Lymphatic filariasis increases tissue compressibility and extracellular fluid in lower limbs of asymptomatic young people in Central Myanmar

Douglass, Janet, Graves, Patricia, Lindsay, Daniel, Becker, Luke, Mason, Jesse, Aye, Ni Ni, Win, San San, Wai, Tint, Win, Yi Yi, and Gordon, Susan (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.

PDF (Published Version) - Published Version
Available under License Creative Commons Attribution.

Download (804kB) | Preview
View at Publisher Website:


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 compressibilityat 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.

Item ID: 51209
Item Type: Article (Research - C1)
ISSN: 2414-6366
Keywords: neglected tropical disease; lower extremity; lymphatic filariasis; tissue tonometry; bio-impedance spectroscopy; lymphedema
Additional Information:

© 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (

Date Deposited: 12 Oct 2017 02:40
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1108 Medical Microbiology > 110803 Medical Parasitology @ 40%
11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110309 Infectious Diseases @ 30%
11 MEDICAL AND HEALTH SCIENCES > 1199 Other Medical and Health Sciences > 119999 Medical and Health Sciences not elsewhere classified @ 30%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920109 Infectious Diseases @ 100%
Downloads: Total: 178
Last 12 Months: 8
More Statistics

Actions (Repository Staff Only)

Item Control Page Item Control Page