Impact of a Community-Based Lymphedema Management Program on Episodes of Adenolymphangitis (ADLA) and Lymphedema Progression - Odisha State, India
Identifieur interne : 002998 ( Main/Exploration ); précédent : 002997; suivant : 002999Impact of a Community-Based Lymphedema Management Program on Episodes of Adenolymphangitis (ADLA) and Lymphedema Progression - Odisha State, India
Auteurs : Katherine E. Mues [États-Unis] ; Michael Deming [États-Unis] ; David G. Kleinbaum [États-Unis] ; Philip J. Budge [États-Unis] ; Mitch Klein [États-Unis] ; Juan S. Leon [États-Unis] ; Aishya Prakash [Inde] ; Jonathan Rout [Inde] ; Leanne M. Fox [États-Unis]Source :
- PLoS Neglected Tropical Diseases [ 1935-2727 ] ; 2014.
Descripteurs français
- KwdFr :
- MESH :
- Wicri :
- geographic : Inde.
English descriptors
- KwdEn :
- MESH :
- geographic , epidemiology : India.
- epidemiology : Lymphangitis, Lymphedema.
- therapy : Lymphangitis, Lymphedema.
- Adult, Aged, Community Health Services, Disease Progression, Female, Humans, Male, Middle Aged, Patient Compliance.
Abstract
Lymphedema management programs have been shown to decrease episodes of adenolymphangitis (ADLA), but the impact on lymphedema progression and of program compliance have not been thoroughly explored. Our objectives were to determine the rate of ADLA episodes and lymphedema progression over time for patients enrolled in a community-based lymphedema management program. We explored the association between program compliance and ADLA episodes as well as lymphedema progression.
A lymphedema management program was implemented in Odisha State, India from 2007–2010 by the non-governmental organization, Church's Auxiliary for Social Action, in consultation with the Centers for Disease Control and Prevention. A cohort of patients was followed over 24 months. The crude 30-day rate of ADLA episodes decreased from 0.35 episodes per person-month at baseline to 0.23 at 24 months. Over the study period, the percentage of patients who progressed to more severe lymphedema decreased (P-value = 0.0004), while those whose lymphedema regressed increased over time (P-value<0.0001). Overall compliance to lymphedema management, lagged one time point, appeared to have little to no association with the frequency of ADLA episodes among those without entry lesions (RR = 0.87 (0.69, 1.10)) and was associated with an increased rate (RR = 1.44 (1.11, 1.86)) among those with entry lesions. Lagging compliance two time points, it was associated with a decrease in the rate of ADLA episodes among those with entry lesions (RR = 0.77 (95% CI: 0.59, 0.99)) and was somewhat associated among those without entry lesions (RR = 0.83 (95% CI: 0.64, 1.06)). Compliance to soap was associated with a decreased rate of ADLA episodes among those without inter-digital entry lesions.
These results indicate that a community-based lymphedema management program is beneficial for lymphedema patients for both ADLA episodes and lymphedema. It is one of the first studies to demonstrate an association between program compliance and rate of ADLA episodes.
Url:
DOI: 10.1371/journal.pntd.0003140
PubMed: 25211334
PubMed Central: 4161333
Affiliations:
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Mues</name><affiliation wicri:level="2"><nlm:aff id="aff1"><addr-line>Department of Epidemiology, Rollins School of Public Health and Laney Graduate School, Emory University, Atlanta, Georgia, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Epidemiology, Rollins School of Public Health and Laney Graduate School, Emory University, Atlanta, Georgia</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author><author><name sortKey="Deming, Michael" sort="Deming, Michael" uniqKey="Deming M" first="Michael" last="Deming">Michael Deming</name><affiliation wicri:level="2"><nlm:aff id="aff2"><addr-line>Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author><author><name sortKey="Kleinbaum, David G" sort="Kleinbaum, David G" uniqKey="Kleinbaum D" first="David G." last="Kleinbaum">David G. Kleinbaum</name><affiliation wicri:level="2"><nlm:aff id="aff3"><addr-line>Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author><author><name sortKey="Budge, Philip J" sort="Budge, Philip J" uniqKey="Budge P" first="Philip J." last="Budge">Philip J. Budge</name><affiliation wicri:level="2"><nlm:aff id="aff2"><addr-line>Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author><author><name sortKey="Klein, Mitch" sort="Klein, Mitch" uniqKey="Klein M" first="Mitch" last="Klein">Mitch Klein</name><affiliation wicri:level="2"><nlm:aff id="aff3"><addr-line>Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author><author><name sortKey="Leon, Juan S" sort="Leon, Juan S" uniqKey="Leon J" first="Juan S." last="Leon">Juan S. Leon</name><affiliation wicri:level="2"><nlm:aff id="aff3"><addr-line>Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author><author><name sortKey="Prakash, Aishya" sort="Prakash, Aishya" uniqKey="Prakash A" first="Aishya" last="Prakash">Aishya Prakash</name><affiliation wicri:level="1"><nlm:aff id="aff4"><addr-line>Church's Auxiliary for Social Action, Odisha, India</addr-line></nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Church's Auxiliary for Social Action, Odisha</wicri:regionArea><wicri:noRegion>Odisha</wicri:noRegion></affiliation></author><author><name sortKey="Rout, Jonathan" sort="Rout, Jonathan" uniqKey="Rout J" first="Jonathan" last="Rout">Jonathan Rout</name><affiliation wicri:level="1"><nlm:aff id="aff4"><addr-line>Church's Auxiliary for Social Action, Odisha, India</addr-line></nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Church's Auxiliary for Social Action, Odisha</wicri:regionArea><wicri:noRegion>Odisha</wicri:noRegion></affiliation></author><author><name sortKey="Fox, Leanne M" sort="Fox, Leanne M" uniqKey="Fox L" first="Leanne M." last="Fox">Leanne M. Fox</name><affiliation wicri:level="2"><nlm:aff id="aff2"><addr-line>Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America</addr-line></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author></analytic><series><title level="j">PLoS Neglected Tropical Diseases</title><idno type="ISSN">1935-2727</idno><idno type="eISSN">1935-2735</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Community Health Services</term><term>Disease Progression</term><term>Female</term><term>Humans</term><term>India (epidemiology)</term><term>Lymphangitis (epidemiology)</term><term>Lymphangitis (therapy)</term><term>Lymphedema (epidemiology)</term><term>Lymphedema (therapy)</term><term>Male</term><term>Middle Aged</term><term>Patient Compliance</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Inde (épidémiologie)</term><term>Lymphangite ()</term><term>Lymphangite (épidémiologie)</term><term>Lymphoedème ()</term><term>Lymphoedème (épidémiologie)</term><term>Mâle</term><term>Observance thérapeutique</term><term>Services de santé communautaires</term><term>Sujet âgé</term><term>Évolution de la maladie</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>India</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Lymphangitis</term><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Lymphangitis</term><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Inde</term><term>Lymphangite</term><term>Lymphoedème</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Community Health Services</term><term>Disease Progression</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Patient Compliance</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Lymphangite</term><term>Lymphoedème</term><term>Mâle</term><term>Observance thérapeutique</term><term>Services de santé communautaires</term><term>Sujet âgé</term><term>Évolution de la maladie</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Inde</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Lymphedema management programs have been shown to decrease episodes of adenolymphangitis (ADLA), but the impact on lymphedema progression and of program compliance have not been thoroughly explored. Our objectives were to determine the rate of ADLA episodes and lymphedema progression over time for patients enrolled in a community-based lymphedema management program. We explored the association between program compliance and ADLA episodes as well as lymphedema progression.</p></sec><sec><title>Methodology/Principal Findings</title><p>A lymphedema management program was implemented in Odisha State, India from 2007–2010 by the non-governmental organization, Church's Auxiliary for Social Action, in consultation with the Centers for Disease Control and Prevention. A cohort of patients was followed over 24 months. The crude 30-day rate of ADLA episodes decreased from 0.35 episodes per person-month at baseline to 0.23 at 24 months. Over the study period, the percentage of patients who progressed to more severe lymphedema decreased (P-value = 0.0004), while those whose lymphedema regressed increased over time (P-value<0.0001). Overall compliance to lymphedema management, lagged one time point, appeared to have little to no association with the frequency of ADLA episodes among those without entry lesions (RR = 0.87 (0.69, 1.10)) and was associated with an increased rate (RR = 1.44 (1.11, 1.86)) among those with entry lesions. Lagging compliance two time points, it was associated with a decrease in the rate of ADLA episodes among those with entry lesions (RR = 0.77 (95% CI: 0.59, 0.99)) and was somewhat associated among those without entry lesions (RR = 0.83 (95% CI: 0.64, 1.06)). Compliance to soap was associated with a decreased rate of ADLA episodes among those without inter-digital entry lesions.</p></sec><sec><title>Conclusions/Significance</title><p>These results indicate that a community-based lymphedema management program is beneficial for lymphedema patients for both ADLA episodes and lymphedema. It is one of the first studies to demonstrate an association between program compliance and rate of ADLA episodes.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Shenoy, Rk" uniqKey="Shenoy R">RK Shenoy</name></author><author><name sortKey="Kumaraswami, V" uniqKey="Kumaraswami V">V Kumaraswami</name></author><author><name sortKey="Suma, Tk" uniqKey="Suma T">TK Suma</name></author><author><name sortKey="Rajan, K" uniqKey="Rajan K">K Rajan</name></author><author><name sortKey="Radhakuttyamma, G" uniqKey="Radhakuttyamma G">G Radhakuttyamma</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Shenoy, Rk" uniqKey="Shenoy R">RK Shenoy</name></author><author><name sortKey="Suma, Tk" uniqKey="Suma T">TK Suma</name></author><author><name sortKey="Rajan, K" uniqKey="Rajan K">K Rajan</name></author><author><name sortKey="Kumaraswami, V" uniqKey="Kumaraswami V">V 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sortKey="Lapa, E" uniqKey="Lapa E">E Lapa</name></author><author><name sortKey="Williamson, J" uniqKey="Williamson J">J Williamson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wijesinghe, Rs" uniqKey="Wijesinghe R">RS Wijesinghe</name></author><author><name sortKey="Wickremasinghe, Ar" uniqKey="Wickremasinghe A">AR Wickremasinghe</name></author><author><name sortKey="Ekanayake, S" uniqKey="Ekanayake S">S Ekanayake</name></author><author><name sortKey="Perera, Ms" uniqKey="Perera M">MS Perera</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bockarie, Mj" uniqKey="Bockarie M">MJ Bockarie</name></author><author><name sortKey="Tisch, Dj" uniqKey="Tisch D">DJ Tisch</name></author><author><name sortKey="Kastens, W" uniqKey="Kastens W">W Kastens</name></author><author><name sortKey="Alexander, Nd" uniqKey="Alexander N">ND Alexander</name></author><author><name sortKey="Dimber, Z" uniqKey="Dimber Z">Z Dimber</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Budge, P" uniqKey="Budge P">P Budge</name></author><author><name sortKey="Little, K" uniqKey="Little K">K Little</name></author><author><name sortKey="Mues, K" uniqKey="Mues K">K Mues</name></author><author><name sortKey="Kennedy, E" uniqKey="Kennedy E">E Kennedy</name></author><author><name sortKey="Prakash, A" uniqKey="Prakash A">A Prakash</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Inde</li><li>États-Unis</li></country><region><li>Géorgie (États-Unis)</li></region></list><tree><country name="États-Unis"><region name="Géorgie (États-Unis)"><name sortKey="Mues, Katherine E" sort="Mues, Katherine E" uniqKey="Mues K" first="Katherine E." last="Mues">Katherine E. Mues</name></region><name sortKey="Budge, Philip J" sort="Budge, Philip J" uniqKey="Budge P" first="Philip J." last="Budge">Philip J. Budge</name><name sortKey="Deming, Michael" sort="Deming, Michael" uniqKey="Deming M" first="Michael" last="Deming">Michael Deming</name><name sortKey="Fox, Leanne M" sort="Fox, Leanne M" uniqKey="Fox L" first="Leanne M." last="Fox">Leanne M. Fox</name><name sortKey="Klein, Mitch" sort="Klein, Mitch" uniqKey="Klein M" first="Mitch" last="Klein">Mitch Klein</name><name sortKey="Kleinbaum, David G" sort="Kleinbaum, David G" uniqKey="Kleinbaum D" first="David G." last="Kleinbaum">David G. Kleinbaum</name><name sortKey="Leon, Juan S" sort="Leon, Juan S" uniqKey="Leon J" first="Juan S." last="Leon">Juan S. Leon</name></country><country name="Inde"><noRegion><name sortKey="Prakash, Aishya" sort="Prakash, Aishya" uniqKey="Prakash A" first="Aishya" last="Prakash">Aishya Prakash</name></noRegion><name sortKey="Rout, Jonathan" sort="Rout, Jonathan" uniqKey="Rout J" first="Jonathan" last="Rout">Jonathan Rout</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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