ULTRASONOGRAPHIC EXAMINATION OF HAITIAN CHILDREN WITH LYMPHATIC FILARIASIS: A LONGITUDINAL ASSESSMENT IN THE CONTEXT OF ANTIFILARIAL DRUG TREATMENT

LEANNE M. FOX Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Hôpital Sainte Croix, Leogane, Haiti

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BRUCE W. FURNESS Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Hôpital Sainte Croix, Leogane, Haiti

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JENNIFER K. HASER Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Hôpital Sainte Croix, Leogane, Haiti

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JEAN-MARC BRISSAU Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Hôpital Sainte Croix, Leogane, Haiti

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JACKY LOUIS-CHARLES Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Hôpital Sainte Croix, Leogane, Haiti

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SUSAN F. WILSON Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Hôpital Sainte Croix, Leogane, Haiti

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DAVID G. ADDISS Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Hôpital Sainte Croix, Leogane, Haiti

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PATRICK J. LAMMIE Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Hôpital Sainte Croix, Leogane, Haiti

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MICHAEL J. BEACH Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Hôpital Sainte Croix, Leogane, Haiti

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To assess the clinical findings associated with detection of adult Wuchereria bancrofti worms on ultrasound, 186 schoolchildren in a filariasis-endemic area of Haiti underwent physical and ultrasonographic examinations. The filaria dance sign (FDS) of adult W. bancrofti was detected in the inguinal and crural lymphatics of 28 (15%) children. FDS detection was more common in older children (P = 0.003) and in those with a history of inguinal lymph node inflammation (P = 0.002) or crural lymphadenopathy on physical exam (P = 0.01). Twenty-five FDS-positive children were reexamined after three annual cycles of mass treatment for lymphatic filariasis (LF). The total number of adult worm nests detected by ultrasound decreased from 29 to 4 (P ≤0.0001). FDS and lymphangiectasia were detected in the intrascrotal (N = 3) and inguinal (N = 1) lymphatic vessels of three postpubescent boys. This study demonstrates clinical and subclinical findings of LF in FDS-positive children.

Author Notes

Reprint requests: 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@bu.edu.
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