Community level morbidity control of lymphoedema using self care and integrative treatment in two lymphatic filariasis endemic districts of South India: a non randomized interventional study
Identifieur interne : 000038 ( PascalFrancis/Checkpoint ); précédent : 000037; suivant : 000039Community level morbidity control of lymphoedema using self care and integrative treatment in two lymphatic filariasis endemic districts of South India: a non randomized interventional study
Auteurs : Saravu R. Narahari [Inde] ; Kuthaje S. Bose [Inde] ; Madhur G. Aggithaya [Inde] ; GADDAM KUMARA SWAMY [Inde] ; Terence J. Ryan [Royaume-Uni] ; Bhaskaran Unnikrishnan [Inde] ; Reynold G. Washington [Inde] ; BALU PALICHERALU SREENIVASA RAO [Inde] ; Shrikrishna Rajagopala [Inde] ; Kadengodlu Manjula [Inde] ; Usha Vandana [Inde] ; THAIVALATH ANANDAN SREEMOL [Inde] ; Mathew Rojith [Inde] ; Shanappa Y. Salimani [Inde] ; Mohammed Shefuvan [Inde]Source :
- Transactions of the Royal Society of Tropical Medicine and Hygiene [ 0035-9203 ] ; 2013.
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- Pascal (Inist)
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- geographic : Inde.
- topic : Homme, Maladie tropicale.
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Abstract
Background: Currently there is no global program to manage lymphoedema as a result of lymphatic filariasis (LF). The primary aim of this study was to determine the efficacy of a previously proposed integrative treatment protocol, using locally available resources to address the morbidity, in a community village setting. Methods: Two LF endemic districts of south India, Gulbarga in Karnataka (GK) and Alleppey in Kerala (AK), were selected for the study. All known patients were invited to an LF camp. Patients with grade two late or three lymphoedema were enrolled. All patients were given training in the integrative procedure which involved patient education and the domiciliary protocol. Results: A total of 730 patients (851 limbs) completed the three and half month follow up. There was a statistically significant (1%) reduction up to mid thigh level volume measurement for both small (0.7-1.1 liters) and large (1.8-5.0 liters) limbs, p < 0.000. In AK inflammatory episodes at the three months interval reduced from 37.5% (127 patients) to 28.3% (96 patients) and in GK from 37.6% (147 patients) to 10.2% (40 patients), p < 0.000. All patients had reduced bacterial entry points. There was an overall improvement in quality of life in all domains of LF specific quality of life questionnaire p < 0.000. Conclusions: Self care and integrative treatment is possible in resource poor Indian village settings. Further work is needed to explore factors leading to better compliance by randomizing the interventions such as washing and emollient compression vs Ayurvedic and yoga interventions before integrative treatment is considered for national health programmes in developing countries.
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Community level morbidity control of lymphoedema using self care and integrative treatment in two lymphatic filariasis endemic districts of South India: a non randomized interventional study</title><author><name sortKey="Narahari, Saravu R" sort="Narahari, Saravu R" uniqKey="Narahari S" first="Saravu R." last="Narahari">Saravu R. Narahari</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institute of Applied Dermatology, IAD Junction, Uliyathadka, Madhur Road, Kasaragod</s1><s2>Kerala 671124</s2><s3>IND</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Inde</country><wicri:noRegion>Kerala 671124</wicri:noRegion></affiliation></author><author><name sortKey="Bose, Kuthaje S" sort="Bose, Kuthaje S" uniqKey="Bose K" first="Kuthaje S." last="Bose">Kuthaje S. 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Ryan</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Department of Dermatology, Churchill Hospital</s1><s2>Oxford</s2><s3>GBR</s3><sZ>5 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region></placeName></affiliation></author><author><name sortKey="Unnikrishnan, Bhaskaran" sort="Unnikrishnan, Bhaskaran" uniqKey="Unnikrishnan B" first="Bhaskaran" last="Unnikrishnan">Bhaskaran Unnikrishnan</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Dept. of Community Medicine, Kasturba Medical College Manipal University</s1><s2>Mangalore, Karnataka</s2><s3>IND</s3><sZ>6 aut.</sZ></inist:fA14><country>Inde</country><wicri:noRegion>Mangalore, Karnataka</wicri:noRegion></affiliation></author><author><name sortKey="Washington, Reynold G" sort="Washington, Reynold G" uniqKey="Washington R" first="Reynold G." last="Washington">Reynold G. 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Salimani</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institute of Applied Dermatology, IAD Junction, Uliyathadka, Madhur Road, Kasaragod</s1><s2>Kerala 671124</s2><s3>IND</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Inde</country><wicri:noRegion>Kerala 671124</wicri:noRegion></affiliation></author><author><name sortKey="Shefuvan, Mohammed" sort="Shefuvan, Mohammed" uniqKey="Shefuvan M" first="Mohammed" last="Shefuvan">Mohammed Shefuvan</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institute of Applied Dermatology, IAD Junction, Uliyathadka, Madhur Road, Kasaragod</s1><s2>Kerala 671124</s2><s3>IND</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Inde</country><wicri:noRegion>Kerala 671124</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">13-0281576</idno><date when="2013">2013</date><idno type="stanalyst">PASCAL 13-0281576 INIST</idno><idno type="RBID">Pascal:13-0281576</idno><idno type="wicri:Area/PascalFrancis/Corpus">000026</idno><idno type="wicri:Area/PascalFrancis/Curation">000929</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000038</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000038</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Community level morbidity control of lymphoedema using self care and integrative treatment in two lymphatic filariasis endemic districts of South India: a non randomized interventional study</title><author><name sortKey="Narahari, Saravu R" sort="Narahari, Saravu R" uniqKey="Narahari S" first="Saravu R." last="Narahari">Saravu R. Narahari</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institute of Applied Dermatology, IAD Junction, Uliyathadka, Madhur Road, Kasaragod</s1><s2>Kerala 671124</s2><s3>IND</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Inde</country><wicri:noRegion>Kerala 671124</wicri:noRegion></affiliation></author><author><name sortKey="Bose, Kuthaje S" sort="Bose, Kuthaje S" uniqKey="Bose K" first="Kuthaje S." last="Bose">Kuthaje S. Bose</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institute of Applied Dermatology, IAD Junction, Uliyathadka, Madhur Road, Kasaragod</s1><s2>Kerala 671124</s2><s3>IND</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Inde</country><wicri:noRegion>Kerala 671124</wicri:noRegion></affiliation></author><author><name sortKey="Aggithaya, Madhur G" sort="Aggithaya, Madhur G" uniqKey="Aggithaya M" first="Madhur G." last="Aggithaya">Madhur G. Aggithaya</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institute of Applied Dermatology, IAD Junction, Uliyathadka, Madhur Road, Kasaragod</s1><s2>Kerala 671124</s2><s3>IND</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Inde</country><wicri:noRegion>Kerala 671124</wicri:noRegion></affiliation></author><author><name sortKey="Gaddam Kumara Swamy" sort="Gaddam Kumara Swamy" uniqKey="Gaddam Kumara Swamy" last="Gaddam Kumara Swamy">GADDAM KUMARA SWAMY</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>National Ayurveda Research Institute For Vector Borne Diseases, New Rajeevnagar</s1><s2>Payakapuram, Vijayawada-520015</s2><s3>IND</s3><sZ>4 aut.</sZ></inist:fA14><country>Inde</country><wicri:noRegion>Payakapuram, Vijayawada-520015</wicri:noRegion></affiliation></author><author><name sortKey="Ryan, Terence J" sort="Ryan, Terence J" uniqKey="Ryan T" first="Terence J." last="Ryan">Terence J. Ryan</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Department of Dermatology, Churchill Hospital</s1><s2>Oxford</s2><s3>GBR</s3><sZ>5 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region></placeName></affiliation></author><author><name sortKey="Unnikrishnan, Bhaskaran" sort="Unnikrishnan, Bhaskaran" uniqKey="Unnikrishnan B" first="Bhaskaran" last="Unnikrishnan">Bhaskaran Unnikrishnan</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Dept. of Community Medicine, Kasturba Medical College Manipal University</s1><s2>Mangalore, Karnataka</s2><s3>IND</s3><sZ>6 aut.</sZ></inist:fA14><country>Inde</country><wicri:noRegion>Mangalore, Karnataka</wicri:noRegion></affiliation></author><author><name sortKey="Washington, Reynold G" sort="Washington, Reynold G" uniqKey="Washington R" first="Reynold G." last="Washington">Reynold G. Washington</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Karnataka Health Promotion Trust</s1><s2>Bangalore, Karnataka</s2><s3>IND</s3><sZ>7 aut.</sZ></inist:fA14><country>Inde</country><wicri:noRegion>Karnataka Health Promotion Trust</wicri:noRegion></affiliation></author><author><name sortKey="Balu Palicheralu Sreenivasa Rao" sort="Balu Palicheralu Sreenivasa Rao" uniqKey="Balu Palicheralu Sreenivasa Rao" last="Balu Palicheralu Sreenivasa Rao">BALU PALICHERALU SREENIVASA RAO</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Dept. of Community Medicine, JJM Medical College</s1><s2>Davangere, Karnataka</s2><s3>IND</s3><sZ>8 aut.</sZ></inist:fA14><country>Inde</country><wicri:noRegion>Davangere, Karnataka</wicri:noRegion></affiliation></author><author><name sortKey="Rajagopala, Shrikrishna" sort="Rajagopala, Shrikrishna" uniqKey="Rajagopala S" first="Shrikrishna" last="Rajagopala">Shrikrishna Rajagopala</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Dept. of Kaumarabhritya, Institute of Post Graduate Teaching & Research in Ayurveda</s1><s2>Jamnagar, Gujarat</s2><s3>IND</s3><sZ>9 aut.</sZ></inist:fA14><country>Inde</country><wicri:noRegion>Jamnagar, Gujarat</wicri:noRegion></affiliation></author><author><name sortKey="Manjula, Kadengodlu" sort="Manjula, Kadengodlu" uniqKey="Manjula K" first="Kadengodlu" last="Manjula">Kadengodlu Manjula</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institute of Applied Dermatology, IAD Junction, Uliyathadka, Madhur Road, Kasaragod</s1><s2>Kerala 671124</s2><s3>IND</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Inde</country><wicri:noRegion>Kerala 671124</wicri:noRegion></affiliation></author><author><name sortKey="Vandana, Usha" sort="Vandana, Usha" uniqKey="Vandana U" first="Usha" last="Vandana">Usha Vandana</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institute of Applied Dermatology, IAD Junction, Uliyathadka, Madhur Road, Kasaragod</s1><s2>Kerala 671124</s2><s3>IND</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Inde</country><wicri:noRegion>Kerala 671124</wicri:noRegion></affiliation></author><author><name sortKey="Thaivalath Anandan Sreemol" sort="Thaivalath Anandan Sreemol" uniqKey="Thaivalath Anandan Sreemol" last="Thaivalath Anandan Sreemol">THAIVALATH ANANDAN SREEMOL</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institute of Applied Dermatology, IAD Junction, Uliyathadka, Madhur Road, Kasaragod</s1><s2>Kerala 671124</s2><s3>IND</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Inde</country><wicri:noRegion>Kerala 671124</wicri:noRegion></affiliation></author><author><name sortKey="Rojith, Mathew" sort="Rojith, Mathew" uniqKey="Rojith M" first="Mathew" last="Rojith">Mathew Rojith</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institute of Applied Dermatology, IAD Junction, Uliyathadka, Madhur Road, Kasaragod</s1><s2>Kerala 671124</s2><s3>IND</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Inde</country><wicri:noRegion>Kerala 671124</wicri:noRegion></affiliation></author><author><name sortKey="Salimani, Shanappa Y" sort="Salimani, Shanappa Y" uniqKey="Salimani S" first="Shanappa Y." last="Salimani">Shanappa Y. Salimani</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institute of Applied Dermatology, IAD Junction, Uliyathadka, Madhur Road, Kasaragod</s1><s2>Kerala 671124</s2><s3>IND</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Inde</country><wicri:noRegion>Kerala 671124</wicri:noRegion></affiliation></author><author><name sortKey="Shefuvan, Mohammed" sort="Shefuvan, Mohammed" uniqKey="Shefuvan M" first="Mohammed" last="Shefuvan">Mohammed Shefuvan</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institute of Applied Dermatology, IAD Junction, Uliyathadka, Madhur Road, Kasaragod</s1><s2>Kerala 671124</s2><s3>IND</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Inde</country><wicri:noRegion>Kerala 671124</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Transactions of the Royal Society of Tropical Medicine and Hygiene</title><title level="j" type="abbreviated">Trans. r. soc. trop. med. hyg.</title><idno type="ISSN">0035-9203</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Transactions of the Royal Society of Tropical Medicine and Hygiene</title><title level="j" type="abbreviated">Trans. r. soc. trop. med. hyg.</title><idno type="ISSN">0035-9203</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Check</term><term>Compression</term><term>Human</term><term>India</term><term>Lymphatic filariasis</term><term>Lymphedema</term><term>Morbidity</term><term>Neglected disease</term><term>Prognosis</term><term>Treatment</term><term>Tropical disease</term><term>Tropical medicine</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Lymphoedème</term><term>Filariose lymphatique</term><term>Morbidité</term><term>Contrôle</term><term>Traitement</term><term>Homme</term><term>Inde</term><term>Maladie tropicale</term><term>Compression</term><term>Médecine tropicale</term><term>Pronostic</term><term>Maladie négligée</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Inde</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term><term>Maladie tropicale</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: Currently there is no global program to manage lymphoedema as a result of lymphatic filariasis (LF). The primary aim of this study was to determine the efficacy of a previously proposed integrative treatment protocol, using locally available resources to address the morbidity, in a community village setting. Methods: Two LF endemic districts of south India, Gulbarga in Karnataka (GK) and Alleppey in Kerala (AK), were selected for the study. All known patients were invited to an LF camp. Patients with grade two late or three lymphoedema were enrolled. All patients were given training in the integrative procedure which involved patient education and the domiciliary protocol. Results: A total of 730 patients (851 limbs) completed the three and half month follow up. There was a statistically significant (1%) reduction up to mid thigh level volume measurement for both small (0.7-1.1 liters) and large (1.8-5.0 liters) limbs, p < 0.000. In AK inflammatory episodes at the three months interval reduced from 37.5% (127 patients) to 28.3% (96 patients) and in GK from 37.6% (147 patients) to 10.2% (40 patients), p < 0.000. All patients had reduced bacterial entry points. There was an overall improvement in quality of life in all domains of LF specific quality of life questionnaire p < 0.000. Conclusions: Self care and integrative treatment is possible in resource poor Indian village settings. Further work is needed to explore factors leading to better compliance by randomizing the interventions such as washing and emollient compression vs Ayurvedic and yoga interventions before integrative treatment is considered for national health programmes in developing countries.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0035-9203</s0></fA01><fA02 i1="01"><s0>TRSTAZ</s0></fA02><fA03 i2="1"><s0>Trans. r. soc. trop. med. hyg.</s0></fA03><fA05><s2>107</s2></fA05><fA06><s2>9</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Community level morbidity control of lymphoedema using self care and integrative treatment in two lymphatic filariasis endemic districts of South India: a non randomized interventional study</s1></fA08><fA11 i1="01" i2="1"><s1>NARAHARI (Saravu R.)</s1></fA11><fA11 i1="02" i2="1"><s1>BOSE (Kuthaje S.)</s1></fA11><fA11 i1="03" i2="1"><s1>AGGITHAYA (Madhur G.)</s1></fA11><fA11 i1="04" i2="1"><s1>GADDAM KUMARA SWAMY</s1></fA11><fA11 i1="05" i2="1"><s1>RYAN (Terence J.)</s1></fA11><fA11 i1="06" i2="1"><s1>UNNIKRISHNAN (Bhaskaran)</s1></fA11><fA11 i1="07" i2="1"><s1>WASHINGTON (Reynold G.)</s1></fA11><fA11 i1="08" i2="1"><s1>BALU PALICHERALU SREENIVASA RAO</s1></fA11><fA11 i1="09" i2="1"><s1>RAJAGOPALA (Shrikrishna)</s1></fA11><fA11 i1="10" i2="1"><s1>MANJULA (Kadengodlu)</s1></fA11><fA11 i1="11" i2="1"><s1>VANDANA (Usha)</s1></fA11><fA11 i1="12" i2="1"><s1>THAIVALATH ANANDAN SREEMOL</s1></fA11><fA11 i1="13" i2="1"><s1>ROJITH (Mathew)</s1></fA11><fA11 i1="14" i2="1"><s1>SALIMANI (Shanappa Y.)</s1></fA11><fA11 i1="15" i2="1"><s1>SHEFUVAN (Mohammed)</s1></fA11><fA14 i1="01"><s1>Institute of Applied Dermatology, IAD Junction, Uliyathadka, Madhur Road, Kasaragod</s1><s2>Kerala 671124</s2><s3>IND</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>10 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></fA14><fA14 i1="02"><s1>National Ayurveda Research Institute For Vector Borne Diseases, New Rajeevnagar</s1><s2>Payakapuram, Vijayawada-520015</s2><s3>IND</s3><sZ>4 aut.</sZ></fA14><fA14 i1="03"><s1>Department of Dermatology, Churchill Hospital</s1><s2>Oxford</s2><s3>GBR</s3><sZ>5 aut.</sZ></fA14><fA14 i1="04"><s1>Dept. of Community Medicine, Kasturba Medical College Manipal University</s1><s2>Mangalore, Karnataka</s2><s3>IND</s3><sZ>6 aut.</sZ></fA14><fA14 i1="05"><s1>Karnataka Health Promotion Trust</s1><s2>Bangalore, Karnataka</s2><s3>IND</s3><sZ>7 aut.</sZ></fA14><fA14 i1="06"><s1>Dept. of Community Medicine, JJM Medical College</s1><s2>Davangere, Karnataka</s2><s3>IND</s3><sZ>8 aut.</sZ></fA14><fA14 i1="07"><s1>Dept. of Kaumarabhritya, Institute of Post Graduate Teaching & Research in Ayurveda</s1><s2>Jamnagar, Gujarat</s2><s3>IND</s3><sZ>9 aut.</sZ></fA14><fA20><s1>566-577</s1></fA20><fA21><s1>2013</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>3084</s2><s5>354000506585260060</s5></fA43><fA44><s0>0000</s0><s1>© 2013 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>25 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>13-0281576</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Transactions of the Royal Society of Tropical Medicine and Hygiene</s0></fA64><fA66 i1="01"><s0>GBR</s0></fA66><fC01 i1="01" l="ENG"><s0>Background: Currently there is no global program to manage lymphoedema as a result of lymphatic filariasis (LF). The primary aim of this study was to determine the efficacy of a previously proposed integrative treatment protocol, using locally available resources to address the morbidity, in a community village setting. Methods: Two LF endemic districts of south India, Gulbarga in Karnataka (GK) and Alleppey in Kerala (AK), were selected for the study. All known patients were invited to an LF camp. Patients with grade two late or three lymphoedema were enrolled. All patients were given training in the integrative procedure which involved patient education and the domiciliary protocol. Results: A total of 730 patients (851 limbs) completed the three and half month follow up. There was a statistically significant (1%) reduction up to mid thigh level volume measurement for both small (0.7-1.1 liters) and large (1.8-5.0 liters) limbs, p < 0.000. In AK inflammatory episodes at the three months interval reduced from 37.5% (127 patients) to 28.3% (96 patients) and in GK from 37.6% (147 patients) to 10.2% (40 patients), p < 0.000. All patients had reduced bacterial entry points. There was an overall improvement in quality of life in all domains of LF specific quality of life questionnaire p < 0.000. Conclusions: Self care and integrative treatment is possible in resource poor Indian village settings. Further work is needed to explore factors leading to better compliance by randomizing the interventions such as washing and emollient compression vs Ayurvedic and yoga interventions before integrative treatment is considered for national health programmes in developing countries.</s0></fC01><fC02 i1="01" i2="X"><s0>002B01</s0></fC02><fC02 i1="02" i2="X"><s0>002B12B04</s0></fC02><fC02 i1="03" i2="X"><s0>002B05E03B4D</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Lymphoedème</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Lymphedema</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Linfedema</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Filariose lymphatique</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Lymphatic filariasis</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Filariasis linfática</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Morbidité</s0><s5>07</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Morbidity</s0><s5>07</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Morbilidad</s0><s5>07</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Contrôle</s0><s5>08</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Check</s0><s5>08</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Control</s0><s5>08</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Traitement</s0><s5>09</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Treatment</s0><s5>09</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Tratamiento</s0><s5>09</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Homme</s0><s5>10</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Human</s0><s5>10</s5></fC03><fC03 i1="06" i2="X" l="SPA"><s0>Hombre</s0><s5>10</s5></fC03><fC03 i1="07" i2="X" l="FRE"><s0>Inde</s0><s2>NG</s2><s5>13</s5></fC03><fC03 i1="07" i2="X" l="ENG"><s0>India</s0><s2>NG</s2><s5>13</s5></fC03><fC03 i1="07" i2="X" l="SPA"><s0>India</s0><s2>NG</s2><s5>13</s5></fC03><fC03 i1="08" i2="X" l="FRE"><s0>Maladie tropicale</s0><s5>14</s5></fC03><fC03 i1="08" i2="X" l="ENG"><s0>Tropical disease</s0><s5>14</s5></fC03><fC03 i1="08" i2="X" l="SPA"><s0>Enfermedad tropical</s0><s5>14</s5></fC03><fC03 i1="09" i2="X" l="FRE"><s0>Compression</s0><s5>15</s5></fC03><fC03 i1="09" i2="X" l="ENG"><s0>Compression</s0><s5>15</s5></fC03><fC03 i1="09" i2="X" l="SPA"><s0>Compresión</s0><s5>15</s5></fC03><fC03 i1="10" i2="X" l="FRE"><s0>Médecine tropicale</s0><s5>16</s5></fC03><fC03 i1="10" i2="X" l="ENG"><s0>Tropical medicine</s0><s5>16</s5></fC03><fC03 i1="10" i2="X" l="SPA"><s0>Medicina tropical</s0><s5>16</s5></fC03><fC03 i1="11" i2="X" l="FRE"><s0>Pronostic</s0><s5>30</s5></fC03><fC03 i1="11" i2="X" l="ENG"><s0>Prognosis</s0><s5>30</s5></fC03><fC03 i1="11" i2="X" l="SPA"><s0>Pronóstico</s0><s5>30</s5></fC03><fC03 i1="12" i2="X" l="FRE"><s0>Maladie négligée</s0><s4>CD</s4><s5>96</s5></fC03><fC03 i1="12" i2="X" l="ENG"><s0>Neglected disease</s0><s4>CD</s4><s5>96</s5></fC03><fC03 i1="12" i2="X" l="SPA"><s0>Enfermedad olvidada</s0><s4>CD</s4><s5>96</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Nématodose</s0></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Nematode disease</s0></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Nematodosis</s0></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Helminthiase</s0></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Helminthiasis</s0></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Helmintiasis</s0></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Parasitose</s0></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Parasitosis</s0></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Parasitosis</s0></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Infection</s0></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Infection</s0></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Infección</s0></fC07><fC07 i1="05" i2="X" l="FRE"><s0>Asie</s0><s2>NG</s2></fC07><fC07 i1="05" i2="X" l="ENG"><s0>Asia</s0><s2>NG</s2></fC07><fC07 i1="05" i2="X" l="SPA"><s0>Asia</s0><s2>NG</s2></fC07><fC07 i1="06" i2="X" l="FRE"><s0>Prévention</s0><s5>37</s5></fC07><fC07 i1="06" i2="X" l="ENG"><s0>Prevention</s0><s5>37</s5></fC07><fC07 i1="06" i2="X" l="SPA"><s0>Prevención</s0><s5>37</s5></fC07><fC07 i1="07" i2="X" l="FRE"><s0>Pathologie de l'appareil circulatoire</s0><s5>38</s5></fC07><fC07 i1="07" i2="X" l="ENG"><s0>Cardiovascular disease</s0><s5>38</s5></fC07><fC07 i1="07" i2="X" l="SPA"><s0>Aparato circulatorio patología</s0><s5>38</s5></fC07><fC07 i1="08" i2="X" l="FRE"><s0>Pathologie des vaisseaux lymphatiques</s0><s5>39</s5></fC07><fC07 i1="08" i2="X" l="ENG"><s0>Lymphatic vessel disease</s0><s5>39</s5></fC07><fC07 i1="08" i2="X" l="SPA"><s0>Linfático patología</s0><s5>39</s5></fC07><fN21><s1>266</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist><affiliations><list><country><li>Inde</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Oxfordshire</li></region><settlement><li>Oxford</li></settlement></list><tree><country name="Inde"><noRegion><name sortKey="Narahari, Saravu R" sort="Narahari, Saravu R" uniqKey="Narahari S" first="Saravu R." last="Narahari">Saravu R. Narahari</name></noRegion><name sortKey="Aggithaya, Madhur G" sort="Aggithaya, Madhur G" uniqKey="Aggithaya M" first="Madhur G." last="Aggithaya">Madhur G. Aggithaya</name><name sortKey="Balu Palicheralu Sreenivasa Rao" sort="Balu Palicheralu Sreenivasa Rao" uniqKey="Balu Palicheralu Sreenivasa Rao" last="Balu Palicheralu Sreenivasa Rao">BALU PALICHERALU SREENIVASA RAO</name><name sortKey="Bose, Kuthaje S" sort="Bose, Kuthaje S" uniqKey="Bose K" first="Kuthaje S." last="Bose">Kuthaje S. Bose</name><name sortKey="Gaddam Kumara Swamy" sort="Gaddam Kumara Swamy" uniqKey="Gaddam Kumara Swamy" last="Gaddam Kumara Swamy">GADDAM KUMARA SWAMY</name><name sortKey="Manjula, Kadengodlu" sort="Manjula, Kadengodlu" uniqKey="Manjula K" first="Kadengodlu" last="Manjula">Kadengodlu Manjula</name><name sortKey="Rajagopala, Shrikrishna" sort="Rajagopala, Shrikrishna" uniqKey="Rajagopala S" first="Shrikrishna" last="Rajagopala">Shrikrishna Rajagopala</name><name sortKey="Rojith, Mathew" sort="Rojith, Mathew" uniqKey="Rojith M" first="Mathew" last="Rojith">Mathew Rojith</name><name sortKey="Salimani, Shanappa Y" sort="Salimani, Shanappa Y" uniqKey="Salimani S" first="Shanappa Y." last="Salimani">Shanappa Y. Salimani</name><name sortKey="Shefuvan, Mohammed" sort="Shefuvan, Mohammed" uniqKey="Shefuvan M" first="Mohammed" last="Shefuvan">Mohammed Shefuvan</name><name sortKey="Thaivalath Anandan Sreemol" sort="Thaivalath Anandan Sreemol" uniqKey="Thaivalath Anandan Sreemol" last="Thaivalath Anandan Sreemol">THAIVALATH ANANDAN SREEMOL</name><name sortKey="Unnikrishnan, Bhaskaran" sort="Unnikrishnan, Bhaskaran" uniqKey="Unnikrishnan B" first="Bhaskaran" last="Unnikrishnan">Bhaskaran Unnikrishnan</name><name sortKey="Vandana, Usha" sort="Vandana, Usha" uniqKey="Vandana U" first="Usha" last="Vandana">Usha Vandana</name><name sortKey="Washington, Reynold G" sort="Washington, Reynold G" uniqKey="Washington R" first="Reynold G." last="Washington">Reynold G. Washington</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Ryan, Terence J" sort="Ryan, Terence J" uniqKey="Ryan T" first="Terence J." last="Ryan">Terence J. Ryan</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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|texte= Community level morbidity control of lymphoedema using self care and integrative treatment in two lymphatic filariasis endemic districts of South India: a non randomized interventional study
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