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Community level morbidity control of lymphoedema using self care and integrative treatment in two lymphatic filariasis endemic districts of South India: a non randomized interventional study.

Abstract

BACKGROUND: Currently there is no global program to manage lymphoedema as a result of lymphatic filariasis (LF). The primary aim of this study was to determine the efficacy of a previously proposed integrative treatment protocol, using locally available resources to address the morbidity, in a community village setting.

METHODS: Two LF endemic districts of south India, Gulbarga in Karnataka (GK) and Alleppey in Kerala (AK), were selected for the study. All known patients were invited to an LF camp. Patients with grade two late or three lymphoedema were enrolled. All patients were given training in the integrative procedure which involved patient education and the domiciliary protocol.

RESULTS: A total of 730 patients (851 limbs) completed the three and half month follow up. There was a statistically significant (1%) reduction up to mid thigh level volume measurement for both small (0.7-1.1 liters) and large (1.8-5.0 liters) limbs, p < 0.000. In AK inflammatory episodes at the three months interval reduced from 37.5% (127 patients) to 28.3% (96 patients) and in GK from 37.6% (147 patients) to 10.2% (40 patients), p < 0.000. All patients had reduced bacterial entry points. There was an overall improvement in quality of life in all domains of LF specific quality of life questionnaire p < 0.000.

CONCLUSIONS: Self care and integrative treatment is possible in resource poor Indian village settings. Further work is needed to explore factors leading to better compliance by randomizing the interventions such as washing and emollient compression vs Ayurvedic and yoga interventions before integrative treatment is considered for national health programmes in developing countries.

More information

Type
Journal Article
Author
Narahari SR
Bose KS
Aggithaya MG
Swamy GK
Ryan TJ
Unnikrishnan B
Washington RG
Rao BPS
Rajagopala S
Manjula K
Vandana U
Sreemol TA
Rojith M
Salimani SY
Shefuvan M
Year of Publication
2013
Journal
Transactions of the Royal Society of Tropical Medicine and Hygiene
Volume
107
Issue
9
Number of Pages
566-77
Language
eng
ISSN Number
1878-3503
DOI
10.1093/trstmh/trt054
Alternate Journal
Trans. R. Soc. Trop. Med. Hyg.
Publication Language
eng