetrazan (diethylcarbamazine) provocation test may be used as an aid in the diagnosis. Anti-parasitic medicines like ivermectin, diethylcarbamazine, albendazole or doxycycline may be used for medical treatment.

Patients with inflammation of the lymph nodes and lymphatics and those with chronic filariasis may require admission, along with anti-inflammatory pain killers, antihistamines, steroids and antibiotics for secondary infections. Chronic patients with swelling due to lymphoedema are advised bed rest, limb elevation and compression bandages. Large hydrocoeles and elephantiasis affecting the scrotum can be managed with surgical excision. However, surgery for gross elephantiasis of the limb is more difficult and may require multiple operations and/or skin grafting. Patients of lymphatic filariasis with chyluria are advised restriction of fatty foods.

Bancroftian filariasis can be cured if diagnosed and treated early. However, in your case since it began 35 years ago, it might be more difficult to treat; but a consultation with a surgeon could provide you a personalised perspective on the treatment possible in your case.