Financial burden impact quality of life among lymphatic Filariasis patients

Abstract

Background Human lymphatic filarial pathology is the leading cause of disability and poverty among people living with the infection. The second goal of the Global Programme to Eliminate Lymphatic Filariasis (GPELF) is to manage the disease’s morbidity to improve patients’ quality of life. Consequently, the current study assessed the overall quality of life of lymphatic filariasis (LF) pathology patients in some selected endemic communities in rural Ghana. Method In the present study, the Lymphatic Filariasis Quality of Life Questionnaire (LFSQQ) was used to evaluate the effect of lymphatic filariasis on the quality of life of people, with the disease in nine (9) communities in the Ahanta West District of the Western Region of Ghana where mass drug administration is being implemented for the past twenty years. Pearson’s correlation, linear regression, and one-way analysis of variance (ANOVA) analyses were used to assess the associations between the LFSQQ instrument domains. Results Of the 155 study participants recruited, 115 (74.19%) were females, and 40 (25.81%) males. A greater proportion of the study participants (40, 25.8%) were presented with stage two (2) lymphoedema, while only two patients had stage seven (7) lymphoedema. The average of the overall quality of life scores of study participants was 68.24. There was a negative Pearson correlation (r = − 0.504, p-value < 0.001) between the stage of lymphoedema (severity of the disease) and the quality of life of the LF patients. In addition, a clear pattern of positive correlation (r = 0.71, p-value < 0.001) was observed between the disease burden and pain/discomfort domains of the study participants. Whereas the highest domain-specific score (85.03) was observed in the domain of self-care, we noted that the environmental domain, which consists of the financial status, was the lowest (45.94) among the study participants. Conclusion Our findings support previous works on the reduced quality of life among lymphatic filariasis patients with pathology. In this study, our results reveal a depressing financial condition among people presenting with late stages of LF pathologies, which eventually reduces their well-being.

Multi-drug resistant bacteria isolates from lymphatic filariasis patients in the Ahanta West District, Ghana

“…Previously, we have shown a positive correlation of the disease burden and pain or discomfort [ 39 ]. In managing the pain and skin peelings (as measures for morbidity management), LF patients resort to the use of antibiotics for self-medication as a preferred alternative to travelling long distance and the cost in accessing primary healthcare [ 5 , 37 ].…”

Insights on Lymphedema Self-Care Knowledge and Practice in Filariasis and Podoconiosis-Endemic Communities in Bangladesh and Ethiopia

“…We anticipate these observations on knowledge and adherence in Bangladesh and Ethiopia will be useful to other endemic countries with similar populations. It is well documented that people affected by lymphedema at all stages have impaired qualify of life and increased financial pressures (34), and that introduction of a hygiene centered self-care program can improve symptoms and reduce ADL episodes (11,12). In our study, people affected by moderate and severe lymphedema and their caregivers were able to learn and apply lymphedema self-care with a high level of adherence over 24-weeks.…”

Filarial Lymphedema Patients Are Characterized by Exhausted CD4+ T Cells

“…Wuchereria bancrofti -driven immunomodulation is a key feature of this helminth’s survival and homeostasis of host’s immune responses to maintain an asymptomatic disease state ( Hoerauf et al., 2005 ; Babu et al., 2006 ; Babu et al., 2009 ; Adjobimey and Hoerauf, 2010 ; Babu and Nutman, 2012 ; Wammes et al., 2012 ; Rajamanickam and Babu, 2013 ; Metenou et al., 2010 ; Ritter et al., 2019 ). However, severe clinical outcomes such as LE can lead to increased DALYs and social stigmatisation ( Gyapong et al., 1996 ; van 't Noordende et al., 2020 ; World Health Organization, 2021 ; World Health Organization, 2020 ; Asiedu et al., 2021 ). Several studies already characterized CD4 + T cells in LE patients and revealed that frequencies of naive, effector memory and central memory CD4 + T cells in patients with filarial disease and chronic infections were not different.…”

“…Despite the tightly controlled immune-regulation, individuals with LF can also develop severe symptoms like hydrocele or lymphedema (LE) as well as adenolymphangitis (ADL) attacks ( World Health Organization, 2020 ; World Health Organisation 2021 ). This often leads to reduced quality of life and increased disability-adjusted life years (DALYs), financial losses, and social separation due to the stigmatization ( Gyapong et al., 1996 ; van 't Noordende et al., 2020 ; Asiedu et al., 2021 ). Interestingly, the majority of patients suffering from severe pathology have usually cleared the infection and their profiles are characterized by increased antigen-specific Th1 and Th17 responses and constant immune activation ( Babu et al., 2009 ; Babu and Nutman, 2012 ; Babu and Nutman, 2014 ).…”