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Measuring the physical and economic impact of filarial lymphoedema in Chikwawa district,Malawi:a case-control study

Infectious Diseases of Poverty 2017年第1期6卷 234-242页

作者： Michelle C.Stanton Masato Yamauchi Square Z.Mkwanda Paul Ndhlovu dorothy emmie matipula Charles Mackenzie Louise A.Kelly-Hope Department of Parasitology Liverpool School of Tropical MedicineLiverpoolUK Ministry of Health LilongweMalawi Chikwawa District Health Office ChikwawaMalawi Chiradzulu District Health Office ChiradzuluMalawi Department of Pathobiology and Diagnostic Investigation Michigan State UniversityEast LansingUSA

Background:Lymphatic filariasis(LF)is one of the primary causes of lymphoedema in sub-Saharan Africa,and has a significant impact on the quality of life(QoL)of those *** this paper we assess the relative impact of lymphoedema on mobility and income in Chikwawa district,***:A random sample of 31 people with lymphoedema and 31 matched controls completed a QoL questionnaire from which both an overall and a mobility-specific score were *** mobility tests were undertaken,namely the 10 m walking test[10MWT]and timed up and go[TUG]test,and a subset of 10 casescontrol pairs wore GPS data loggers for 3 weeks to measure their mobility in a more natural *** economic data was collected from all 31 case-control pairs,and each participant undertaking the GPS activity recorded daily earnings and health expenditure throughout the observation ***:Cases had a significantly poorer overall QoL(cases=32.2,controls=6.0,P<0.01)and mobility-specific(cases=43.1,controls=7.4,P<0.01)scores in comparison to *** were also significantly slower(P<0.01)at completing the timed mobility tests,*** 10MWT speed of 0.83 m/s in comparison to 1.10 m/s for *** inconsistent relationship was observed between mobility-specific QoL scores and the timed test results for cases(10MWT correlation=−0.06,95%CI=(−0.41,0.30)),indicating that their perceived disability differed from their measured disability,whereas the results were consistent for controls(10MWT correlation=−0.61,95%CI=(−0.79,−0.34)).GPS summaries indicated that cases generally walk shorter distances at slower speeds than control,covering a smaller geographical area(median area by kernel smoothing:cases=1.25 km2,controls=2.10 km^(2),P=0.16).Cases reported earning less than half that earned by controls per week(cases=$0.70,controls=$1.86,P=0.064),with a smaller proportion of their earnings(16%vs 22%,P=0.461)being spent on ***:Those affected by lymphoede

关键词： Lymphatic filariasis Lymphoedema Morbidity Malawi GPS Mobility Quality of life

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