Elephantiasis: Dealing with the neglected and incurable disease

Rakiya Ahmad, lives in Anguwan Rogo, Jos North Local Government Area of Plateau State and she suffers from a disease she has realised has no cure. Her right leg is swollen and she now knows that the swelling and bouts of fever, she experiences is not arthritis but a disease called lymphatic filariasis, popularly known […]

Rakiya Ahmad, lives in Anguwan Rogo, Jos North Local Government Area of Plateau State and she suffers from a disease she has realised has no cure.
Her right leg is swollen and she now knows that the swelling and bouts of fever, she experiences is not arthritis but a disease called lymphatic filariasis, popularly known as elephantiasis.
“I think my leg would have been bigger than this if not for the treatment I started seven years ago. There were signs that my other leg was getting infected but I think the drugs helped,” she said.
Ahmad said the illness started with a fever some time during the 2001 crises in Jos. 15 years after, she is still living with the disease, and still suffers from recurrent fevers.
She said: “Once the fever starts, I can’t stand on my leg and I will need as many as five blankets to cover up. But as the fever starts to subside, the leg becomes very itchy and when I try to scratch it, I feel like I’m being stung by an insect. Gradually the skin on the leg then sheds off but the skin is very, very thick.”
She is however happy that the swelling on her leg is not as grotesque as others she has seen, such as Hamisu Isa who has dragged his elephantiasis left leg for about 30 years. Isa serves as the chairman of those who suffer from the disease in Plateau State but says his disease was as a result of a fracture to his left knee following a car accident in 1985.
The disease known as lymphatic filariasis is classified under Neglected Tropical Diseases (NTDs) caused by a parasite which is transmitted by mosquitoes.
Experts say the parasite also known as Wuchereria bancrofti lives in the lymphatic system of victims and causes blockages to the return of fluids to the circulatory system.
 With repeated infection, carriers of the parasite suffer from periodic fever, and pains in the muscles which leads to severe limb and genital swelling, a condition popularly called elephantiasis.
The Carter Centre, a foundation established by a former United States president ,Jimmy Carter and based in Jos is known for its works on Neglected Tropical Diseases including lymphatic filariasis,  onchocerciasis (River blindness), malaria, bilharzia and stomach worms.
Though Rakiya Ahmad was told that mosquito is the transmitter of the parasite, she says she sometimes wonders if other people’s insinuation that her illness is spiritual is actually true.
For Isa, he doubts that mosquito was a contributing factor to his accident but admits that the car that hit him in 1985 had pushed him into an old refuse dump where the likelihood of being bitten by a carrying mosquito is high. 
The centre’s director of integrated programmes in Plateau and Nasarawa states, Dr. Abel Eigege who is also an expert on lymphatic filariasis says based on the World Health Organisation (WHO) meeting of International Task Force for disease eradication in 2011, Nigeria is estimated to have the highest population at risk of the disease in sub-Saharan Africa.
Dr. Eigege however said it is not all types of mosquitoes that transmit lymphatic filariasis, adding that “the transmission is by female anopheles mosquitoes especially  those who live in marshy and bushy areas where there are mosquitoes, and not just any type of mosquito but the anopheles’ mosquito. When a female anopheles mosquito bites someone who is infected, it takes the blood meal, and when it is trying to bite another person, it deposits the larva.”
The Carter Centre in 2013 announced that it has eliminated transmission of the disease in Nigeria’s North Central States of Plateau and Nasarawa.
The country representative of the centre, Dr. Emmanuel Miri in February this year reiterated this position during the centre’s annual programme review in Jos saying that with such news, Plateau and Nasarawa states have become the first two Nigerian states to stop the transmission of lymphatic filariasis.
“What that means is that young children will not be infected, the old persons who are not infected will not be infected again but you could still see somebody who has elephantiasis, and what we do for them is to provide lymphidima management for them, and also form a support group to help them,” said Dr. Eigege.
The news of eliminating transmission of the disease sounds exciting to Ahmad and Isa who say the thought that many people will escape their fate is a welcome development.
 As carriers of the disease, they know that there is no complete cure that can eliminate the swelling on their legs, however, they are taught that proper hygiene can reduce the complication caused by the disease and help them live their lives as normal as they can.
Rakiya Ahmad and Hamisu Isa who have frequented Carter Centre in the last few years say they meet after every three months for general checks and discussions with other carriers of the disease.
 “I am advised to be careful not to get malaria or typhoid or bruise any part of my leg because once I get a fever or injury on the leg, then the fever starts and it’s horrible,” Ahmad said.
Isa said: “When the fever starts, I feel as if my entire body is on fire and no matter how broke I am, I just have to find the money to buy drugs which are also expensive.”
He added that is why there are benefits that come with visiting the Carter Centre where drugs are sometimes given to them free. “Sometimes Jimmy Carter sends drugs to us and it is always free, we have never paid a kobo and I have also travelled to places like Mangu, Pankshin, Wase and parts of Nasarawa State with them for observation and awareness creation,” he said. 
People suffering from lymphatic filariasis can relieve their pains according to Dr. Eigege by cooling their legs with cold clean water, drinking more water than usual, washing the leg as well as taking aspirin or paracetamol for fever.