Lymphoedema-management measures practised by cases of chronic lymphatic filariasis.

Abstract

Lymphatic filariasis (LF) has been targeted for global elimination (Anon. 1996) based on a two-part strategy of transmission control (using annual mass treatments with anti-filarial drugs) and morbidity management (Seim et al. 1999). The annual mass drug administrations which are primarily aimed at pre-patent and patent infections are gaining momentum and being expanded. The management of LF-attributable morbidity to provide relief to the chronic cases is however still in its formative stage. Lymphoedema of the lower and upper limbs is an overt and often grotesque clinical manifestation of LF. It is particularly common in India where there are an estimated 7.4 million cases (Ramaiah et al. 2000). Simple and feasible methods for the management of lymphoedema - based on foot hygiene limb elevation prevention of secondary infection and exercise - have recently been developed (Dreyer et al. 2002). It remains unclear however which if any of these methods - or alternative methods of lymphoedema management - are being practised in communities where LF is endemic. The information that is available (Babu and Nayak 2003) indicates that many lymphoedema cases may need to be oriented away from their current practices and towards the new more effective methods of morbidity management. (excerpt)