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To assess clinical findings associated with Wuchereria bancrofti infection, 192 school children in a filariasis-endemic area of Haiti underwent physical and ultrasonographic examinations and testing for circulating filarial antigen (CFA). The CFA-positive children were more likely than CFA-negative children to have severe interdigital lesions (
1 macerated lesion with involvement of 4 toe web spaces) (P < 0.0001) and inguinal (P = 0.003) or crural (P = 0.004) lymph node pathology. In multivariate analysis, CFA positivity remained a significant predictor for severe interdigital lesions (P = 0.006) and inguinal lymph node pathology (P = 0.05). Ultrasound detected adult worms and lymphangectasia (diameter = 2.0–4.0 mm) in 11 (10.8%) CFA-positive children. Among CFA-positive children, ultrasonographic detection of adult worms was associated with inguinal (P = 0.01) and crural (P = 0.004) lymph node pathology and advanced pubertal stage (sexual maturity rating = 3–5) (P = 0.02). This is the first study to associate interdigital lesions with filarial infection in children.
Received April 12, 2005. Accepted for publication May 16, 2005.
Acknowledgments: We thank Bruce W. Furness for assistance with the ultrasonographic examinations and Jean-Marc Brissau, Marc André Ledain, Yves Gerry Clerfé, and the Hôpital Sainte Croix Filariasis Team for their assistance with the project. We are especially indebted to the children of Leogane who participated in this study.
Financial support: This project was supported by the Emerging Infections Program of the Centers for Disease Control and Prevention. A Bill & Melinda Gates Foundation grant to Notre Dame University provided salary support for Dr. Madsen V. Beau de Rochars.
* Address correspondence to LeAnne M. Fox, Center for International Health and Development, Boston University School of Public Health, 85 East Concord Street, Boston, MA 02118. E-mail: lfox{at}bu.edu or leanne.fox{at}childrens.harvard.edu
Authors’ addresses: LeAnne M. Fox, Center for International Health and Development, Boston University School of Public Health, 85 East Concord Street, Boston, MA 02118, Telephone: 617-414-1209, Fax: 617-414-1261, E-mail: lfox{at}bu.edu or leanne.fox{at}childrens.harvard.edu. Susan F. Wilson, New Jersey Medical School, Newark, NJ 07101, Telephone: 973-220-8547, swiss_miss31{at}yahoo.com. David G. Addiss, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30341-3724, Telephone: 770-488-7760, Fax: 770-488-7761, E-mail: dga1{at}cdc.gov. Jacky Louis-Charles and Madsen V. Beau de Rochars, Filariasis Program, Hôpital Sainte Croix, Leogane, Haiti, Telephone: 509-512-1868, Fax: 509-235-1845, E-mail: jlouisch{at}yahoo.com and mbeauder{at}nd.edu. Patrick J. Lammie, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30341-3724, Telephone: 770-488-4054, Fax: 770-488-4108, E-mail: pjl1{at}cdc.gov.
Reprint requests: LeAnne M. Fox, Center for International Health and Development, Boston University School of Public Health, 85 East Concord Street, Boston, MA 02118.
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  T. McPHERSON, M. P. FAY, S. SINGH, R. PENZER, and R. HAY HEALTH WORKERS' AGREEMENT IN CLINICAL DESCRIPTION OF FILARIAL LYMPHEDEMA. Am J Trop Med Hyg, March 1, 2006; 74(3): 500 - 504. [Abstract] [Full Text] [PDF]
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