- The mainstay of management in chronic filariasis is lymphedema care, as the chronic stage is characterized by lymphatic dysfunction and resultant lymphedema rather than active infection.
- Antifilarial drugs, while effective in killing microfilariae and adult worms, do not reverse established lymphatic damage.
- Therefore, treatment focuses on preventing secondary bacterial infections, maintaining hygiene, limb elevation, and compression therapy to reduce swelling and prevent progression.
- Surgical removal of worms is not practical due to their diffuse lymphatic location.
- Corticosteroids have no role in chronic management.

- Thus, effective lymphedema care is essential to improve quality of life and reduce morbidity in chronic filarial patients.

Reference: Davidson’s Principles and Practice of Medicine, 23rd Edition, Chapter: Tropical Medicine, Page 1034.