LymphedemaV1, Main, Exploration, bibRecord, 005896

Feasibility and Effectiveness of Basic Lymphedema Management in Leogane, Haiti, an Area Endemic for Bancroftian Filariasis

Identifieur interne : 005896 ( Main/Exploration ); précédent : 005895; suivant : 005897

Feasibility and Effectiveness of Basic Lymphedema Management in Leogane, Haiti, an Area Endemic for Bancroftian Filariasis

Auteurs : David G. Addiss [États-Unis] ; Jacky Louis-Charles [Haïti] ; Jacquelin Roberts [États-Unis] ; Frederic Leconte [Haïti] ; Joyanna M. Wendt [États-Unis] ; Marie Denise Milord [Haïti] ; Patrick J. Lammie [États-Unis] ; Gerusa Dreyer [Brésil]

Source :

PLoS Neglected Tropical Diseases [ 1935-2727 ] ; 2010.

RBID : PMC:2857874

Descripteurs français

KwdFr :
- Adolescent, Adulte, Adulte d'âge moyen, Animaux, Enfant, Femelle, Filariose lymphatique (), Filariose lymphatique (anatomopathologie), Filariose lymphatique (diagnostic), Filariose lymphatique (épidémiologie), Haïti (épidémiologie), Humains, Incidence, Jeune adulte, Maladies endémiques, Mâle, Sujet âgé, Sujet âgé de 80 ans ou plus, Wuchereria bancrofti (isolement et purification), Études prospectives.
MESH :
- anatomopathologie : Filariose lymphatique.
- diagnostic : Filariose lymphatique.
- isolement et purification : Wuchereria bancrofti.
- épidémiologie : Filariose lymphatique, Haïti.
- Adolescent, Adulte, Adulte d'âge moyen, Animaux, Enfant, Femelle, Filariose lymphatique, Humains, Incidence, Jeune adulte, Maladies endémiques, Mâle, Sujet âgé, Sujet âgé de 80 ans ou plus, Études prospectives.
Wicri :
- geographic : Haïti.

English descriptors

KwdEn :
- Adolescent, Adult, Aged, Aged, 80 and over, Animals, Child, Elephantiasis, Filarial (diagnosis), Elephantiasis, Filarial (epidemiology), Elephantiasis, Filarial (pathology), Elephantiasis, Filarial (therapy), Endemic Diseases, Female, Haiti (epidemiology), Humans, Incidence, Male, Middle Aged, Prospective Studies, Wuchereria bancrofti (isolation & purification), Young Adult.
MESH :
- geographic , epidemiology : Haiti.
- diagnosis : Elephantiasis, Filarial.
- epidemiology : Elephantiasis, Filarial.
- isolation & purification : Wuchereria bancrofti.
- pathology : Elephantiasis, Filarial.
- therapy : Elephantiasis, Filarial.
- Adolescent, Adult, Aged, Aged, 80 and over, Animals, Child, Endemic Diseases, Female, Humans, Incidence, Male, Middle Aged, Prospective Studies, Young Adult.

Abstract

Background

Approximately 14 million persons living in areas endemic for lymphatic filariasis have lymphedema of the leg. Clinical studies indicate that repeated episodes of bacterial acute dermatolymphangioadenitis (ADLA) lead to progression of lymphedema and that basic lymphedema management, which emphasizes hygiene, skin care, exercise, and leg elevation, can reduce ADLA frequency. However, few studies have prospectively evaluated the effectiveness of basic lymphedema management or assessed the role of compressive bandaging for lymphedema in resource-poor settings.

Methodology/Principal Findings

Between 1995 and 1998, we prospectively monitored ADLA incidence and leg volume in 175 persons with lymphedema of the leg who enrolled in a lymphedema clinic in Leogane, Haiti, an area endemic for Wuchereria bancrofti. During the first phase of the study, when a major focus of the program was to reduce leg volume using compression bandages, ADLA incidence was 1.56 episodes per person-year. After March 1997, when hygiene and skin care were systematically emphasized and bandaging discouraged, ADLA incidence decreased to 0.48 episodes per person-year (P<0.0001). ADLA incidence was significantly associated with leg volume, stage of lymphedema, illiteracy, and use of compression bandages. Leg volume decreased in 78% of patients; over the entire study period, this reduction was statistically significant only for legs with stage 2 lymphedema (P = 0.01).

Conclusions/Significance

Basic lymphedema management, which emphasized hygiene and self-care, was associated with a 69% reduction in ADLA incidence. Use of compression bandages in this setting was associated with an increased risk of ADLA. Basic lymphedema management is feasible and effective in resource-limited areas that are endemic for lymphatic filariasis.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2857874

DOI: 10.1371/journal.pntd.0000668
PubMed: 20422031
PubMed Central: 2857874

Affiliations:

Le document en format XML

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<term>Adult</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Animals</term>
<term>Child</term>
<term>Endemic Diseases</term>
<term>Female</term>
<term>Humans</term>
<term>Incidence</term>
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<term>Enfant</term>
<term>Femelle</term>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Approximately 14 million persons living in areas endemic for lymphatic filariasis have lymphedema of the leg. Clinical studies indicate that repeated episodes of bacterial acute dermatolymphangioadenitis (ADLA) lead to progression of lymphedema and that basic lymphedema management, which emphasizes hygiene, skin care, exercise, and leg elevation, can reduce ADLA frequency. However, few studies have prospectively evaluated the effectiveness of basic lymphedema management or assessed the role of compressive bandaging for lymphedema in resource-poor settings.</p>
</sec>
<sec><title>Methodology/Principal Findings</title>
<p>Between 1995 and 1998, we prospectively monitored ADLA incidence and leg volume in 175 persons with lymphedema of the leg who enrolled in a lymphedema clinic in Leogane, Haiti, an area endemic for <italic>Wuchereria bancrofti</italic>
. During the first phase of the study, when a major focus of the program was to reduce leg volume using compression bandages, ADLA incidence was 1.56 episodes per person-year. After March 1997, when hygiene and skin care were systematically emphasized and bandaging discouraged, ADLA incidence decreased to 0.48 episodes per person-year (P<0.0001). ADLA incidence was significantly associated with leg volume, stage of lymphedema, illiteracy, and use of compression bandages. Leg volume decreased in 78% of patients; over the entire study period, this reduction was statistically significant only for legs with stage 2 lymphedema (P = 0.01).</p>
</sec>
<sec><title>Conclusions/Significance</title>
<p>Basic lymphedema management, which emphasized hygiene and self-care, was associated with a 69% reduction in ADLA incidence. Use of compression bandages in this setting was associated with an increased risk of ADLA. Basic lymphedema management is feasible and effective in resource-limited areas that are endemic for lymphatic filariasis.</p>
</sec>
</div>
</front>
<back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Michael, E" uniqKey="Michael E">E Michael</name>
</author>
<author><name sortKey="Bundy, Dap" uniqKey="Bundy D">DAP Bundy</name>
</author>
<author><name sortKey="Grenfell, Bt" uniqKey="Grenfell B">BT Grenfell</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Ottesen, Ea" uniqKey="Ottesen E">EA Ottesen</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Seim, A" uniqKey="Seim A">A Seim</name>
</author>
<author><name sortKey="Dreyer, G" uniqKey="Dreyer G">G Dreyer</name>
</author>
<author><name sortKey="Addiss, D" uniqKey="Addiss D">D Addiss</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Dreyer, G" uniqKey="Dreyer G">G Dreyer</name>
</author>
<author><name sortKey="Medeiros, Z" uniqKey="Medeiros Z">Z Medeiros</name>
</author>
<author><name sortKey="Netto, Mj" uniqKey="Netto M">MJ Netto</name>
</author>
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Feasibility and Effectiveness of Basic Lymphedema Management in Leogane, Haiti, an Area Endemic for Bancroftian Filariasis

Feasibility and Effectiveness of Basic Lymphedema Management in Leogane, Haiti, an Area Endemic for Bancroftian Filariasis

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