02395nas a2200193   4500000000100000008004100001260005400042653001700096653001300113653002400126100001300150700001800163245011600181856015500297300001200452490000800464520170400472022002502176       2020                            d  bAmerican Society of Tropical Medicine and Hygiene10aParasitology10aVirology10aInfectious Diseases1 aSawers L1 aStillwaggon E00aEconomic Costs and Benefits of Community-Based Lymphedema-Management Programs for Lymphatic Filariasis in India  uhttp://www.ajtmh.org/docserver/fulltext/14761645/103/1/tpmd190898.pdf?expires=1594902964&id=id&accname=guest&checksum=A841117D3092BB20963551057963F9FD  a295-3020 v1033 aLymphatic filariasis (LF) is endemic in 72 countries; 15 million persons live with chronic filarial lymphedema.
It can be a disabling condition, frequently painful, leading to reduced mobility, social exclusion, and depression. The Global Program to Eliminate Lymphatic Filariasis aims to stop new infections and care for affected persons, but morbidity management has been initiated in only 38 countries. We examine economic costs and benefits of alleviating chronic lymphedema and its effects through simple limb care. We use economic and epidemiological data from 12 Indian states in which 99% of Indians with filariasis reside. Using census data, we calculate the age distribution of filarial lymphedema and predict the burden of morbidity of infected persons. We estimate lifetime medical costs and lost earnings due to lymphedema and acute dermatolymphangioadenitis (ADLA) with and without community-based limb-care programs. Programs of community-based limb care in all Indian endemic areas would reduce costs of disability by 52%, saving a per person average of US$2,721, equivalent to 703 workdays. Per-person savings are 185 times the program’s per-person cost. Chronic lymphedema and ADLA impose a substantial physical and economic burden in filariasis-endemic areas. Low-cost programs for 
 lymphedema management based on limb washing and topical medication are effective in reducing the number of ADLA episodes and stopping progression of disabling lymphedema. With reduced disability, people can work longer hours per day, more days per year, and in more strenuous, higher paying jobs, resulting in important
economic benefits to themselves, their families, and their communities.  a0002-9637, 1476-1645