Sarah Martindale1, Square Z Mkwanda2, Emma Smith1, David Molyneux1, Michelle C Stanton1, Louise A Kelly-Hope3. 1. Centre for Neglected Tropical Diseases, Department of Parasitology, Liverpool School of Tropical Medicine, UK. 2. National Lymphatic Filariasis Elimination Programme, Ministry of Health, Lilongwe, Malawi. 3. Centre for Neglected Tropical Diseases, Department of Parasitology, Liverpool School of Tropical Medicine, UK Louise.Kelly-Hope@lstmed.ac.uk.
Abstract
BACKGROUND: Lymphatic filariasis (LF) is a disfiguring parasitic disease and one of the leading causes of disability in the world. This study aimed to assess the severity of lymphoedema, the physical restrictions and socio-economic impact on affected individuals living in an endemic community in Malawi. METHODS: In a single health centre catchment area, a follow-up survey was conducted to assess 69 lymphoedema cases, and the impact of their condition in eight different areas of their lives. Differences were examined by sex, age and severity of disease. The overall level of disability was quantified and the impact of acute dermatolymphangioadenitis (ADLA) attacks was examined. RESULTS: Lymphoedema cases were most affected by pain/discomfort and anxiety/depression, which also had an economic impact. Male and older (>60 years) individuals reported more problems. Higher disability levels based on a quantified score were significantly associated with decreased walking distance and working hours. ADLA significantly increased pain/discomfort and reduced cognition, and also affected the individuals' self-care, social participation and ability to work. CONCLUSIONS: Filarial lymphoedema causes significant hardship, particularly in relation to ADLAs, and the scale of the problem needs to be better defined with new specific tools so that the best support and care can be provided to those in greatest need.
BACKGROUND:Lymphatic filariasis (LF) is a disfiguring parasitic disease and one of the leading causes of disability in the world. This study aimed to assess the severity of lymphoedema, the physical restrictions and socio-economic impact on affected individuals living in an endemic community in Malawi. METHODS: In a single health centre catchment area, a follow-up survey was conducted to assess 69 lymphoedema cases, and the impact of their condition in eight different areas of their lives. Differences were examined by sex, age and severity of disease. The overall level of disability was quantified and the impact of acute dermatolymphangioadenitis (ADLA) attacks was examined. RESULTS: Lymphoedema cases were most affected by pain/discomfort and anxiety/depression, which also had an economic impact. Male and older (>60 years) individuals reported more problems. Higher disability levels based on a quantified score were significantly associated with decreased walking distance and working hours. ADLA significantly increased pain/discomfort and reduced cognition, and also affected the individuals' self-care, social participation and ability to work. CONCLUSIONS:Filarial lymphoedema causes significant hardship, particularly in relation to ADLAs, and the scale of the problem needs to be better defined with new specific tools so that the best support and care can be provided to those in greatest need.
Authors: Michelle C Stanton; Masato Yamauchi; Square Z Mkwanda; Paul Ndhlovu; Dorothy Emmie Matipula; Charles Mackenzie; Louise A Kelly-Hope Journal: Infect Dis Poverty Date: 2017-04-03 Impact factor: 4.520
Authors: Mohammad J Karim; Rouseli Haq; Hayley E Mableson; A S M Sultan Mahmood; Mujibur Rahman; Salim M Chowdhury; A K M Fazlur Rahman; Israt Hafiz; Hannah Betts; Charles Mackenzie; Mark J Taylor; Louise A Kelly-Hope Journal: PLoS Negl Trop Dis Date: 2019-07-15
Authors: Louise A Kelly-Hope; Mohammad Jahirul Karim; Asm Sultan Mahmood; Abdullah Al Kawsar; Abul Khair; Hannah Betts; Janet Douglass; Armelle Forrer; Mark J Taylor Journal: J Clin Med Date: 2021-05-25 Impact factor: 4.241
Authors: Joseph Pryce; Hayley E Mableson; Ramesh Choudhary; Basu Dev Pandey; Dambar Aley; Hannah Betts; Charles D Mackenzie; Louise A Kelly-Hope; Hugh Cross Journal: BMC Public Health Date: 2018-01-30 Impact factor: 3.295