The association between microfilaraemia and disease in lymphatic filariasis

E. Michael, B. T. Grenfell, D. A.P. Bundy

Research output: Contribution to journalArticlepeer-review

53 Scopus citations


A standard tenet in the epidemiology of lymphatic filariasis is that patent infection is negatively related to chronic disease. We examine the empirical evidence for this relation by using published data from field studies carried out in a variety of bancroftian filariasis endemic areas. Meta-analysis of the individual study results for each disease category of hydrocele in males only, lymphoedema only, and both conditions combined (total chronic disease) indicate, contrary to expectation, no evidence for a negative association between infection and disease. Indeed, the trend of the empirical evidence is towards the opposite direction, with the majority of studies showing equal propensity of disease in microfilaraemics (mf+ves) and amicrofilaraemics (mf-ves), and more studies indicating a positive rather than a negative relation. There was also a trend for more positive studies for hydrocele compared to lymphoedema. Theoretical analysis suggests that between-study differences in blood sample volumes are unlikely to confound this finding. Analysis of between-study heterogeneity suggests that variations in the local incidence or prevalence of infection rather than unique geographical, including vector, differences might underlie the observed between-study variability in the microfilaraemia-disease association. These results are discussed in terms of dynamic explanations for infection-disease relations in lymphatic filariasis.

Original languageEnglish (US)
Pages (from-to)33-40
Number of pages8
JournalProceedings of the Royal Society B: Biological Sciences
Issue number1345
StatePublished - 1994
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • General Immunology and Microbiology
  • General Environmental Science
  • General Biochemistry, Genetics and Molecular Biology
  • General Agricultural and Biological Sciences


Dive into the research topics of 'The association between microfilaraemia and disease in lymphatic filariasis'. Together they form a unique fingerprint.

Cite this