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Article

Lymphatic Filariasis Increases Tissue Compressibility and Extracellular Fluid in Lower Limbs of Asymptomatic Young People in Central Myanmar

by
Janet Douglass
1,*,
Patricia Graves
2,
Daniel Lindsay
1,
Luke Becker
2,
Maureen Roineau
2,
Jesse Masson
2,
Ni Ni Aye
3,
San San Win
4,
Tint Wai
3,
Yi Yi Win
3 and
Susan Gordon
1,5
1
Division of Tropical Health and Medicine, James Cook University, Townsville 4811, Australia
2
Division of Tropical Health and Medicine, James Cook University, Cairns 4870, Australia
3
Department of Health, Myanmar Ministry of Health and Sports, Nay Pyi Taw 15011, Myanmar
4
World Health Organization, Country Office, Yangon 11201, Myanmar
5
College of Nursing & Health Sciences, Flinders University, Bedford Park 5042, Australia
*
Author to whom correspondence should be addressed.
Trop. Med. Infect. Dis. 2017, 2(4), 50; https://doi.org/10.3390/tropicalmed2040050
Submission received: 15 August 2017 / Revised: 13 September 2017 / Accepted: 17 September 2017 / Published: 27 September 2017
(This article belongs to the Special Issue Neglected and Emerging Tropical Diseases in South and Southeast Asia and Northern Australia)
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Abstract

When normal lymphatic function is hampered, imperceptible subcutaneous edema can develop and progress to overt lymphedema. Low-cost reliable devices for objective assessment of lymphedema are well accepted in clinical practice and research on breast-cancer related lymphedema but are untested in populations with lymphatic filariasis (LF). This is a cross-sectional analysis of baseline data in a longitudinal study on asymptomatic, LF antigen-positive and -negative young people in Myanmar. Rapid field screening was used to identify antigen-positive cases and a group of antigen-negative controls of similar age and gender were invited to continue in the study. Tissue compressibility was assessed with three tissue tonometers, and free fluids were assessed using bio-impedance spectroscopy (BIS). Infection status was confirmed by Og4C3 antigen assay. At baseline (n = 98), antigen-positive cases had clinically relevant increases in tissue compressibility at the calf using a digital Indurometer (11.1%, p = 0.021), and in whole-leg free fluid using BIS (9.2%, p = 0.053). Regression analysis for moderating factors (age, gender, hydration) reinforced the between-infection group differences. Results demonstrate that sub-clinical changes associated with infection can be detected in asymptomatic cases. Further exploration of these low-cost devices in clinical and research settings on filariasis-related lymphedema are warranted.
Keywords: neglected tropical disease; lower extremity; lymphatic filariasis; tissue tonometry; bio-impedance spectroscopy; lymphedema neglected tropical disease; lower extremity; lymphatic filariasis; tissue tonometry; bio-impedance spectroscopy; lymphedema

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MDPI and ACS Style

Douglass, J.; Graves, P.; Lindsay, D.; Becker, L.; Roineau, M.; Masson, J.; Aye, N.N.; Win, S.S.; Wai, T.; Win, Y.Y.; et al. Lymphatic Filariasis Increases Tissue Compressibility and Extracellular Fluid in Lower Limbs of Asymptomatic Young People in Central Myanmar. Trop. Med. Infect. Dis. 2017, 2, 50. https://doi.org/10.3390/tropicalmed2040050

AMA Style

Douglass J, Graves P, Lindsay D, Becker L, Roineau M, Masson J, Aye NN, Win SS, Wai T, Win YY, et al. Lymphatic Filariasis Increases Tissue Compressibility and Extracellular Fluid in Lower Limbs of Asymptomatic Young People in Central Myanmar. Tropical Medicine and Infectious Disease. 2017; 2(4):50. https://doi.org/10.3390/tropicalmed2040050

Chicago/Turabian Style

Douglass, Janet, Patricia Graves, Daniel Lindsay, Luke Becker, Maureen Roineau, Jesse Masson, Ni Ni Aye, San San Win, Tint Wai, Yi Yi Win, and et al. 2017. "Lymphatic Filariasis Increases Tissue Compressibility and Extracellular Fluid in Lower Limbs of Asymptomatic Young People in Central Myanmar" Tropical Medicine and Infectious Disease 2, no. 4: 50. https://doi.org/10.3390/tropicalmed2040050

APA Style

Douglass, J., Graves, P., Lindsay, D., Becker, L., Roineau, M., Masson, J., Aye, N. N., Win, S. S., Wai, T., Win, Y. Y., & Gordon, S. (2017). Lymphatic Filariasis Increases Tissue Compressibility and Extracellular Fluid in Lower Limbs of Asymptomatic Young People in Central Myanmar. Tropical Medicine and Infectious Disease, 2(4), 50. https://doi.org/10.3390/tropicalmed2040050

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