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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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Surgical debulking, lymphatico venous anastomosis, vascularised lymph node transfer in lower limb lymphoedema

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Plastic and Aesthetic Research 2020年第4期7卷 27-39页

作者： Hari Venkatramani Rajasabapathy Raja Shanmugakrishnan Murugesan Senthil Kumaran Shanmuganathan Raja Sabapathy Plastic Hand&Reconstructive Microsurgery&BurnsGanga HospitalCoimbatore 641043India

lymphoedema is a chronic debilitating disease of the lymphatic system that occurs due to either abnormal development or damage of the lymphatics resulting from cancer or *** optimal treatment of lymphoedema is still *** is tailored according to clinical features,investigations and expectations of each *** patients should undergo a trial of conservative management with compression therapy,manual lymphatic drainage and external sequential compression *** lymphoedema is treated by lymphovascular anastomosis,where the lymph vessels are connected to the subdermal veins by *** late cases when the limb is fibrotic,vascularised lymph node transfers are done,where lymph nodes are transferred from a healthy area to the affected *** advanced cases,when the limb is fibrotic with cutaneous folds and skin changes,surgical debulking is *** lymphoedema,along with accumulation of lymphatic tissue,there is also fat deposition,which can be removed by *** should be conversant with all treatment modalities to provide the lymphoedema patient with optimal care.

关键词： lymphoedema lymphovascular anastomosis vascularised lymph node transfers liposuction surgical debulking

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Scaling-up filariasis lymphoedema management into the primary health care system in Kerala State, Southern India: a case study in healthcare equity

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Infectious Diseases of Poverty 2022年第1期11卷 74-81页

作者： Suma T.Krishnasastry Charles D.Mackenzie Rajeev Sadanandan Filariasis Research Unit WHO Collaborating Center for LF MMDPLymphatic Filariasis Morbidity Management and Disability PreventionDepartment of Internal MedicineGovt.T.D.Medical College HospitalKerala University of Health SciencesAlappuzha688005India NTD Support Center Task Force for Global HealthAtlantaGA30030USA Health Systems Transformation Platform New Delhi110070India

Background:Lymphatic filariasis(LF)remains one of the world’s most debilitating parasitic infections and is a major contributor to poor health in many endemic *** provision of continuing care for all those affected by LF and its consequences is an important component of the United Nations’Sustainable Development *** aim of this study is to integrate lymphedema care into the primary health care system of the State by developing lymphedema clinics at each district,through training of health personnel to fulfill WHO recommendation for morbidity management and disability ***:Selected health care providers from all the districts in Kerala State of India participated in intensive training sessions endorsed by the State’s health *** six training sessions(from 5 June 2017 to 25 May 2018)included appropriate self-care information and development of individual plans for each participating institution to provide instruction and care for their lymphoedema *** learning achieved by attendees was assessed by pre-and post-training *** number of lymphoedema patients receiving care and instruction from the post-training activities of each participating institution was assessed from local records,6 months after the conclusion of the training ***:One hundred and eighty-four medical personnel(91 doctors and 93 nurses)from 82 medical institutions were trained which quickly led to the establishment of active lymphoedema clinics providing the essential package of care(EPC)for lymphoedema patients at all the participating *** months after the training sessions the number of previously unidentified lymphoedema patients registered and receiving care at these clinics ranged from 296 to almost 400 per clinic,with a total of 3,477 new patients receiving training in ***:Generalist health personnel,when appropriately trained,can provide quality lymphoedema care in public health settings and patients

关键词： Lymphatic filariasis Health equity India lymphoedema Global program to eliminate lymphatic filariasis

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