Impact of Community-Based Lymphedema Management on Perceived Disability among Patients with Lymphatic Filariasis in Orissa State, India
Identifieur interne : 003574 ( Main/Exploration ); précédent : 003573; suivant : 003575Impact of Community-Based Lymphedema Management on Perceived Disability among Patients with Lymphatic Filariasis in Orissa State, India
Auteurs : Philip J. Budge [États-Unis] ; Kristen M. Little [États-Unis] ; Katherine E. Mues [États-Unis] ; Erin D. Kennedy [États-Unis] ; Aiysha Prakash [Inde] ; Jonathan Rout [Inde] ; Leanne M. Fox [États-Unis]Source :
- PLoS Neglected Tropical Diseases [ 1935-2727 ] ; 2013.
Descripteurs français
- KwdFr :
- Adolescent, Adulte, Adulte d'âge moyen, Femelle, Filariose lymphatique (diagnostic), Filariose lymphatique (psychologie), Filariose lymphatique (traitement médicamenteux), Humains, Inde, Jeune adulte, Lymphoedème (diagnostic), Lymphoedème (psychologie), Lymphoedème (traitement médicamenteux), Mâle, Personnes handicapées, Population rurale, Sujet âgé, Sujet âgé de 80 ans ou plus, Études de cohortes, Études prospectives.
- MESH :
- diagnostic : Filariose lymphatique, Lymphoedème.
- psychologie : Filariose lymphatique, Lymphoedème.
- traitement médicamenteux : Filariose lymphatique, Lymphoedème.
- Adolescent, Adulte, Adulte d'âge moyen, Femelle, Humains, Inde, Jeune adulte, Mâle, Personnes handicapées, Population rurale, Sujet âgé, Sujet âgé de 80 ans ou plus, Études de cohortes, Études prospectives.
- Wicri :
- geographic : Inde.
English descriptors
- KwdEn :
- Adolescent, Adult, Aged, Aged, 80 and over, Cohort Studies, Disabled Persons, Elephantiasis, Filarial (diagnosis), Elephantiasis, Filarial (drug therapy), Elephantiasis, Filarial (psychology), Female, Humans, India, Lymphedema (diagnosis), Lymphedema (drug therapy), Lymphedema (psychology), Male, Middle Aged, Prospective Studies, Rural Population, Young Adult.
- MESH :
- geographic : India.
- diagnosis : Elephantiasis, Filarial, Lymphedema.
- drug therapy : Elephantiasis, Filarial, Lymphedema.
- psychology : Elephantiasis, Filarial, Lymphedema.
- Adolescent, Adult, Aged, Aged, 80 and over, Cohort Studies, Disabled Persons, Female, Humans, Male, Middle Aged, Prospective Studies, Rural Population, Young Adult.
Abstract
Lymphatic filariasis (LF) infects approximately 120 million people worldwide. As many as 40 million have symptoms of LF disease, including lymphedema, elephantiasis, and hydrocele. India constitutes approximately 45% of the world's burden of LF. The Indian NGO Church's Auxiliary for Social Action (CASA) has been conducting a community-based lymphedema management program in Orissa State since 2007 that aims to reduce the morbidity associated with lymphedema and elephantiasis. The objective of this analysis is to evaluate the effects of this program on lymphedema patients' perceived disability.
For this prospective cohort study, 370 patients ≥14 years of age, who reported lymphedema lasting more than three months in one or both legs, were recruited from villages in the Bolagarh sub-district, Khurda District, Orissa, India. The World Health Organization Disability Assessment Schedule II was administered to participants at baseline (July, 2009), and then at regular intervals through 24 months (July, 2011), to assess patients' perceived disability. Disability scores decreased significantly (p<0.0001) from baseline to 24 months. Multivariable analysis using mixed effects modeling found that employment and time in the program were significantly associated with lower disability scores after two years of program involvement. Older age, female gender, the presence of other chronic health conditions, moderate (Stage 3) or advanced (Stage 4–7) lymphedema, reporting an adenolymphangitis (ADL) episode during the previous 30 days, and the presence of inter-digital lesions were associated with higher disability scores. Patients with moderate or advanced lymphedema experienced greater improvements in perceived disability over time. Patients participating in the program for at least 12 months also reported losing 2.5 fewer work days per month (p<0.001) due to their lymphedema, compared to baseline.
These results indicate that community-based lymphedema management programs can reduce disability and prevent days of work lost. These effects were sustained over a 24 month period.
Url:
DOI: 10.1371/journal.pntd.0002100
PubMed: 23516648
PubMed Central: 3597476
Affiliations:
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Little</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="Mues, Katherine E" sort="Mues, Katherine E" uniqKey="Mues K" first="Katherine E." last="Mues">Katherine E. Mues</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><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="Kennedy, Erin D" sort="Kennedy, Erin D" uniqKey="Kennedy E" first="Erin D." last="Kennedy">Erin D. Kennedy</name><affiliation wicri:level="2"><nlm:aff id="aff1"><addr-line>Epidemic Intelligence Service, 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>Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author><author><name sortKey="Prakash, Aiysha" sort="Prakash, Aiysha" uniqKey="Prakash A" first="Aiysha" last="Prakash">Aiysha Prakash</name><affiliation wicri:level="1"><nlm:aff id="aff4"><addr-line>Church's Auxiliary for Social Action, East Zone, Kolkata, India</addr-line></nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Church's Auxiliary for Social Action, East Zone, Kolkata</wicri:regionArea><wicri:noRegion>Kolkata</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, East Zone, Kolkata, India</addr-line></nlm:aff><country xml:lang="fr">Inde</country><wicri:regionArea>Church's Auxiliary for Social Action, East Zone, Kolkata</wicri:regionArea><wicri:noRegion>Kolkata</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="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Cohort Studies</term><term>Disabled Persons</term><term>Elephantiasis, Filarial (diagnosis)</term><term>Elephantiasis, Filarial (drug therapy)</term><term>Elephantiasis, Filarial (psychology)</term><term>Female</term><term>Humans</term><term>India</term><term>Lymphedema (diagnosis)</term><term>Lymphedema (drug therapy)</term><term>Lymphedema (psychology)</term><term>Male</term><term>Middle Aged</term><term>Prospective Studies</term><term>Rural Population</term><term>Young Adult</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Femelle</term><term>Filariose lymphatique (diagnostic)</term><term>Filariose lymphatique (psychologie)</term><term>Filariose lymphatique (traitement médicamenteux)</term><term>Humains</term><term>Inde</term><term>Jeune adulte</term><term>Lymphoedème (diagnostic)</term><term>Lymphoedème (psychologie)</term><term>Lymphoedème (traitement médicamenteux)</term><term>Mâle</term><term>Personnes handicapées</term><term>Population rurale</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Études de cohortes</term><term>Études prospectives</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>India</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Elephantiasis, Filarial</term><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Filariose lymphatique</term><term>Lymphoedème</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Elephantiasis, Filarial</term><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="psychologie" xml:lang="fr"><term>Filariose lymphatique</term><term>Lymphoedème</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Elephantiasis, Filarial</term><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Filariose lymphatique</term><term>Lymphoedème</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Cohort Studies</term><term>Disabled Persons</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Prospective Studies</term><term>Rural Population</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Inde</term><term>Jeune adulte</term><term>Mâle</term><term>Personnes handicapées</term><term>Population rurale</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Études de cohortes</term><term>Études prospectives</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>Lymphatic filariasis (LF) infects approximately 120 million people worldwide. As many as 40 million have symptoms of LF disease, including lymphedema, elephantiasis, and hydrocele. India constitutes approximately 45% of the world's burden of LF. The Indian NGO Church's Auxiliary for Social Action (CASA) has been conducting a community-based lymphedema management program in Orissa State since 2007 that aims to reduce the morbidity associated with lymphedema and elephantiasis. The objective of this analysis is to evaluate the effects of this program on lymphedema patients' perceived disability.</p></sec><sec><title>Methodology/Principal Findings</title><p>For this prospective cohort study, 370 patients ≥14 years of age, who reported lymphedema lasting more than three months in one or both legs, were recruited from villages in the Bolagarh sub-district, Khurda District, Orissa, India. The World Health Organization Disability Assessment Schedule II was administered to participants at baseline (July, 2009), and then at regular intervals through 24 months (July, 2011), to assess patients' perceived disability. Disability scores decreased significantly (p<0.0001) from baseline to 24 months. Multivariable analysis using mixed effects modeling found that employment and time in the program were significantly associated with lower disability scores after two years of program involvement. Older age, female gender, the presence of other chronic health conditions, moderate (Stage 3) or advanced (Stage 4–7) lymphedema, reporting an adenolymphangitis (ADL) episode during the previous 30 days, and the presence of inter-digital lesions were associated with higher disability scores. Patients with moderate or advanced lymphedema experienced greater improvements in perceived disability over time. Patients participating in the program for at least 12 months also reported losing 2.5 fewer work days per month (p<0.001) due to their lymphedema, compared to baseline.</p></sec><sec><title>Significance</title><p>These results indicate that community-based lymphedema management programs can reduce disability and prevent days of work lost. These effects were sustained over a 24 month period.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Addiss, D" uniqKey="Addiss D">D Addiss</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kumari, Ak" uniqKey="Kumari A">AK Kumari</name></author><author><name sortKey="Jy Das, Lk" uniqKey="Jy Das L">LK JY, Das</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Kerketta, As" uniqKey="Kerketta A">AS Kerketta</name></author><author><name sortKey="Babu, Bv" uniqKey="Babu B">BV Babu</name></author><author><name sortKey="Rath, K" uniqKey="Rath K">K Rath</name></author><author><name sortKey="Janqid, Pk" uniqKey="Janqid P">PK Janqid</name></author><author><name sortKey="Nayak, An" uniqKey="Nayak A">AN Nayak</name></author></analytic></biblStruct><biblStruct><analytic><author><name 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Das</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chhotray, Gp" uniqKey="Chhotray G">GP Chhotray</name></author><author><name sortKey="Ranjit, Mr" uniqKey="Ranjit M">MR Ranjit</name></author><author><name sortKey="Khuntia, Hk" uniqKey="Khuntia H">HK Khuntia</name></author><author><name sortKey="Acharya, As" uniqKey="Acharya A">AS Acharya</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Suma, Tk" uniqKey="Suma T">TK Suma</name></author><author><name sortKey="Shenoy, Rk" uniqKey="Shenoy R">RK Shenoy</name></author><author><name sortKey="Kumaraswami, V" uniqKey="Kumaraswami V">V Kumaraswami</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mcpherson, T" uniqKey="Mcpherson T">T McPherson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Shenoy, Rk" uniqKey="Shenoy R">RK Shenoy</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Pani, Sp" uniqKey="Pani S">SP Pani</name></author><author><name sortKey="Yuvaraj, J" uniqKey="Yuvaraj J">J Yuvaraj</name></author><author><name sortKey="Vanamail, P" uniqKey="Vanamail P">P Vanamail</name></author><author><name sortKey="Dhanda, V" uniqKey="Dhanda V">V Dhanda</name></author><author><name sortKey="Michael, E" uniqKey="Michael E">E Michael</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Shenoy, Rk" uniqKey="Shenoy R">RK Shenoy</name></author><author><name sortKey="Sandhya, K" uniqKey="Sandhya K">K Sandhya</name></author><author><name sortKey="Sumar, Tk" uniqKey="Sumar T">TK Sumar</name></author><author><name sortKey="Kumaraswami, V" uniqKey="Kumaraswami V">V Kumaraswami</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Brantus, P" uniqKey="Brantus P">P Brantus</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="Budge, Philip J" sort="Budge, Philip J" uniqKey="Budge P" first="Philip J." last="Budge">Philip J. Budge</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="Fox, Leanne M" sort="Fox, Leanne M" uniqKey="Fox L" first="Leanne M." last="Fox">Leanne M. Fox</name><name sortKey="Kennedy, Erin D" sort="Kennedy, Erin D" uniqKey="Kennedy E" first="Erin D." last="Kennedy">Erin D. Kennedy</name><name sortKey="Little, Kristen M" sort="Little, Kristen M" uniqKey="Little K" first="Kristen M." last="Little">Kristen M. Little</name><name sortKey="Mues, Katherine E" sort="Mues, Katherine E" uniqKey="Mues K" first="Katherine E." last="Mues">Katherine E. Mues</name><name sortKey="Mues, Katherine E" sort="Mues, Katherine E" uniqKey="Mues K" first="Katherine E." last="Mues">Katherine E. Mues</name></country><country name="Inde"><noRegion><name sortKey="Prakash, Aiysha" sort="Prakash, Aiysha" uniqKey="Prakash A" first="Aiysha" last="Prakash">Aiysha 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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