@article{102884,
  keywords = {Lymphoedema, MMDP, Kenya},
  author = {Kepha S and Were V and Okello G and Okoyo C and Omondi WP and Njomo DW},
  title = {Piloting lymphoedema management for lymphatic filariasis: experiences and perceptions of patients and stakeholders from Kwale county, coastal Kenya},
  abstract = {<p><strong>Background</strong></p>

<p>The global program to eliminate lymphatic filariasis (GPELF) was started in 2003 with two strategies: mass drug administration (MDA) to interrupt disease transmission and the morbidity management and disability prevention (MMDP) to provide basic hygienic care to filariasis lymphoedema patients.</p>

<p><strong>Methods</strong></p>

<p>We conducted a mixed methods study with pre-intervention, intervention and post-intervention phases without control groups among 106 participants from two lymphatic filariasis-endemic wards of Lunga Lunga subcounty, Kwale county on the coastal Kenya between 2019 and 2021. During the intervention phase, a lymphoedema management care package was developed using participatory approaches. In the post-intervention phase, qualitative data was collected to assess perceptions of the impact of the intervention on patients’ knowledge of and access to lymphoedema management services.</p>

<p><strong>Results</strong></p>

<p>In the pre-intervention phase, 86.8% of patients reported experiencing pain, swelling, or redness in their limbs, and 44.3% felt negatively about their condition. More than half (52.8%) did not know the cause of their limb swelling, and 73.6% did not use appropriate footwear. Additionally, 57.5% did not know how to care for their wounds to prevent acute attacks. Key challenges included financial constraints (39.6% spent up to 200 Ksh per visit), long distances to health facilities (24.5% lived&gt;5&nbsp;km away), and stigma. In the post-intervention phase, participants reported improved knowledge and self-care practices, including washing, elevating, and exercising affected limbs. Community health volunteers (CHVs) were reported to play a critical role in raising awareness, identifying and referring patients, and improving health-seeking behavior, which contributed to increased service utilization and perceived improvements in quality of life.</p>

<p><strong>Conclusion</strong></p>

<p>Training of health care providers, caregivers and patients using the developed intervention care package contributed to improved knowledge on cause and management of lymphoedema. The CHVs played a critical role in the identification and referral of patients, which contributed to improved health-care seeking behaviour and&nbsp;increased service utilization. Collaboration with the county health authorities contributed to improved quality of health care services provided for lymphoedema management.</p>
},
  year = {2025},
  journal = {BMC Public Health},
  volume = {25},
  pages = {1-14},
  publisher = {Springer Science and Business Media LLC},
  issn = {1471-2458},
  url = {https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-025-24303-w.pdf},
  doi = {10.1186/s12889-025-24303-w},
  language = {ENG},
}