Measuring the physical and economic impact of filarial lymphoedema in Chikwawa district, Malawi: a case-control study
Identifieur interne : 000378 ( Main/Exploration ); précédent : 000377; suivant : 000379Measuring the physical and economic impact of filarial lymphoedema in Chikwawa district, Malawi: a case-control study
Auteurs : Michelle C. Stanton [Royaume-Uni] ; Masato Yamauchi [Royaume-Uni] ; Square Z. Mkwanda [Malawi] ; Paul Ndhlovu [Malawi] ; Dorothy Emmie Matipula [Malawi] ; Charles Mackenzie [Royaume-Uni, États-Unis] ; Louise A. Kelly-Hope [Royaume-Uni]Source :
- Infectious Diseases of Poverty [ 2049-9957 ] ; 2017.
Descripteurs français
- KwdFr :
- Activités de la vie quotidienne, Adulte d'âge moyen, Enquêtes et questionnaires, Examen physique, Facteurs socioéconomiques, Femelle, Filariose lymphatique (physiopathologie), Filariose lymphatique (économie), Humains, Indice de gravité médicale, Malawi, Mobilité réduite, Mâle, Qualité de vie, Revenu (), Surveillance de la population, Études cas-témoins, Études rétrospectives, Évaluation de l'incapacité.
- MESH :
- physiopathologie : Filariose lymphatique.
- économie : Filariose lymphatique.
- Activités de la vie quotidienne, Adulte d'âge moyen, Enquêtes et questionnaires, Examen physique, Facteurs socioéconomiques, Femelle, Humains, Indice de gravité médicale, Malawi, Mobilité réduite, Mâle, Qualité de vie, Revenu, Surveillance de la population, Études cas-témoins, Études rétrospectives, Évaluation de l'incapacité.
English descriptors
- KwdEn :
- Activities of Daily Living, Case-Control Studies, Disability Evaluation, Elephantiasis, Filarial (economics), Elephantiasis, Filarial (physiopathology), Female, Humans, Income (statistics & numerical data), Malawi, Male, Middle Aged, Mobility Limitation, Physical Examination, Population Surveillance, Quality of Life, Retrospective Studies, Severity of Illness Index, Socioeconomic Factors, Surveys and Questionnaires.
- MESH :
- economics : Elephantiasis, Filarial.
- physiopathology : Elephantiasis, Filarial.
- statistics & numerical data : Income.
- Activities of Daily Living, Case-Control Studies, Disability Evaluation, Female, Humans, Malawi, Male, Middle Aged, Mobility Limitation, Physical Examination, Population Surveillance, Quality of Life, Retrospective Studies, Severity of Illness Index, Socioeconomic Factors, Surveys and Questionnaires.
Abstract
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 affected. In this paper we assess the relative impact of lymphoedema on mobility and income in Chikwawa district, Malawi.
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 calculated. Two mobility tests were undertaken, namely the 10 m walking test [10MWT] and timed up and go [TUG] test, and a subset of 10 cases-control pairs wore GPS data loggers for 3 weeks to measure their mobility in a more natural setting. Retrospective 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 period.
Cases had a significantly poorer overall QoL (cases = 32.2, controls = 6.0,
Those affected by lymphoedema are at a clear disadvantage to their unaffected peers, experiencing a lower QoL as confirmed by both subjective and objective mobility measures, and lower income. This study also indicates that objective measures of mobility may be a useful supplement to self-assessed QoL questionnaires when assessing the future impact of lymphoedema management interventions.
The online version of this article (doi:10.1186/s40249-017-0241-2) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1186/s40249-017-0241-2
PubMed: 28366168
PubMed Central: 5376674
Affiliations:
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Le document en format XML
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<term>Case-Control Studies</term>
<term>Disability Evaluation</term>
<term>Elephantiasis, Filarial (economics)</term>
<term>Elephantiasis, Filarial (physiopathology)</term>
<term>Female</term>
<term>Humans</term>
<term>Income (statistics & numerical data)</term>
<term>Malawi</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Mobility Limitation</term>
<term>Physical Examination</term>
<term>Population Surveillance</term>
<term>Quality of Life</term>
<term>Retrospective Studies</term>
<term>Severity of Illness Index</term>
<term>Socioeconomic Factors</term>
<term>Surveys and Questionnaires</term>
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<keywords scheme="KwdFr" xml:lang="fr"><term>Activités de la vie quotidienne</term>
<term>Adulte d'âge moyen</term>
<term>Enquêtes et questionnaires</term>
<term>Examen physique</term>
<term>Facteurs socioéconomiques</term>
<term>Femelle</term>
<term>Filariose lymphatique (physiopathologie)</term>
<term>Filariose lymphatique (économie)</term>
<term>Humains</term>
<term>Indice de gravité médicale</term>
<term>Malawi</term>
<term>Mobilité réduite</term>
<term>Mâle</term>
<term>Qualité de vie</term>
<term>Revenu ()</term>
<term>Surveillance de la population</term>
<term>Études cas-témoins</term>
<term>Études rétrospectives</term>
<term>Évaluation de l'incapacité</term>
</keywords>
<keywords scheme="MESH" qualifier="economics" xml:lang="en"><term>Elephantiasis, Filarial</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Filariose lymphatique</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Elephantiasis, Filarial</term>
</keywords>
<keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Income</term>
</keywords>
<keywords scheme="MESH" qualifier="économie" xml:lang="fr"><term>Filariose lymphatique</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Activities of Daily Living</term>
<term>Case-Control Studies</term>
<term>Disability Evaluation</term>
<term>Female</term>
<term>Humans</term>
<term>Malawi</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Mobility Limitation</term>
<term>Physical Examination</term>
<term>Population Surveillance</term>
<term>Quality of Life</term>
<term>Retrospective Studies</term>
<term>Severity of Illness Index</term>
<term>Socioeconomic Factors</term>
<term>Surveys and Questionnaires</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Activités de la vie quotidienne</term>
<term>Adulte d'âge moyen</term>
<term>Enquêtes et questionnaires</term>
<term>Examen physique</term>
<term>Facteurs socioéconomiques</term>
<term>Femelle</term>
<term>Humains</term>
<term>Indice de gravité médicale</term>
<term>Malawi</term>
<term>Mobilité réduite</term>
<term>Mâle</term>
<term>Qualité de vie</term>
<term>Revenu</term>
<term>Surveillance de la population</term>
<term>Études cas-témoins</term>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>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 affected. In this paper we assess the relative impact of lymphoedema on mobility and income in Chikwawa district, Malawi.</p>
</sec>
<sec><title>Methods</title>
<p>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 calculated. Two mobility tests were undertaken, namely the 10 m walking test [10MWT] and timed up and go [TUG] test, and a subset of 10 cases-control pairs wore GPS data loggers for 3 weeks to measure their mobility in a more natural setting. Retrospective 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 period.</p>
</sec>
<sec><title>Results</title>
<p>Cases had a significantly poorer overall QoL (cases = 32.2, controls = 6.0, <italic>P</italic>
< 0.01) and mobility-specific (cases = 43.1, controls = 7.4, <italic>P</italic>
< 0.01) scores in comparison to controls. Cases were also significantly slower (<italic>P</italic>
< 0.01) at completing the timed mobility tests, e.g. mean 10MWT speed of 0.83 m/s in comparison to 1.10 m/s for controls. An inconsistent relationship was observed between mobility-specific QoL scores and the timed test results for cases (10MWT correlation = −0.06, 95% <italic>CI</italic>
= (−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% <italic>CI</italic>
= (−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 km<sup>2</sup>
, controls = 2.10 km<sup>2</sup>
, <italic>P</italic>
= 0.16). Cases reported earning less than half that earned by controls per week (cases = $0.70, controls = $1.86, <italic>P</italic>
= 0.064), with a smaller proportion of their earnings (16% vs 22%, <italic>P</italic>
= 0.461) being spent on healthcare.</p>
</sec>
<sec><title>Conclusions</title>
<p>Those affected by lymphoedema are at a clear disadvantage to their unaffected peers, experiencing a lower QoL as confirmed by both subjective and objective mobility measures, and lower income. This study also indicates that objective measures of mobility may be a useful supplement to self-assessed QoL questionnaires when assessing the future impact of lymphoedema management interventions.</p>
</sec>
<sec><title>Electronic supplementary material</title>
<p>The online version of this article (doi:10.1186/s40249-017-0241-2) contains supplementary material, which is available to authorized users.</p>
</sec>
</div>
</front>
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</author>
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<biblStruct><analytic><author><name sortKey="Zeldenryk, Lm" uniqKey="Zeldenryk L">LM Zeldenryk</name>
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</author>
<author><name sortKey="Speare, R" uniqKey="Speare R">R Speare</name>
</author>
<author><name sortKey="Gordon, S" uniqKey="Gordon S">S Gordon</name>
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</author>
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</author>
<author><name sortKey="Das, Lk" uniqKey="Das L">LK Das</name>
</author>
<author><name sortKey="Krishnamoorthy, K" uniqKey="Krishnamoorthy K">K Krishnamoorthy</name>
</author>
</analytic>
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<biblStruct><analytic><author><name sortKey="Ton, Tgn" uniqKey="Ton T">TGN Ton</name>
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<author><name sortKey="Mackenzie, C" uniqKey="Mackenzie C">C Mackenzie</name>
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<author><name sortKey="Molyneux, Dh" uniqKey="Molyneux D">DH Molyneux</name>
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