Filariasis

Umbrella term for infection with filarial nematodes. Egypt's own Nile Delta focus (lymphatic filariasis) has been declared eliminated as a public health problem, so a genuinely new Egyptian case is very unlikely - but a Cairo practice sees returning travellers and migrants, and chronic lymphoedema, hydrocele or acute adenolymphangitis in a patient from a previously endemic Delta village still needs recognising. Confirm the species and the microfilarial count before any drug: that is what decides the treatment, and getting it wrong can kill. - Refer, with advice

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

No dose - referral pathway, no medicine given in primary care

Umbrella term for infection with filarial nematodes. Egypt's own Nile Delta focus (lymphatic filariasis) has been declared eliminated as a public health problem, so a genuinely new Egyptian case is very unlikely - but a Cairo practice sees returning travellers and migrants, and chronic lymphoedema, hydrocele or acute adenolymphangitis in a patient from a previously endemic Delta village still needs recognising. Confirm the species and the microfilarial count before any drug: that is what decides the treatment, and getting it wrong can kill.

150 micrograms/kg as a SINGLE dose, swallowed on an empty stomach and washed down with a full glass of water. Repeat at 3-to-6-month intervals until symptoms have gone, which can mean 10 years of treatment or longer. The same 150 micrograms/kg single dose is the ivermectin half of the first-line pair for lymphatic filariasis with onchocerciasis. - One dose, repeated every 3 to 6 months while symptoms persist; the article says treatment may take 10 years or more

150 mcg/kg/dose

(The same 150 micrograms/kg single dose. The article states no separate paediatric regimen and no minimum age or weight; ivermectin is conventionally avoided under 15 kg, which no document held here states, so weigh the child and take specialist advice in the very small.)

Filariasis - disease-level clinical article (filariasis-full.txt)

Ivermectin is the article's drug of choice where onchocerciasis is the only infection present, given as a single dose of 150 micrograms/kg - one sentence carrying both the indication and the dose. It is registered in Egypt in eleven forms, IVACTIN 6 mg at 13.50 EGP for six tablets. Egypt's own lymphatic-filariasis focus in the Delta was eliminated, but a Cairo practice sees returning travellers and migrants from sub-Saharan Africa, which is who the card is for.

200 mg orally once daily for 6 weeks, given together with ivermectin 150 micrograms/kg as a single dose. It works by killing the Wolbachia endosymbiont, which is why the course is long. x 6 weeks

NOT for young children - doxycycline is a tetracycline and stains developing teeth; it is conventionally avoided under 8 years. The article states no paediatric filarial regimen at all. A child with filariasis goes to a tropical-medicine service.

Filariasis - disease-level clinical article (filariasis-full.txt)

For lymphatic filariasis with onchocerciasis the article makes the pair first-line and states both doses in one sentence: doxycycline by mouth, 200 mg once daily for 6 weeks, together with a single 150 micrograms/kg dose of ivermectin. It names doxycycline separately as the alternative in lymphatic filariasis where DEC cannot be got or cannot be given - which in Egypt is always, since no DEC product is registered. Doxycycline is on every Egyptian shelf.

Loiasis with more than 8000 microfilariae/mL: 200 mg twice daily for 21 days, to bring the burden down before anything else is given. It is also the additional alternative in lymphatic filariasis for patients who cannot take doxycycline or who have loiasis or onchocerciasis as well, where it is combined with ivermectin. x 21 days for the loiasis load-reduction course

The article states no paediatric filarial regimen. Albendazole is dosed elsewhere in this app for the common intestinal worms; the 21-day loiasis course is a different use and a specialist decision.

Filariasis - disease-level clinical article (filariasis-full.txt)

Where the count runs above 8000 microfilariae/mL the article starts with albendazole to bring the burden down - 200 mg twice a day for 21 days - and adds apheresis when the load is very high; drug, dose and duration in one sentence. It names albendazole again as the alternative in lymphatic filariasis. Eleven Egyptian products are registered, ALZENTAL 200 mg among them. It sits at line 2 because it is the load-reduction and fallback drug, not the first thing given.