Michelle C Stanton1, Emma L Smith2, Sarah Martindale2, Square Z Mkwanda3, Louise A Kelly-Hope2. 1. Centre for Neglected Tropical Diseases, Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK michelle.stanton@lstmed.ac.uk. 2. Centre for Neglected Tropical Diseases, Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK. 3. Lymphatic Filariasis Elimination Programme, Ministry of Health, Lilongwe, Malawi.
Abstract
BACKGROUND: Hydrocoele surgery is the recommended treatment for the common clinical manifestation of lymphatic filariasis in men. This study determined the geographical differences in surgery accessibility, and improvements in the quality of life of patients in Chikwawa district, Malawi. METHODS: Surgery records from Chikwawa District Hospital (CDH), between 2008 and 2013, were used to map surgery rates by village, spatial dependence by census enumeration area and relationship of distance (kilometres) to CDH. A subset of patients were selected to quantify and compare their physical and socio-economic well-being and level of disability pre- and post-surgery using a standardised questionnaire. RESULTS: A total of 476 hydrocoele surgical cases were identified with 260 cases geo-referenced and mapped. A significant negative relationship between village-level surgery rates and distance to CDH (r=-0.137; 95% CI: -0.47 to -0.26) was found, and clusters of enumeration areas with high surgery rates identified around the CDH. Significant improvements in patients' ability to walk and work were found and the overall level of disability was reduced post-surgery. CONCLUSIONS: Hydrocoele surgery positively impacted on patients, improving their physical and socio-economic output. Surgical services need to scale-up and expand to reach cases that have less access to the best treatment currently available.
BACKGROUND: Hydrocoele surgery is the recommended treatment for the common clinical manifestation of lymphatic filariasis in men. This study determined the geographical differences in surgery accessibility, and improvements in the quality of life of patients in Chikwawa district, Malawi. METHODS: Surgery records from Chikwawa District Hospital (CDH), between 2008 and 2013, were used to map surgery rates by village, spatial dependence by census enumeration area and relationship of distance (kilometres) to CDH. A subset of patients were selected to quantify and compare their physical and socio-economic well-being and level of disability pre- and post-surgery using a standardised questionnaire. RESULTS: A total of 476 hydrocoele surgical cases were identified with 260 cases geo-referenced and mapped. A significant negative relationship between village-level surgery rates and distance to CDH (r=-0.137; 95% CI: -0.47 to -0.26) was found, and clusters of enumeration areas with high surgery rates identified around the CDH. Significant improvements in patients' ability to walk and work were found and the overall level of disability was reduced post-surgery. CONCLUSIONS: Hydrocoele surgery positively impacted on patients, improving their physical and socio-economic output. Surgical services need to scale-up and expand to reach cases that have less access to the best treatment currently available.
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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
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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
Authors: Biruk Kebede; Sarah Martindale; Belete Mengistu; Biruck Kebede; Asrat Mengiste; Fikre H/Kiros; Abraham Tamiru; Gail Davey; Louise A Kelly-Hope; Charles D Mackenzie Journal: PLoS Negl Trop Dis Date: 2018-07-02
Authors: Larry Sawers; Eileen Stillwaggon; John Chiphwanya; Square Z Mkwanda; Hannah Betts; Sarah Martindale; Louise A Kelly-Hope Journal: PLoS Negl Trop Dis Date: 2020-03-25