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

Addiss, David G.; Louis‐Charles, Jacky; Roberts, Jacquelin M.; LeConte, Frederic; Wendt, Joyanna; Milord, Marie Denise; Lammie, Patrick J.; Dreyer, Gerusa

doi:10.1371/journal.pntd.0000668

Cited by 50 publications

(74 citation statements)

References 36 publications

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“…These findings are consistent with other studies which have also found a decrease in ADLA episodes following enrollment in a lymphedema management program [2], [3], [13], [14], [23], [24]. Other programs have found a similar plateauing of the ADLA rate 3–12 months after beginning lymphedema management [13], [14]. Although our results show a significant decrease in the rate of ADLA episodes over the 2 years since the lymphedema management program was implemented, we recognize that this decrease may be partially influenced by patient receipt of anti-filarial drugs during the two MDAs that took place over the course of the study [21].…”

Section: Discussionsupporting

confidence: 93%

“…The study in Léogâne, Haiti found that compliance was associated with female gender and age >40 years [13], two associations we did not find. Patients enrolled in the limb-care program in Sri Lanka identified inconvenience, inability to find footwear large enough to fit, and forgetting to exercise the affected limb as the main reasons for non-compliance to the limb-care program [27].…”

Section: Discussioncontrasting

confidence: 85%

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Impact of a Community-Based Lymphedema Management Program on Episodes of Adenolymphangitis (ADLA) and Lymphedema Progression - Odisha State, India

et al. 2014

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BackgroundLymphedema 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.Methodology/Principal FindingsA 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.Conclusions/SignificanceThese 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.

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Section: Discussionsupporting

confidence: 93%

Section: Discussioncontrasting

confidence: 85%

Impact of a Community-Based Lymphedema Management Program on Episodes of Adenolymphangitis (ADLA) and Lymphedema Progression - Odisha State, India

et al. 2014

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“…Among individuals aged 15 and older who reported lymphedema, older age (70 years and older) was highly associated with an increased prevalence of advanced stage lymphedema; which is consistent with findings in other LF endemic areas, such as Haiti [24]. The increase in prevalence of lymphedema with increasing age corresponds to the fact that lymphedema symptoms often do not appear until years or even decades after an individual is first infected and they tend to worsen over time and with the number of ADL episodes a person experiences.…”

Section: Discussionsupporting

confidence: 84%

Evaluating the Burden of Lymphedema Due to Lymphatic Filariasis in 2005 in Khurda District, Odisha State, India

Walsh¹,

Little²,

Wiegand³

et al. 2016

PLoS Negl Trop Dis

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BackgroundOver 1.1 billion people worldwide are at risk for lymphatic filariasis (LF), and the global burden of LF-associated lymphedema is estimated at 16 million affected people, yet country-specific estimates are poor.Methodology/Principal FindingsA house-to-house morbidity census was conducted to assess the burden and severity of lymphedema in a population of 1,298,576 persons living in the LF-endemic district of Khurda in Odisha State, India. The burden of lymphedema in Khurda is widespread geographically, and 1.3% (17,036) of the total population report lymphedema. 51.3% of the patients reporting lymphedema were female, mean age 49.4 years (1–99). Early lymphedema (Dreyer stages 1 & 2) was reported in two-thirds of the patients. Poisson regression analysis was conducted in order to determine risk factors for advanced lymphedema (Dreyer stages 4–7). Increasing age was significantly associated with advanced lymphedema, and persons 70 years and older had a prevalence three times greater than individuals ages 15–29 (aPR: 3.21, 95% CI 2.45, 4.21). The number of adenolymphangitis (ADL) episodes reported in the previous year was also significantly associated with advanced lymphedema (aPR 4.65, 95% CI 2.97–7.30). This analysis is one of the first to look at potential risk factors for advanced lymphedema using morbidity census data from an entire district in Odisha State, India.SignificanceThese data highlight the magnitude of lymphedema in LF-endemic areas and emphasize the need to develop robust estimates of numbers of individuals with lymphedema in order to identify the extent of lymphedema management services needed in these regions.

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“…The use of CDT to reduce lymphedema was used in an endemic area, as shown in the study conducted in Haiti by Addiss et al 24 .…”

Section: Discussionmentioning

confidence: 99%

Terapia complexa descongestiva com uso de material alternativo na redução e controle do linfedema em pacientes de área endêmica de filariose: um ensaio clínico

et al. 2016

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RESUMO A filariose linfática põe em risco bilhões de pessoas em todo o mundo. Apesar disso, pouco se sabe sobre o impacto da morbidade crônica da doença, como o linfedema. A terapia complexa descongestiva apresenta-se como padrão ouro para tratar linfedemas, mas ainda não existem protocolos viáveis para implementação em países em desenvolvimento. O objetivo deste ensaio clínico foi avaliar a eficácia dessa técnica, com o uso de material alternativo, e comparar seus efeitos na qualidade de vida, funcionalidade e peso corporal. Os grupos intervenção e controle foram avaliados por meio de perimetria e cálculo do volume dos membros, do questionário de qualidade de vida Whoqol-bref, do teste de funcionalidade e mobilidade de membros inferiores Timed Up and Go e avaliação do peso corporal. O grupo intervenção recebeu a terapia complexa descongestiva duas vezes por semana, durante dez semanas, utilizando-se um material alternativo para o enfaixamento, confeccionado com tecido de cambraia, o que apresenta baixo custo em relação às faixas importadas. O grupo controle recebeu palestra com informações sobre a doença e orientações de cuidados e higiene dos membros. A amostra foi composta por trinta pacientes com idade média de 50,8±10 anos, sendo 52,9% mulheres. Na análise estatística foram utilizados os testes t de Student, Multivariate analysis of variance, teste de Wilcoxon e Kolmogorov-Smirnov. A significância adotada foi de 5% (p<0,05). Houve redução significativa do volume e perimetria do linfedema no grupo intervenção, e aumentou no grupo controle. A funcionalidade não apresentou melhora significativa na avaliação pelo teste Timed Up and Go. A qualidade de vida teve melhora significativa nos domínios físico e meio ambiente no grupo intervenção. O efeito do tratamento no peso corporal também foi significativo, apresentando redução no grupo controle e intergrupos. A terapia complexa descongestiva mostrou-se eficaz na redução e no controle do linfedema e impactou de maneira positiva, aumentando os valores numéricos dos aspectos físico e meio ambiente da qualidade de vida do grupo intervenção.

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

Cited by 50 publications

References 36 publications

Impact of a Community-Based Lymphedema Management Program on Episodes of Adenolymphangitis (ADLA) and Lymphedema Progression - Odisha State, India

Impact of a Community-Based Lymphedema Management Program on Episodes of Adenolymphangitis (ADLA) and Lymphedema Progression - Odisha State, India

Evaluating the Burden of Lymphedema Due to Lymphatic Filariasis in 2005 in Khurda District, Odisha State, India

Terapia complexa descongestiva com uso de material alternativo na redução e controle do linfedema em pacientes de área endêmica de filariose: um ensaio clínico

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