Developing and demonstrating a comprehensive community-based model for morbidity management, disability prevention and rehabilitation of lymphatic filariasis patients: study protocol for an implementation research

Background

Lymphatic Filariasis (LF) is a neglected tropical disease and the leading cause of lymphedema worldwide, causing physical, socio-economic, and psychological burdens. Although transmission has substantially declined, many individuals suffer chronic complications. Morbidity management and disability prevention (MMDP) is critical, yet existing health systems lack comprehensive community-based services. This study aims to develop and evaluate a community-based model for MMDP and the rehabilitation of LF patients.

Methods

This non-randomised, open-labelled, parallel-arm implementation research will be conducted in six Brugia endemic panchayats of Alappuzha district, Kerala, India, with 1,050 participants. Three panchayats will be assigned to the intervention arm and three to the control arm. The intervention group will receive home-based education, foot-care kits, Complete Decongestive Therapy, customised footwear, and form peer support groups. The control group will receive home-based education alone. Focus Group Discussions (FGDs) will be conducted to explore self-care practices and gaps in care provision. Quantitative outcomes include limb girth, ADLA frequency, quality of life, and self-care practices, which will be analysed for within- and between-group changes. Qualitative data will be transcribed, translated, coded, and thematically analysed.

Discussion

This study addresses the MMDP component of the Filariasis Control Program by developing a sustainable community-based model for lymphedema care. By establishing local CDT centres staffed by trained physiotherapists from the study area, the project aims to provide facility-level care to populations most in need. Findings will guide policymakers on integrating community-based rehabilitation into existing healthcare systems.