A New Case of Bancroftian Filariasis after Years since Validation of Successful Elimination in Egypt.

Background: Lymphatic filariasis (LF) is a mosquito-borne neglected tropical disease found worldwide in tropical and subtropical regions. Wuchereria bancrofti is responsible for more than 90% of infections. This disease can lead to significant morbidity, disability, and economic burden. According to WHO-recommended strategies, Egypt launched a national LF elimination programme in 2000 and successfully achieved the elimination of LF in 2017. This study aimed to evaluate the LF transmission after years of the validation of elimination in Alkorain village, Sharqia governorate, Egypt. Methods: A cross-sectional study was conducted in Alkorain village, Sharqia governorate, Egypt, including patients attending the Alkorain Endemic Diseases Centre who were randomly selected at the study period and were tested for filarial antibodies; then test-positive cases underwent a provocation test followed by preparation of Giemsa-stained thick blood films. Results: Of 360 study participants, only one LF case (0.3%) was detected, who was a 15-year-old female student that presented with mild fever, malaise, and right lower limb swelling. Physical examination revealed pitting edema of her right leg, with several insect bites on the skin of both legs. Filariasis IgG/IgM rapid test, filarial antigen ELISA assay and stained thick blood smears indicated infection with bancroftian filariasis. The patient responded well to oral administration of a single dose of diethylcarbamazine plus albendazole. Conclusion: Our study concluded that the elimination of LF in Alkorain village is still maintained. Based on our case, it is necessary to consider LF in any patient from a previously endemic region who presents with unexplained limb swelling.