KATHMANDU, APRIL 07

Neglected tropical diseases are parasitic, viral or bacterial diseases causing illness for more than one billion population globally. However, it specifically traps people under the poverty line.

Hence, these diseases are related to not only people's health but also their economic status, education and productivity.

They are termed 'neglected' because they generally afflict poor people and can be eradicated through prevention strategies, and so have not received much attention from health researchers.

Nepal has been able to eradicate most of the neglected tropical diseases. However, lymphatic filariasis, or elephantiasis, is still prevalent and is not going to be easy to eradicate.

Most importantly, there is no real cure or a vaccine for it.

Lymphatic filariasis starts with a mosquito bite. Once the parasite in the mosquito enters the human body, it attacks the lymphatic vessels, and the human body begins to exhibit symptoms like enlargement of the limbs. There are drugs to kill the adult or larval parasites.

However, when they die, they release toxin producing bacteria, which trigger inflammation, worsening the swelling.

Also, the drugs are provided before diagnosis as a preventive measure. This strategy could be effective, but due to lack of awareness, rumours, public fears and labour drain to India, the strategy of Mass Drug Administration (MDA) before diagnosis has been less fruitful.

India itself suffers from this problem, and Nepalis going there for work should be aware of this disease and follow the MDA measures. Priority should be given to not only medication but also diagnosis. Early, affordable and easy diagnosis kits should be available.

Another possible strategy could be to repurpose our traditional herbal medicines as an alternative to the synthetic drugs to make people feel comfortable with the MDA. Also with several protein engineering approaches advancing around the world, Nepal's research community can contribute in finding a single effective protein-based therapeutic for killing the bacteria.

These are all preventive strategies.

There is surgery as a treatment for filarial hydroceles, but it is not a standardised method.

There is still no cure for lymphatic filariasis. A cure may not be related only to destroying parasites or the bacteria. It is related more to our body's mechanism to heal the destruction caused by the parasites. The research community should opt for this approach, too.

The disease may be termed 'neglected', but we cannot neglect it. We live in the same community where the disease is still prevalent. It is our responsibility to join hands to eradicate it.

A version of this article appears in the print on April 8, 2021, of The Himalayan Times.