When diabetes meets a neglected tropical disease: chronic lymphatic filariasis due to Wuchereria bancrofti—a case report

BACKGROUND: Lymphatic filariasis (LF) is a neglected tropical disease in some parts of India and results in chronic lymphedema, hydrocele and acute inflammatory episodes. Even outreach to communities often yields undiagnosed cases of chronic cases needing confirmatory testing and tied-in care. This case illustrates the confluence between chronic infectious and metabolic diseases in rural India, and the requirement of comprehensive primary care. CASE REPORT: A 75-year-old South Asian male farmer with type-2 diabetes mellitus detected at a rural camp in the community from rural Kayar, Yavatmal district, Central India, reported to us with chronic swelling of right lower limb and scrotum approximately since 7 years and fever for the past 2 days. We received him in our rural medical college, lab investigations done and blood smear showed microfilariae; ultrasonography confirmed the filarial dance sign, diabetes was associated as a complicating factor. Glycemic optimization, symptomatic treatment for infestation of filariasis and advice on limb hygiene were provided and patient was counseled about vector control and follow-up. CONCLUSION: This report highlights the importance of community-based screening camps for detection of chronic LF, confirmation by diagnostic tests at referral centers, and subsequent integration of management of such cases with that for chronic diseases. It highlights the necessity of incorporating neglected tropical disease (NTD) control with noncommunicable disease (NCD) management within rural health programs to strengthen surveillance and sustain progress toward LF elimination targets.