569:(helminths), and that a positive serologic test does not necessarily distinguish among infections. The new tests have not reached the point-of-care level yet, but show promise for highlighting high-risk areas and individuals with co-endemic loiasis and onchocerciasis. Specifically, Thomas Nutman and colleagues at the National Institutes of Health have described the a luciferase immunoprecipitation assay (LIPS) and the related QLIPS (quick version). Whereas a previously described LISXP-1 ELISA test had a poor sensitivity (55%), the QLIPS test is practical, as it requires only a 15 minutes incubation, while delivering high sensitivity (97%) and specificity (100%). No report on the distribution status of LIPS or QLIPS testing is available, but these tests would help to limit complications derived from mass ivermectin treatment for onchocerciasis or dangerous strong doses of diethylcarbamazine for loiasis alone (as pertains to individual with high
275:. These carriers are blood-sucking and day-biting, and they are found in rainforest-like environments in western and central Africa. Infective larvae (L3) mature to adults (L5) in the subcutaneous tissues of the human host, after which the adult worms—assuming presence of a male and female worm—mate and produce microfilariae. The cycle of infection continues when a non-infected mango or deer fly takes a blood meal from a microfilaremic human host, and this stage of the transmission is possible because of the combination of the diurnal periodicity of microfilariae and the day-biting tendencies of the
96:
646:(DEC), though ivermectin use while not curative (i.e., it will not kill the adult worms) can substantially reduce the microfilarial load. The recommended dosage of DEC is 8–10 mg/kg/d taken three times daily for 21 days per CDC. The pediatric dose is the same. DEC is effective against microfilariae and somewhat effective against macrofilariae (adult worms). The recommended dosage of ivermectin is 150 μg/kg in patients with a low microfilaria load (with densities less than 8000 mf/mL).
658:
male
Gabonian immigrant employed proparacaine and povidone-iodine drops, a wire eyelid speculum, and 0.5 ml 2% lidocaine with epinephrine 1:100,000, injected superiorly. A 2-mm incision was made and the immobile worm was removed with forceps. Gatifloxacin drops and an eye-patch over ointment were utilized post surgery and there were no complications (unfortunately, the patient did not return for DEC therapy to manage the additional worm—and microfilariae—present in his body).
779:, another filariasis. Ivermectin, a microfilaricidal drug, may be contraindicated in patients who are co-infected with loiasis and have associated high microfilarial loads. The theory is that the killing of massive numbers of microfilaria, some of which may be near the ocular and brain region, can lead to encephalopathy. Indeed, cases of this have been documented so frequently over the last decade that a term has been given for this set of complication: neurologic
610:—endemic Gabon, for example, had the following results: 6 of 20 individuals in a placebo group contracted the disease, compared to 0 of 16 in the DEC-treated group. Seropositivity for antifilarial IgG antibody was also much higher in the placebo group. The recommended prophylactic dose is 300 mg DEC given orally once weekly. The only associated symptom in the Peace Corps study was nausea.
650:
initial albendazole administration has proved helpful (and is superior to ivermectin, which can also be risky despite its slower-acting microfilaricidal effects over DEC). The CDC recommended dosage for albendazole is 200 mg taken twice a day for 21 days. Also, in cases where two or more DEC treatments have failed to provide a cure, subsequent albendazole treatment can be administered.
341:
deer flies require a blood meal for production of a second batch of eggs. This batch is deposited near water, where the eggs hatch in 5–7 days. The larvae mature in water or soil, where they feed on organic material such as decaying animal and vegetable products. Fly larvae are 1–6 cm (0.39–2.36 in) long and take 1–3 years to mature from egg to adult. When fully mature,
65:
898:. In a study done at five different co-endemic regions for onchocerciasis and loiasis, doxycycline was shown to be effective in treating over 12,000 individuals infected with both parasites with minimal complications. Drawbacks to using doxycycline include bacterial resistance and patient compliance because of a longer treatment regimen and emergence of doxycycline-resistant
741:-endemic regions, infection rates vary from 9 to 70 percent of the population. Areas at high risk of severe adverse reactions to mass treatment (with Ivermectin) are at present determined by the prevalence in a population of >20% microfilaremia, which has been recently shown in eastern Cameroon (2007 study), for example, among other locales in the region.
829:, mutism and incontinence. Some cases of coma were reported as early as D2. The severity of adverse effects increased with higher microfilarial loads. Hemorrhaging of the eye, particularly the retinal and conjunctiva regions, is another common sign associated with SAE of ivermectin treatment in patients with
657:
infection in some instances can involve surgery, though the timeframe during which surgical removal of the worm must be carried out is very short. A detailed surgical strategy to remove an adult worm is as follows (from a real case in New York City). The 2007 procedure to remove an adult worm from a
340:
spp. are small (5–20 mm, 0.20–0.79 in long) with a large head and downward-pointing mouthparts. Their wings are clear or speckled brown. They are hematophagous and typically live in forested and muddy habitats like swamps, streams and reservoirs, and in rotting vegetation. Female mango and
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so that areas and individuals at a higher risk for neurologic consequences can be identified prior to microfilaricidal treatment. Additionally, the treatment of choice for loiasis, diethylcarbamazine, can lead to serious complications in and of itself when administered in standard doses to patients
352:
The bite of the mango fly can be very painful, possibly because of the laceration style employed; rather than puncturing the skin as a mosquito does, the mango fly (and deer fly) makes a laceration in the skin and subsequently laps up the blood. Female flies require a fair amount of blood for their
246:
larvae migrate to the subcutaneous tissue, where they mature to adult worms in approximately one year, but sometimes up to four years. Adult worms migrate in the subcutaneous tissues at a speed less than 1 cm/min, mating and producing more microfilariae. The adult worms can live up to 17 years
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2. Wanji, S., Tendongfor, N., Nji, T., Esum, M., Che, J. N., Nkwescheu, A., Alassa, F., Kamnang, G., Enyong, P. A., Taylor, M. J., Hoerauf, A., and D. W. Taylor. 2009. Community-directed delivery of doxycycline for the treatment of onchocerciasis in areas of co-endemicity with loiasis in
Cameroon.
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microfilarial load in the patient prior to treatment. Studies have sought to delineate the sequence of events following ivermectin treatment that lead to neurologic SAE and sometimes death, while also trying to understand the mechanisms of adverse reactions to develop more appropriate treatments.
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In patients with high microfilaria load and/or the possibility of an onchocerciasis coinfection, treatment with DEC and/or ivermectin may be contraindicated or require a substantially lower initial dose, as the rapid microfilaricidal actions of the drugs can provoke encephalopathy. In these cases,
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vector has a limited flying range, but vector elimination efforts are not common, likely because the insects bite outdoors and have a diverse, if not long, range, living in the forest and biting in the open, as mentioned in the vector section. No vaccine has been developed for loiasis and there is
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worms are sexually dimorphic, with males considerably smaller than females at 30–34 mm long and 0.35–0.42 mm wide compared to 40–70 mm long and 0.5 mm wide. Adults live in the subcutaneous tissues of humans, where they mate and produce wormlike eggs called microfilariae. These
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microfilarial loads however, and microfilariae can be observed in the urine occasionally. Generally, patients recovered from SAE within 6–7 months post-ivermectin treatment; however, when their complications were unmanaged and patients were left bed-ridden, death resulted due to gastrointestinal
364:
are attracted to canopied rainforests, they do not do their biting there. Instead, they leave the forest and take most blood meals in open areas. The flies are attracted to smoke from wood fires and they use visual cues and sensation of carbon dioxide plumes to find their preferred host, humans.
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The identification of microfilariae was made in 1890 by the ophthalmologist
Stephen McKenzie. Localized angioedema, a common clinical presentation of loiasis, was observed in 1895 in the coastal Nigerian town of Calabar—hence the name "Calabar" swellings. This observation was made by a Scottish
613:
Researchers believe that geo-mapping of appropriate habitat and human settlement patterns may, with the use of predictor variables such as forest, land cover, rainfall, temperature, and soil type, allow for estimation of Loa loa transmission in the absence of point-of-care diagnostic tests. In
969:
infection was noted in the
Caribbean (Santo Domingo) in 1770. A French surgeon named Mongin tried but failed to remove a worm passing across a woman's eye. A few years later, in 1778, the surgeon François Guyot noted worms in the eyes of West African slaves on a French ship to America; he
821:
Within 12–24 hours post-ivermectin treatment (D1), individuals complained of fatigue, anorexia, and headache, joint and lumbar pain—a bent forward walk was characteristic during this initial stage accompanied by fever. Stomach pain and diarrhea were also reported in several individuals.
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Advanced diagnostic methods have been developed since the appearance the SAEs, but more specific diagnostic tests that have been or are currently being development (see: Diagnostics) must to be supported and distributed if adequate loiasis surveillance is to be achieved.
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The first mechanism suggests that ivermectin causes immobility in microfilariae, which then obstructs microcirculation in cerebral regions. This is supported by the retinal hemorrhaging seen in some patients, and is possibly responsible for the neurologic SAE reported.
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The second hypothesis suggests that microfilariae may try to escape drug treatment by migrating to brain capillaries and further into brain tissue; this is supported by pathology reports demonstrating a microfilarial presence in brain tissue post-ivermectin treatment.
593:
Blood tests to reveal microfilaremia are useful in many, but not all cases, as one-third of loiasis patients are amicrofilaremic. By contrast, eosinophilia is almost guaranteed in cases of loiasis, and blood testing for eosinophil fraction may be useful.
626:-soaked clothing, and thick, long-sleeved and long-legged clothing ought to be worn to decrease susceptibility to the bite of the mango or deer fly vector. Because the vector is day-biting, mosquito (bed) nets do not increase protection against loiasis.
196:(Calabar swellings) in the arms and legs, caused by immune reactions, are common. Calabar swellings are 3–10 cm (1.2–3.9 in) in surface area, sometimes erythematous, and not pitting. When chronic, they can form cyst-like enlargements of the
589:
as a skin-test antigen for filariasis diagnosis. If the patient was infected, the extract would cause an artificial allergic reaction and associated
Calabar swelling similar to that caused, in theory, by metabolic products of the worm or dead worms.
291:. Other minor potential reservoirs have been indicated in various fly-biting habit studies, such as hippopotamus, wild ruminants (e.g. buffalo), rodents and lizards. A simian type of loiasis exists in monkeys and apes but it is transmitted by
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does not normally affect vision but can be painful when moving about the eyeball or across the bridge of the nose. Loiasis can cause red itchy swellings below the skin called "Calabar swellings". The disease is treated with the drug
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Jacobsen, KH; Andress, BC; Bhagwat, EA; Bryant, CA; Chandrapu, VR; Desmonts, CG; Matthews, TM; Ogunkoya, A; Wheeler, TJ; Williams, AS (October 2022). "A call for loiasis to be added to the WHO list of neglected tropical diseases".
810:
In a study looking at mass ivermectin treatment in
Cameroon, one of the greatest endemic regions for both onchocerciasis and loiasis, a sequence of events in the clinical manifestation of adverse effects was outlined.
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intensity was with microscopic examination of standardized blood smears, which is not practical in endemic regions. Because mass diagnostic methods were not available, complications started to surface once mass
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There is much overlap between the endemicity of the two distinct filariases, which complicates mass treatment programs for onchocerciasis and necessitates the development of greater diagnostics for loiasis.
1369:
Nutman, TB, KD Miller, M Mulligan, GN Reinhardt, BJ currie, C Steel, and EA Ottesen. "Diethylcarbamazine prophylaxis for human loiasis. Results of a double-blind study."New Eng J Med. (1988), 319: 752–56.
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is also called the "African eye worm". The passage over the eyeball can be sensed, but it usually takes less than 15 minutes. Eyeworms affect men and women equally, but advanced age is a risk factor.
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507:. It is important to time the blood collection with the known periodicity of the microfilariae (between 10:00 a.m. and 2:00 p.m.). The blood sample can be a thick smear, stained with
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microfilariae are 250–300 μm long, 6–8 μm wide and can be distinguished morphologically from other filariae, as they are sheathed and contain body nuclei that extend to the tip of the tail.
452:. The female worms measure 40 to 70 mm in length and 0.5 mm in diameter, while the males measure 30 to 34 mm in length and 0.35 to 0.43 mm in diameter. Adults produce
802:, and mass treatment with ivermectin can have SAE. These include hemorrhage of the conjunctiva and retina, heamaturia, and other encephalopathies that are all attributed to the initial
794:
In
Central and West Africa, initiatives to control onchocerciasis involve mass treatment with ivermectin. However, these regions typically have high rates of co-infection with both
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Lastly, the third hypothesis attributes hypersensitivity and inflammation at the cerebral level to post-ivermectin treatment complications, and perhaps the release of bacteria from
219:(itching). They reappear at referent locations at irregular time intervals. Subconjunctival migration of an adult worm to the eyes can also occur frequently, and this is the reason
902:. However, in the study over 97% of the patients complied with treatment, so it does pose as a promising treatment for onchocerciasis, while avoiding complications associated with
580:. Adult worms migrating across the eye are another potential diagnostic, but the short timeframe for the worm's passage through the conjunctiva makes this observation less common.
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infections and is observed between D2 and D5 post-treatment. This can be visible for up to 5 weeks following treatment and has increased severity with higher microfilarial loads.
1379:
Thomson MC, Obsomer V, Dunne M, Connor SJ, Molyneux DH (September 2000). "Satellite mapping of Loa loa prevalence in relation to ivermectin use in west and central Africa".
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Mechanisms for SAE have been proposed. Though microfilarial load is a major risk factor to post-ivermectin SAE, three main hypotheses have been proposed for the mechanisms.
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As of 2009, loiasis is endemic to 11 countries, all in western or central Africa, and an estimated 12–13 million people have the disease. The highest incidence is seen in
1203:
Gouteux JP, Noireau F, Staak C (April 1989). "The host preferences of
Chrysops silacea and C. dimidiata (Diptera: Tabanidae) in an endemic area of Loa loa in the Congo".
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have also been observed following ivermectin treatment, but this is common when using ivermectin to treat onchocerciasis. The effect is exacerbated when there are high
642:
Treatment of loiasis involves chemotherapy or, in some cases, surgical removal of adult worms followed by systemic treatment. The current drug of choice for therapy is
879:
More research into the mechanisms of post-ivermectin treatment SAE is needed to develop drugs that are appropriate for individuals with multiple parasitic infections.
614:
addition to geo-mapping and chemoprophylaxis, the same preventative strategies used for malaria should be undertaken to avoid contraction of loiasis. Specifically,
480:. There the microfilariae develop into first-stage larvae and subsequently into third-stage infective larvae. The third-stage infective larvae migrate to the fly's
1422:
Chippaux JP, Bouchité B, Demanou M, Morlais I, Le Goff G (September 2000). "Density and dispersal of the loaiasis vector
Chrysops dimidiata in southern Cameroon".
1281:
1517:
Nam, Julie N., Shanian Reddy, and Norman C. Charles. "Surgical
Management of Conjunctival Loiasis." Ophthal Plastic Reconstr Surg. (2008). Vol 24(4): 316–17.
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1002:, the scientific name for the infectious agent, is an indigenous term itself and it is likely that there are many other terms used from region to region.
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1500:
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Calabar swellings are the primary tool for visual diagnosis. Identification of adult worms is possible from tissue samples collected during subcutaneous
472:. The fly ingests microfilariae during a blood meal. After ingestion, the microfilariae lose their sheaths and migrate from the fly's midgut through the
1581:"Clinical picture, epidemiology and outcome of Loa-associated serious adverse events related to mass ivermectin treatment of onchocerciasis in Cameroon"
299:, has been isolated as a vector of simian loiasis, but this variant hunts within the forest and has not as yet been associated with human infection.
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take human blood meals approximately 90% of the time, with hippopotamus, wild ruminant, rodent and lizard blood meals making up the other 10%.
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168:(DEC), and when appropriate, surgical methods may be employed to remove adult worms from the conjunctiva. Loiasis belongs to the group of
998:
filariasis, filaria loa, filaria lacrimalis, filaria subconjunctivalis, Calabar swellings, fugitive swellings, and microfilaria diurnal.
402:
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in certain areas of west and central Africa, as mass ivermectin treatment of onchocerciasis can lead to SAEs in patients who have high
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for circulating filarial antigens constitutes a useful diagnostic approach, because microfilaremia can be low and variable. Though the
1357:
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aforementioned reproductive purposes and thus may take multiple blood meals from the same host if disturbed during the first one.
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Grigsby, Margaret E. and Donald H. Keller. "Loa-loa in the District of Columbia." J Narl Med Assoc. (1971), Vol 63(3): 198–201.
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measuring 250 to 300 ÎĽm by 6 to 8 ÎĽm, which are sheathed and have diurnal periodicity. Microfilariae have been recovered from
894:, the bacteria believed to play a major role in the onset of onchocerciasis, while having no effect on the microfilariae of
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microfilarial densities, or loads. This fact necessitates the development of more specific diagnostics tests for
468:. During the day, they are found in peripheral blood, but during the noncirculation phase, they are found in the
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1987:
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detection are of limited value because substantial antigenic cross-reactivity exists between filaria and other
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334:. These species exist only in Africa and are popularly known as deer flies and mango, or mangrove, flies.
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Metzger, Wolfram Gottfried; Benjamin Mordmüller (2013). "Loa loa – does it deserve to be neglected?".
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have been developed in recent years. This is despite the fact that many recently developed methods of
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and Calabar swellings was not realized until 1910 (by Patrick Manson). The determination of vector—
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448:, where they penetrate into the bite wound. The larvae develop into adults that commonly reside in
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1538:"Encephalopathy after ivermectin treatment in a patient infected with Loa loa and Plasmodium spp"
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John, David T. and William A. Petri, Jr. Markell and Voge's Medical Parasitology. 9th ed. 2006.
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2007:
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when moved. The swellings may last for one to three days and may be accompanied by localized
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Vector elimination strategies are an interesting consideration. It has been shown that the
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loiasis, loaiasis, Calabar swellings, fugitive swelling, tropical swelling, African eyeworm
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are often mentioned as vectors, the two most prominent vectors are from the tabanid genus
295:. There is no crossover between the human and simian types of the disease. A related fly,
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Kamgno J, Boussinesq M, Labrousse F, Nkegoum B, Thylefors BI, Mackenzie CD (April 2008).
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filarial worm can reach from three to seven centimetres long and migrates throughout the
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reports that no serologic diagnostics are available, tests that are highly specific to
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Endemicity is closely linked to the habitats of the two known human loiasis vectors,
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34:"Eye worm" redirects here. For another parasitic nematode known as "eye worm", see
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886:. This drug has been shown to be effective in killing both the adult worm of
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ophthalmologist named Douglas Argyll-Robertson, but the association between
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An area of tremendous concern regarding loiasis is its co-endemicity with
172:, and there is a call for it to be included in the high priority listing.
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Burbelo PD, Ramanathan R, Klion AD, Iadarola MJ, Nutman TB (July 2008).
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but are restricted to travelers who have returned from endemic regions.
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is often prominent in filarial infections. Dead worms may cause chronic
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microfilaremia. Some patients can develop lymphatic dysfunction causing
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One drug that has been proposed for the treatment of onchocerciasis is
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Boussinesq, M., Gardon, J., Gardon-Wendel, N., and J. Chippaux. 2003.
1085:"Filarial worm (Loa loa) in the anterior chamber. Report of two cases"
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Padgett JJ, Jacobsen KH (October 2008). "Loiasis: African eye worm".
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Synonyms for the disease include African eye worm, loaiasis, loaina,
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714:. The disease was once endemic to the western African countries of
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Diethylcarbamazine has been shown as an effective prophylaxis for
583:
In the past, healthcare providers used a provocative injection of
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after treatment to SAE. This has been observed with the bacteria
1300:"Rapid, Novel, Specific, High-Throughput Assay for Diagnosis of
933:. It is estimated that over 10 million humans are infected with
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By day 2 (D2), many patients experienced confusion, agitation,
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and can infect another human when the fly takes a blood meal.
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Human loiasis geographical distribution is restricted to the
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infection. A study of Peace Corps volunteers in the highly
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is transmitted by several species of tabanid flies (Order:
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microfilarial load of greater than 3,000 per ml of blood.
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Centers for Disease Control and Prevention (2019-04-18).
27:
This article is about the disease. For the parasite, see
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It was noted that the patients used in this study had a
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infective larvae (L3) are transmitted to humans by the
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The Medical Letter – Filariasis. Available online at:
527:, concentration techniques can be used. These include
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Parasitic infestations, stings, and bites of the skin
1280:"Loiasis." 2009. The Institute of Tropical Medicine.
125:. Humans contract this disease through the bite of a
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Vector Control – Horseflies and deerflies (tabanids)
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spp.—was made in 1912 by the British parasitologist
440:, day-biting flies) introduces third-stage filarial
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tissues of the eye where it can be easily observed.
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Andrews' Diseases of the Skin: clinical Dermatology
698:infection are lower but it is still present in and
79:
54:
46:
349:assume the day-biting tendencies of all tabanids.
775:treatment programs started being carried out for
970:successfully removed a worm from one man's eye.
75:microfilaria in thin blood smear (Giemsa stain)
1019:James, William D.; Berger, Timothy G. (2006).
436:. During a blood meal, an infected fly (genus
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848:bleeding, septic shock, and large abscesses.
766:In the 1990s, the only method of determining
8:
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759:Cases have been reported on occasion in the
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420:filariasis originates with flies from two
115:) is a skin and eye disease caused by the
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1150:
1148:
1146:
1108:
400:
1011:
184:such as loiasis most often consists of
1499:: CS1 maint: archived copy as title (
1492:
155:of humans, occasionally crossing into
1655:
1653:
1604:Parasites & Vectors. 2(39): 1–10.
1238:
1236:
1234:
287:Humans are the primary reservoir for
231:, which may lead to the formation of
7:
1083:Osuntokun O, Olurin O (March 1975).
318:). Although horseflies of the genus
634:little report on this possibility.
25:
1242:World Health Organization (WHO).
1436:10.1046/j.1365-2915.2000.00249.x
965:The first well recorded case of
531:of the blood sample lyzed in 2%
1662:"History of Human Parasitology"
1050:The Lancet. Infectious Diseases
555:Institute for Tropical Medicine
476:to the thoracic muscles of the
372:spp. biting habits showed that
1616:The Lancet Infectious Diseases
1217:10.1080/00034983.1989.11812326
1:
1678:10.1128/CMR.15.4.595-612.2002
1628:10.1016/S1473-3099(13)70263-9
1393:10.1016/S0140-6736(00)02733-1
1163:Trans. R. Soc. Trop. Med. Hyg
1062:10.1016/S1473-3099(22)00064-0
921:, being especially common in
2310:Diphyllobothrium mansonoides
1175:10.1016/j.trstmh.2008.03.022
929:. Humans are the only known
676:Democratic Republic of Congo
2647:Angiostrongylus cantonensis
2296:Spirometra erinaceieuropaei
1258:"CDC – Loiasis – Diagnosis"
734:but has since disappeared.
444:onto the skin of the human
170:neglected tropical diseases
2963:
33:
26:
2887:Capillaria philippinensis
2810:Halicephalobus gingivalis
2781:Strongyloides stercoralis
1555:10.4269/ajtmh.2008.78.546
71:
62:
2893:Intestinal capillariasis
1988:Dicrocoelium dendriticum
680:Central African Republic
535:(Knott's technique), or
2880:Trichuriasis / Whipworm
2830:Enterobius vermicularis
2625:Cutaneous larva migrans
2198:Echinococcus granulosus
2138:Heterophyes heterophyes
2124:Gastrodiscoides hominis
1947:Trichobilharzia regenti
1660:Cox FE (October 2002).
408:life cycle. Source: CDC
233:granulomatous reactions
2728:Visceral larva migrans
2523:Gnathostoma spinigerum
2376:Dracunculus medinensis
2282:Diphyllobothrium latum
2061:Paragonimus westermani
2028:Opisthorchis viverrini
1205:Ann Trop Med Parasitol
781:serious adverse events
573:microfilarial loads).
409:
200:around the sheaths of
2609:Ancylostoma duodenale
2152:Metagonimus yokogawai
1542:Am. J. Trop. Med. Hyg
1023:. Saunders Elsevier.
984:Robert Thomson Leiper
957:microfilarial loads.
672:Republic of the Congo
424:species of the genus
404:
215:(skin eruptions) and
2861:Trichinella spiralis
2688:Ascaris lumbricoides
2502:Lymphatic filariasis
2484:Wuchereria bancrofti
1666:Clin. Microbiol. Rev
1320:10.1128/JCM.00490-08
1101:10.1136/bjo.59.3.166
153:subcutaneous tissues
2875:Trichuris trichiura
2802:Trichostrongyliasis
2418:Onchocerca volvulus
1974:Clonorchis sinensis
1909:Schistosoma mansoni
1890:Trematode infection
586:Dirofilaria immitis
549:detection using an
541:nucleopore membrane
450:subcutaneous tissue
247:in the human host.
242:In the human host,
86:Infectious diseases
2761:Parascaris equorum
2747:Dioctophyme renale
2653:Angiostrongyliasis
2633:Necator americanus
2603:Hookworm infection
2463:Dirofilaria repens
2288:Diphyllobothriasis
2179:Tapeworm infection
2110:Fasciolopsis buski
1800:External resources
1591:2021-11-22 at the
1308:J. Clin. Microbiol
1284:2008-12-02 at the
747:Chrysops dimidiata
644:diethylcarbamazine
503:procedure to find
410:
176:Signs and symptoms
166:diethylcarbamazine
2942:Tropical diseases
2914:
2913:
2910:
2909:
2846:
2845:
2583:
2582:
2579:
2578:
2330:
2329:
2326:
2325:
2204:E. multilocularis
2168:
2167:
2008:Fasciola hepatica
1860:Parasitic disease
1826:
1825:
1424:Med. Vet. Entomol
1387:(9235): 1077–78.
1358:The Gideon Online
1056:(10): e299–e302.
1030:978-0-7216-2921-6
931:natural reservoir
692:Equatorial Guinea
523:). For increased
198:connective tissue
103:
102:
90:tropical medicine
41:Medical condition
18:Tropical swelling
16:(Redirected from
2954:
2795:Trichostrongylus
2787:Strongyloidiasis
2667:Metastrongylosis
2399:
2363:
2354:
2345:
2249:Hymenolepis nana
2185:
2085:Intestinal fluke
1896:
1881:
1853:
1846:
1839:
1830:
1712:
1700:
1699:
1689:
1657:
1648:
1647:
1611:
1605:
1601:
1595:
1577:
1568:
1567:
1557:
1533:
1527:
1524:
1518:
1515:
1506:
1504:
1498:
1490:
1488:
1487:
1481:
1475:. Archived from
1474:
1465:
1456:
1455:
1419:
1413:
1412:
1376:
1370:
1367:
1361:
1355:
1342:
1341:
1331:
1295:
1289:
1278:
1272:
1271:
1269:
1268:
1253:
1247:
1240:
1229:
1228:
1200:
1187:
1186:
1158:
1141:
1138:
1123:
1122:
1112:
1080:
1074:
1073:
1044:
1035:
1034:
1016:
917:forest areas of
620:insect repellent
358:Chrysops silacea
207:, becoming very
99:
98:
67:
44:
21:
2962:
2961:
2957:
2956:
2955:
2953:
2952:
2951:
2917:
2916:
2915:
2906:
2842:
2815:
2766:
2673:
2621:Ancylostomiasis
2591:
2575:
2555:
2535:Gnathostomiasis
2508:
2405:
2388:
2339:
2336:
2322:
2273:Pseudophyllidea
2267:
2218:Taenia saginata
2176:
2164:
2116:Fasciolopsiasis
2101:Echinostomiasis
2079:
2046:
2040:Opisthorchiasis
1959:
1939:Schistosomiasis
1933:S. intercalatum
1887:
1885:Fluke/trematode
1876:
1873:
1866:
1857:
1827:
1822:
1821:
1795:
1794:
1723:
1709:
1704:
1703:
1659:
1658:
1651:
1613:
1612:
1608:
1602:
1598:
1593:Wayback Machine
1585:Filaria Journal
1578:
1571:
1535:
1534:
1530:
1525:
1521:
1516:
1509:
1491:
1485:
1483:
1479:
1472:
1470:"Archived copy"
1468:
1466:
1459:
1421:
1420:
1416:
1378:
1377:
1373:
1368:
1364:
1356:
1345:
1314:(7): 2298–304.
1297:
1296:
1292:
1286:Wayback Machine
1279:
1275:
1266:
1264:
1255:
1254:
1250:
1241:
1232:
1202:
1201:
1190:
1160:
1159:
1144:
1139:
1126:
1089:Br J Ophthalmol
1082:
1081:
1077:
1046:
1045:
1038:
1031:
1018:
1017:
1013:
1008:
992:
963:
906:co-infections.
872:that live with
694:. The rates of
664:
640:
600:
567:parasitic worms
499:is a practical
495:examination of
490:
399:
386:
305:
285:
269:Chrysops silica
258:
253:
178:
157:subconjunctival
93:
42:
39:
32:
23:
22:
15:
12:
11:
5:
2960:
2958:
2950:
2949:
2944:
2939:
2934:
2929:
2919:
2918:
2912:
2911:
2908:
2907:
2905:
2904:
2897:
2896:
2895:
2883:
2871:
2870:
2869:
2856:
2854:
2848:
2847:
2844:
2843:
2841:
2840:
2839:
2838:
2825:
2823:
2817:
2816:
2814:
2813:
2806:
2805:
2804:
2791:
2790:
2789:
2776:
2774:
2768:
2767:
2765:
2764:
2757:
2756:
2755:
2753:Dioctophymosis
2743:
2736:
2735:
2734:
2716:Toxocara canis
2712:
2711:
2710:
2698:
2697:
2696:
2683:
2681:
2675:
2674:
2672:
2671:
2670:
2669:
2661:Metastrongylus
2657:
2656:
2655:
2643:
2642:
2641:
2629:
2628:
2627:
2615:A. braziliense
2605:
2599:
2597:
2585:
2584:
2581:
2580:
2577:
2576:
2574:
2573:
2565:
2563:
2557:
2556:
2554:
2553:
2552:
2551:
2539:
2538:
2537:
2518:
2516:
2510:
2509:
2507:
2506:
2505:
2504:
2480:
2479:
2478:
2476:Dirofilariasis
2466:
2459:
2458:
2457:
2455:Mansonelliasis
2445:
2444:
2443:
2428:
2427:
2426:
2424:Onchocerciasis
2413:
2411:
2396:
2390:
2389:
2387:
2386:
2385:
2384:
2382:Dracunculiasis
2371:
2369:
2360:
2351:
2342:
2332:
2331:
2328:
2327:
2324:
2323:
2321:
2320:
2319:
2318:
2306:
2305:
2304:
2292:
2291:
2290:
2277:
2275:
2269:
2268:
2266:
2265:
2264:
2263:
2261:Hymenolepiasis
2245:
2244:
2243:
2214:
2213:
2212:
2210:Echinococcosis
2193:
2191:
2189:Cyclophyllidea
2182:
2170:
2169:
2166:
2165:
2163:
2162:
2161:
2160:
2158:Metagonimiasis
2148:
2147:
2146:
2144:Heterophyiasis
2134:
2133:
2132:
2130:Amphistomiasis
2120:
2119:
2118:
2106:
2105:
2104:
2089:
2087:
2081:
2080:
2078:
2077:
2076:
2075:
2073:Paragonimiasis
2056:
2054:
2048:
2047:
2045:
2044:
2043:
2042:
2024:
2023:
2022:
2004:
2003:
2002:
2000:Dicrocoeliasis
1984:
1983:
1982:
1969:
1967:
1961:
1960:
1958:
1957:
1956:
1955:
1953:Swimmer's itch
1943:
1942:
1941:
1927:S. haematobium
1904:
1902:
1893:
1878:
1868:
1867:
1858:
1856:
1855:
1848:
1841:
1833:
1824:
1823:
1820:
1819:
1804:
1803:
1801:
1797:
1796:
1793:
1792:
1781:
1770:
1755:
1740:
1724:
1719:
1718:
1716:
1715:Classification
1708:
1707:External links
1705:
1702:
1701:
1672:(4): 595–612.
1649:
1622:(4): 353–357.
1606:
1596:
1569:
1528:
1519:
1507:
1457:
1414:
1371:
1362:
1343:
1290:
1273:
1248:
1230:
1188:
1169:(10): 983–89.
1142:
1124:
1075:
1036:
1029:
1010:
1009:
1007:
1004:
991:
988:
962:
959:
942:onchocerciasis
777:onchocerciasis
663:
660:
653:Management of
639:
636:
599:
596:
529:centrifugation
489:
486:
428:(deer flies),
398:
395:
385:
382:
304:
301:
297:Chrysops langi
293:Chrysops langi
284:
281:
257:
254:
252:
249:
177:
174:
101:
100:
83:
77:
76:
69:
68:
60:
59:
56:
52:
51:
40:
24:
14:
13:
10:
9:
6:
4:
3:
2:
2959:
2948:
2945:
2943:
2940:
2938:
2935:
2933:
2930:
2928:
2927:Helminthiases
2925:
2924:
2922:
2903:
2902:
2898:
2894:
2891:
2890:
2889:
2888:
2884:
2881:
2877:
2876:
2872:
2868:
2865:
2864:
2863:
2862:
2858:
2857:
2855:
2853:
2849:
2837:
2834:
2833:
2832:
2831:
2827:
2826:
2824:
2822:
2818:
2812:
2811:
2807:
2803:
2800:
2799:
2798:
2796:
2792:
2788:
2785:
2784:
2783:
2782:
2778:
2777:
2775:
2773:
2769:
2763:
2762:
2758:
2754:
2751:
2750:
2749:
2748:
2744:
2742:
2741:
2740:Baylisascaris
2737:
2733:
2729:
2726:
2725:
2724:
2723:
2718:
2717:
2713:
2709:
2706:
2705:
2704:
2703:
2699:
2695:
2692:
2691:
2690:
2689:
2685:
2684:
2682:
2680:
2676:
2668:
2665:
2664:
2663:
2662:
2658:
2654:
2651:
2650:
2649:
2648:
2644:
2640:
2637:
2636:
2635:
2634:
2630:
2626:
2622:
2619:
2618:
2617:
2616:
2611:
2610:
2606:
2604:
2601:
2600:
2598:
2595:
2590:
2586:
2572:
2571:
2567:
2566:
2564:
2562:
2558:
2550:
2547:
2546:
2545:
2544:
2540:
2536:
2533:
2532:
2531:
2530:
2525:
2524:
2520:
2519:
2517:
2515:
2511:
2503:
2500:
2499:
2498:
2497:
2492:
2491:
2490:Brugia malayi
2486:
2485:
2481:
2477:
2474:
2473:
2472:
2471:
2467:
2465:
2464:
2460:
2456:
2453:
2452:
2451:
2450:
2446:
2442:
2440:
2436:
2435:
2434:
2433:
2429:
2425:
2422:
2421:
2420:
2419:
2415:
2414:
2412:
2409:
2404:
2400:
2397:
2395:
2391:
2383:
2380:
2379:
2378:
2377:
2373:
2372:
2370:
2368:
2364:
2361:
2359:
2355:
2352:
2350:
2346:
2343:
2341:
2333:
2317:
2314:
2313:
2312:
2311:
2307:
2303:
2300:
2299:
2298:
2297:
2293:
2289:
2286:
2285:
2284:
2283:
2279:
2278:
2276:
2274:
2270:
2262:
2259:
2258:
2257:
2256:
2251:
2250:
2246:
2242:
2241:Cysticercosis
2238:
2235:
2234:
2233:
2231:
2226:
2225:
2220:
2219:
2215:
2211:
2208:
2207:
2206:
2205:
2200:
2199:
2195:
2194:
2192:
2190:
2186:
2183:
2180:
2175:
2171:
2159:
2156:
2155:
2154:
2153:
2149:
2145:
2142:
2141:
2140:
2139:
2135:
2131:
2128:
2127:
2126:
2125:
2121:
2117:
2114:
2113:
2112:
2111:
2107:
2103:
2102:
2098:
2097:
2096:
2095:
2091:
2090:
2088:
2086:
2082:
2074:
2071:
2070:
2069:
2068:
2067:P. kellicotti
2063:
2062:
2058:
2057:
2055:
2053:
2049:
2041:
2038:
2037:
2036:
2035:
2030:
2029:
2025:
2021:
2018:
2017:
2016:
2015:
2010:
2009:
2005:
2001:
1998:
1997:
1996:
1995:
1990:
1989:
1985:
1981:
1980:Clonorchiasis
1978:
1977:
1976:
1975:
1971:
1970:
1968:
1966:
1962:
1954:
1951:
1950:
1949:
1948:
1944:
1940:
1937:
1936:
1935:
1934:
1929:
1928:
1923:
1922:
1917:
1916:
1911:
1910:
1906:
1905:
1903:
1901:
1897:
1894:
1891:
1886:
1882:
1879:
1875:
1874:platyhelminth
1869:
1865:
1864:helminthiases
1861:
1854:
1849:
1847:
1842:
1840:
1835:
1834:
1831:
1818:
1815:
1811:
1810:
1806:
1805:
1802:
1798:
1791:
1787:
1786:
1782:
1780:
1776:
1775:
1771:
1769:
1765:
1764:
1760:
1756:
1754:
1750:
1749:
1745:
1741:
1739:
1735:
1734:
1730:
1726:
1725:
1722:
1717:
1713:
1706:
1697:
1693:
1688:
1683:
1679:
1675:
1671:
1667:
1663:
1656:
1654:
1650:
1645:
1641:
1637:
1633:
1629:
1625:
1621:
1617:
1610:
1607:
1600:
1597:
1594:
1590:
1586:
1582:
1576:
1574:
1570:
1565:
1561:
1556:
1551:
1548:(4): 546–51.
1547:
1543:
1539:
1532:
1529:
1523:
1520:
1514:
1512:
1508:
1502:
1496:
1482:on 2009-01-15
1478:
1471:
1464:
1462:
1458:
1453:
1449:
1445:
1441:
1437:
1433:
1430:(3): 339–44.
1429:
1425:
1418:
1415:
1410:
1406:
1402:
1398:
1394:
1390:
1386:
1382:
1375:
1372:
1366:
1363:
1359:
1354:
1352:
1350:
1348:
1344:
1339:
1335:
1330:
1325:
1321:
1317:
1313:
1309:
1305:
1303:
1294:
1291:
1287:
1283:
1277:
1274:
1263:
1259:
1252:
1249:
1245:
1239:
1237:
1235:
1231:
1226:
1222:
1218:
1214:
1211:(2): 167–72.
1210:
1206:
1199:
1197:
1195:
1193:
1189:
1184:
1180:
1176:
1172:
1168:
1164:
1157:
1155:
1153:
1151:
1149:
1147:
1143:
1137:
1135:
1133:
1131:
1129:
1125:
1120:
1116:
1111:
1106:
1102:
1098:
1095:(3): 166–67.
1094:
1090:
1086:
1079:
1076:
1071:
1067:
1063:
1059:
1055:
1051:
1043:
1041:
1037:
1032:
1026:
1022:
1015:
1012:
1005:
1003:
1001:
997:
989:
987:
985:
981:
977:
971:
968:
960:
958:
956:
951:
947:
943:
938:
936:
932:
928:
924:
920:
916:
912:
907:
905:
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724:Guinea Bissau
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497:microfilariae
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458:spinal fluids
455:
454:microfilariae
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57:
53:
49:
45:
37:
30:
19:
2937:Eye diseases
2900:
2885:
2873:
2859:
2836:Enterobiasis
2828:
2808:
2794:
2779:
2759:
2745:
2738:
2732:Toxocariasis
2721:
2714:
2700:
2686:
2659:
2645:
2639:Necatoriasis
2631:
2614:
2607:
2568:
2541:
2528:
2521:
2514:Thelazioidea
2495:
2488:
2482:
2469:
2461:
2447:
2438:
2437:
2430:
2416:
2374:
2308:
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2203:
2196:
2150:
2136:
2122:
2108:
2099:
2092:
2066:
2059:
2033:
2026:
2014:F. gigantica
2013:
2006:
1993:
1986:
1972:
1945:
1932:
1926:
1920:
1915:S. japonicum
1914:
1907:
1807:
1783:
1772:
1757:
1742:
1727:
1669:
1665:
1619:
1615:
1609:
1599:
1584:
1545:
1541:
1531:
1522:
1484:. Retrieved
1477:the original
1427:
1423:
1417:
1384:
1380:
1374:
1365:
1311:
1307:
1301:
1293:
1276:
1265:. Retrieved
1261:
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979:
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927:Ogooué River
908:
903:
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695:
665:
662:Epidemiology
654:
652:
648:
641:
630:
628:
618:-containing
612:
607:
603:
601:
592:
584:
582:
575:
570:
558:
545:
513:haematoxylin
504:
491:
437:
434:C. dimidiata
433:
429:
425:
417:
411:
405:
389:
387:
378:C. dimidiata
377:
373:
369:
367:
362:C. dimidiata
361:
357:
355:
351:
347:C. dimidiata
346:
342:
337:
336:
332:C. dimidiata
331:
327:
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319:
307:
306:
296:
292:
288:
286:
276:
273:C. dimidiata
272:
268:
260:
259:
256:Transmission
243:
241:
225:Eosinophilia
220:
186:asymptomatic
179:
160:
148:
147:. The adult
144:
130:
120:
112:
106:
105:
104:
72:
47:
2901:C. hepatica
2867:Trichinosis
2852:Adenophorea
2708:Anisakiasis
2589:Strongylida
2570:Gongylonema
2561:Spiruroidea
2549:Thelaziasis
2529:G. hispidum
2403:Filarioidea
2367:Camallanida
2349:Secernentea
2316:Sparganosis
2302:Sparganosis
2255:H. diminuta
2224:T. asiatica
2094:Echinostoma
2034:O. felineus
2020:Fasciolosis
1965:Liver fluke
1900:Blood fluke
1262:www.cdc.gov
925:and on the
919:West Africa
911:rain forest
888:O. volvulus
884:doxycycline
874:O. volvulus
841:proteinuria
800:O. volvulus
737:Throughout
728:Ivory Coast
551:immunoassay
525:sensitivity
493:Microscopic
368:A study of
192:. Episodic
55:Other names
2921:Categories
2772:Rhabditida
2694:Ascariasis
2679:Ascaridida
2470:D. immitis
2449:Mansonella
2441:filariasis
2408:Filariasis
2335:Roundworm/
2052:Lung fluke
1921:S. mekongi
1862:caused by
1785:DiseasesDB
1486:2009-02-27
1304:Infection"
1267:2022-11-14
1006:References
953:with high
837:Haematuria
827:dysarthria
773:ivermectin
753:C. silicea
624:permethrin
598:Prevention
539:through a
537:filtration
501:diagnostic
430:C. silacea
384:Morphology
374:C. silacea
343:C. silacea
328:C. silacea
314:; Family:
194:angioedema
190:lymphedema
182:filariasis
109:filariasis
50:filariasis
2496:B. timori
2394:Spirurida
2340:infection
2237:Taeniasis
2230:T. solium
1994:D. hospes
1877:infection
1872:Flatworm/
1809:eMedicine
1636:1473-3099
1587:2: 1–13.
900:Wolbachia
892:Wolbachia
869:Wolbachia
638:Treatment
488:Diagnosis
482:proboscis
478:arthropod
397:Lifecycle
356:Although
316:Tabanidae
283:Reservoir
229:abscesses
213:urticaria
137:mango fly
135:spp.) or
81:Specialty
2947:Zoonoses
2821:Oxyurida
2702:Anisakis
2594:hookworm
2543:Thelazia
2358:Spiruria
2338:Nematode
1814:derm/888
1696:12364371
1644:24332895
1589:Archived
1564:18385346
1495:cite web
1452:29279412
1444:11016443
1409:11743223
1401:11009145
1338:18508942
1282:Archived
1183:18466939
1070:35500592
990:Synonyms
980:Chrysops
937:larvae.
923:Cameroon
783:(SAEs).
668:Cameroon
631:Chrysops
578:biopsies
563:antibody
533:formalin
521:staining
474:hemocoel
438:Chrysops
426:Chrysops
370:Chrysops
338:Chrysops
324:Chrysops
277:Chrysops
267:vectors
265:deer fly
237:fibrosis
217:pruritus
132:Chrysops
127:deer fly
117:nematode
36:Thelazia
2722:T. cati
2439:Loa loa
2432:Loa loa
2174:Cestoda
1817:med/794
1779:D008118
1329:2446928
1302:Loa loa
1246:. 1997.
1225:2604456
1119:1131358
1110:1017374
1000:Loa loa
996:Loa loa
976:Loa loa
967:Loa loa
961:History
955:Loa loa
950:Loa loa
946:Loa loa
935:Loa loa
768:Loa loa
739:Loa loa
696:Loa loa
684:Nigeria
655:Loa loa
604:Loa loa
571:Loa loa
559:Loa loa
547:Antigen
505:Loa loa
418:Loa loa
406:Loa loa
320:Tabanus
312:Diptera
308:Loa loa
289:Loa loa
261:Loa loa
244:Loa loa
221:Loa loa
209:painful
205:tendons
161:Loa loa
149:Loa loa
145:Loa loa
141:vectors
122:Loa loa
113:Loiasis
107:Loa loa
73:Loa loa
48:Loa loa
29:Loa loa
2232:(pork)
1738:1F66.0
1694:
1687:126866
1684:
1642:
1634:
1562:
1450:
1442:
1407:
1399:
1381:Lancet
1336:
1326:
1223:
1181:
1117:
1107:
1068:
1027:
904:L. loa
896:L. loa
864:L. loa
845:L. loa
831:L. loa
816:L. loa
804:L. loa
796:L. loa
720:Guinea
712:Uganda
700:Angola
690:, and
509:Giemsa
466:sputum
442:larvae
414:vector
388:Adult
303:Vector
202:muscle
139:, the
92:
1768:125.2
1753:B74.3
1480:(PDF)
1473:(PDF)
1448:S2CID
1405:S2CID
915:swamp
716:Ghana
704:Benin
688:Gabon
519:(see
517:eosin
470:lungs
462:urine
279:spp.
251:Cause
119:worm
2797:spp.
1790:7576
1774:MeSH
1763:9-CM
1692:PMID
1640:PMID
1632:ISSN
1560:PMID
1501:link
1440:PMID
1397:PMID
1334:PMID
1221:PMID
1179:PMID
1115:PMID
1066:PMID
1025:ISBN
913:and
890:and
839:and
798:and
750:and
732:Mali
730:and
710:and
708:Chad
616:DEET
515:and
464:and
446:host
432:and
416:for
412:The
376:and
360:and
345:and
330:and
271:and
235:and
143:for
111:, (
1759:ICD
1744:ICD
1729:ICD
1682:PMC
1674:doi
1624:doi
1550:doi
1432:doi
1389:doi
1385:356
1324:PMC
1316:doi
1213:doi
1171:doi
1167:102
1105:PMC
1097:doi
1058:doi
608:Loa
511:or
390:Loa
2923::
2730:/
2719:/
2623:/
2612:/
2526:/
2493:/
2487:/
2252:/
2239:/
2227:/
2221:/
2201:/
2064:/
2031:/
2011:/
1991:/
1930:/
1924:/
1918:/
1912:/
1812::
1788::
1777::
1766::
1751::
1748:10
1736::
1733:11
1690:.
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326:—
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