Treatment of Lymphatic Filariasis

Diethylcarbamazine (DEC) tablet @ 6 mg./kg. body weight for 12 days is administered for mf. carrier cases present in circulating peripheral blood which can be detected only during night blood survey.

DEC tablets @ 6 mg./kg/ body weight for 7 days in a month is administered.

Foot hygiene, foot care and physical exercise is suggested.

Drug Dosage Schedule

Streamlined Dose
Age in Years Dose of DEC Number of Tablets
< 2 Nil Nil
2–5 100 mg 1 tablet of 100 mg
6–14 200 mg 2 tablets of 100 mg each
15 & above 300 mg 3 tablets of 100 mg each

DEC is now supplied to all MDA districts as 100 mg tablets. The drug has been in use in India for more than five decades. It is a very safe drug at the recommended dose. The single dose of 6 mg DEC per kg body weight has to be adjusted and age–wise streamlined dosage is given below:

Note: The advantage of streamlined DEC dosage is that the number of tablets are less and the three doses can easily be remembered by the peripheral drug administrator.

Guidelines on Morbidity Management for Prevention and Control of Disability Filaria patients with damaged lymphatic vessels often have more bacteria on the skin than usual. The large number of bacteria on the skin, multiple skin lesions, slow lymph fluid movement and the reduced ability of the lymph nodes to filter the bacteria cause inflammation characteristic of an acute attack. Repeated bacterial infections precipitate frequent acute attacks, which further damage the tiny lymphatic vessels in the skin, reducing their ability to drain fluid. This vicious cycle continues, aggravating the condition of the patient.

Good hygine and treatment of entry leisions are important measures for managing lymphoedema. The patients should be encouraged to practise skin care and hygine and to use proper footwear. The reduction in the frequency of the acute attacks is an indication that the patient’s condition is improving. Effective, simple and cheap techniques have now been available to minimize the suffering caused by the acute and chronic manifestations of the disease.

A. Hygine – Washing 1. Supplies needed

  • Clean water at room temperature.
  • Soap (least expensive soap without perfume is usually the best).
  • Basin.
  • Chair or Stool.
  • Towel.
  • Footwear within easy reach.

2. Check skin for

  • Entry lesions, including very small lesions between the toes that can hardly be seen.
  • Entry lesions between the toes may cause itching. Scratching can further damage the skin and can provoke an acute attack; tell patients to avoid scratching.
  • Toenails should be trimmed in such a way that the skin is not injured. Do not try to clean under the nails with sharp objects as these can cause entry lesions.

It is important to check the skin every time the leg is washed because entry lesions allow bacteria to enter the skin and this will cause acute attacks. If entry lesions are found, they should be cleaned carefully.