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By Sharmain Grainger Mosquitoes have been known to transmit a number of diseases. Often fogging and residual spraying are the key measures to help safeguard people from these prevailing health threats.Chief Medical Officer, Dr. Shamdeo PersaudHowever, safeguarding people against filariasis, which is transmitted by Culex mosquitoes, requires just a bit more than just vector control measures. Adherence to preventative treatment has been proven to be the key to reducing its prevalence.This infection is transmitted when a Culex mosquito, infected with the filarial worm, bites a human being. According to the Centres for Disease Control and Prevention (CDC), the adult worm only lives in the human lymph system which is tasked with maintaining the body’s fluid balance and fighting infections. Moreover, when a person manifests symptoms of filariasis, it is officially called lymphatic filariasis.However, manifestation of symptoms may not occur until years after a person has been infected. The infection is known to cause fluid accumulation and swelling which becomes evident in areas such as the legs, arms and breasts and is called (lymphedema). Swelling of the private parts too is not uncommon. In men this is called hydrocele.PREVENTIONIn order to combat filariasis, the Ministry of Public Health has been embracing a “knock it out at the source” approach, according to Chief Medical Officer (CMO),David Backes Jersey, Dr. Shamdeo Persaud.“Rather than just try to get rid of the mosquitoes,Alexander Steen Jersey, we are getting to the source which is human beings that carry around the micro filarial worm,” informed Dr. Persaud.Moreover, treatment in the form of albendazole is used. This treatment is used for a variety of parasitic worm infestations. The Ministry has also relied quite heavily on salt fortified with diethylcarbamazine which is commonly referred to as DEC Salt. This salt can be used in the place of regular salt to season foods daily.A symptom of filariasisBut the Ministry has also taken on board a DEC tablet distribution initiative. This has been ongoing for a number of years, whereby persons are recruited by the Ministry to go out into the field to distribute DEC tablets.“Once people get an annual dose of that treatment, the number of the worms is reduce to zero in their bodies, so even if the mosquito is present and you are bitten, you wouldn’t have any worms to transmit,” Dr. Persaud explained.As such the use of the DEC tablets is considered an immunisation tactic against filariasis.“Using the tablets will help to prevent you from harbouring the filarial worm,” the CMO stressed.He however noted that persons who don’t take advantage of this treatment will remain at risk of contracting filariasis,CM Punk Jersey, and even eventually developing its associated symptoms.“We would like to see 100 per cent compliance,” said the CMO of the use of DEC tablets.But there are some people who have developed allergic reactions after the use of the tablets. In such cases, persons should continue the use of DEC salt.One of the cleaned canals in the heart of the city.Dr. Persaud however noted that “we are hoping that the majority, who have no reaction to the treatment,Devan Dubnyk Jersey, will take it so that we will form a herd protection…”Herd protection refers to a state of immunity that occurs when the immunisation of a significant portion of a population provides a measure of protection for individuals who have not yet developed immunity.Currently the conformity level – that is, persons who accept and utilise the treatment provided to them – across Georgetown, the East Coast of Demerara and the East Bank of Demerara, stands at about 75 per cent, according to Dr. Persaud.Three consistent rounds of the DEC tablet distributions have occurred in Region Four and the CMO informed that plans for another round is currently in the discussion phase. This is being done in collaboration with the Guyana Water Incorporated, he noted.At least five distribution exercises have also occurred in Region Five, and according to Dr. Persaud,Jonathan Drouin Team North America Jersey, the Region is at a point where “they need to do some surveys to ascertain the percentage of conformity. There might be some pockets and so they will have to target those areas,” added Dr. Persaud.Region Three,Jared Spurgeon Jersey, inclusive of the West Coast,Artemi Panarin Jersey, West Bank and Essequibo Islands,Scott Darling Jersey, has also benefited from an initial distribution round. And there are plans to expand the programme even further in the quest to possibly eradicate the disease altogether.CLEAN-UP IMPACTWhile an ongoing cleanup campaign in the city augurs well for the reduction of disease-causing vectors, and by extension, the future of health care in Guyana, such activities do not come without some side effects.According to Dr. Persaud, while the cleanup efforts coupled with fogging activities have been helping to control the prevalence of the Aedes aegypti mosquitoes that transmit dengue fever, and the Chikungunya and Zika viruses, it has been discovered that the environment has instead been allowing Culex mosquitoes to flourish.A number of city residents have complained of “gigantic” black mosquitoes that have been increasingly invading their surroundings since the start of earnest cleanup activities last year. It was expected that the cleanup efforts would have helped to control the mosquito situation.The Culex mosquitoes, Dr. Persaud explained, are usually a larger breed when compared to the Aedes. But unlike the Aedes mosquitoes, which are known to breed in relatively clean water, the Culex species thrives well in high organic waters, such as those found in drains and canals around the city, the CMO noted.“I don’t have scientific details, but I guess more breeding sites have been cleared for these mosquitoes…cleaning the environment is good and will certainly have positive effects,Andrew Desjardins Jersey, but the mosquitoes seem to also be thriving as a result.”Dr. Persaud is however optimistic that with sustained cleaning of the environment, it is likely that fish will also be able to thrive in the city waterways, which will in turn help to slow the breeding ability of the Culex mosquitoes.“Lots of fish species can feed on the larva of mosquitoes, but there might still be opportunities for breeding.”As such, he reiterated that one of the surest ways of helping to combat filariasis is to embrace adherence to the use of treatment that is being made readily available.