Impact of basic lymphedema management and antifilarial treatment on acute dermatolymphangioadenitis episodes and filarial antigenaemia

Ha, El-Nahas; El-Shazly, Assem M.; Abulhassan, Mohamad; Nabih, Nairmen; Mousa, Nasser

doi:10.4103/0974-777x.83527

Cited by 14 publications

(9 citation statements)

References 24 publications

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“…Recent studies, however, find that lymphedema management leads to net regression of lymphedema stage as well as reduction in the number of ADLA episodes. 12 , 15 , 17 , 23 – 35 , 56 …”

Section: Discussionmentioning

confidence: 99%

Economic Costs and Benefits of a Community-Based Lymphedema Management Program for Lymphatic Filariasis in Odisha State, India

Stillwaggon

Sawers

Rout³

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Lymphatic filariasis afflicts 68 million people in 73 countries, including 17 million persons living with chronic lymphedema. The Global Programme to Eliminate Lymphatic Filariasis aims to stop new infections and to provide care for persons already affected, but morbidity management programs have been initiated in only 24 endemic countries. We examine the economic costs and benefits of alleviating chronic lymphedema and its effects through a simple limb-care program. For Khurda District, Odisha State, India, we estimated lifetime medical costs and earnings losses due to chronic lymphedema and acute dermatolymphangioadenitis (ADLA) with and without a community-based limb-care program. The program would reduce economic costs of lymphedema and ADLA over 60 years by 55%. Savings of US$1,648 for each affected person in the workforce are equivalent to 1,258 days of labor. Per-person savings are more than 130 times the per-person cost of the program. Chronic lymphedema and ADLA impose a substantial physical and economic burden on the population in filariasis-endemic areas. Low-cost programs for lymphedema management based on limb washing and topical medication for infection are effective in reducing the number of ADLA episodes and stopping progression of disabling and disfiguring lymphedema. With reduced disability, people are able to work longer hours, more days per year, and in more strenuous, higher-paying jobs, resulting in an important economic benefit to themselves, their families, and their communities. Mitigating the severity of lymphedema and ADLA also reduces out-of-pocket medical expense.

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“…Recent studies, however, find that lymphedema management leads to net regression of lymphedema stage as well as reduction in the number of ADLA episodes. 12 , 15 , 17 , 23 – 35 , 56 …”

Section: Discussionmentioning

confidence: 99%

Economic Costs and Benefits of a Community-Based Lymphedema Management Program for Lymphatic Filariasis in Odisha State, India

Stillwaggon

Sawers

Rout³

et al. 2016

The American Society of Tropical Medicine and Hygiene

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“…Nevertheless, recent studies find that MMDP leads to net regression of the morbidity caused by filarial lymphedema. 15 – 30 , 36 This study underestimates the costs of LF morbidity and benefits of MMDP in other ways by not including economic costs that do not fall on persons with chronic lymphedema and ADLA. We exclude costs to others, including society as a whole or the government.…”

Section: Discussionmentioning

confidence: 99%

“…In the treatment scenario, we assume, based on experience reported in numerous studies cited earlier, that the community limb-care program on average halts the progression of lymphedema as patients age and reduces the frequency of ADLA. [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] Consequently, we assume that people in each age cohort remain in their baseline lymphedema stage throughout their working lives. Based on the results of the limb-care program in Khurda, we assume that the frequency of ADLA episodes for each age cohort will be 34% lower than in the notreatment scenario.…”

Section: Methodsmentioning

confidence: 99%

“…Simple, low-cost methods can prevent recurrent ADLA episodes or reduce their frequency and, thus, slow or end lymphedema progression. [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] These methods include washing the legs and feet with soap, clean water, and a small cloth-paying special attention to interdigital crevasses, skin folds, and entry lesions; drying the limbs with clean towels; and applying antifungal creams, antibiotic ointments, or antiseptics. Also helpful is elevating affected limbs, exercising to improve lymphatic and venous drainage, and wearing shoes 9 (see the online Supplement for additional discussion; see also ref.…”

Section: Nature Of the Diseasementioning

confidence: 99%

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Economic Costs and Benefits of Community-Based Lymphedema-Management Programs for Lymphatic Filariasis in India

Sawers

Stillwaggon

2020

The American Journal of Tropical Medicine and Hygiene

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Lymphatic filariasis (LF) is endemic in 72 countries; 15 million persons live with chronic filarial lymphedema. It can be a disabling condition, frequently painful, leading to reduced mobility, social exclusion, and depression. The Global Program to Eliminate Lymphatic Filariasis aims to stop new infections and care for affected persons, but morbidity management has been initiated in only 38 countries. We examine economic costs and benefits of alleviating chronic lymphedema and its effects through simple limb care. We use economic and epidemiological data from 12 Indian states in which 99% of Indians with filariasis reside. Using census data, we calculate the age distribution of filarial lymphedema and predict the burden of morbidity of infected persons. We estimate lifetime medical costs and lost earnings due to lymphedema and acute dermatolymphangioadenitis (ADLA) with and without community-based limb-care programs. Programs of community-based limb care in all Indian endemic areas would reduce costs of disability by 52%, saving a per person average of US$2,721, equivalent to 703 workdays. Per-person savings are 185 times the program's per-person cost. Chronic lymphedema and ADLA impose a substantial physical and economic burden in filariasis-endemic areas. Low-cost programs for lymphedema management based on limb washing and topical medication are effective in reducing the number of ADLA episodes and stopping progression of disabling lymphedema. With reduced disability, people can work longer hours per day, more days per year, and in more strenuous, higher paying jobs, resulting in important economic benefits to themselves, their families, and their communities. Author's Dedication. Eileen Stillwaggon passed away not long after this paper was accepted for publication by the AJTMH. Eileen's participation in this project exemplifies qualities that she brought to all of her scholarship. She applied her skills as an economist to show that curing or preventing disease could be far cheaper than failing to do so. From her first piece of published research to her last, she worked to undermine racial and gender discrimination. A recurrent theme in her research were efforts to expose how racism distorts medical research and thus health policy. Her passion to make the world a better place will be sorely missed.

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“…Both lymphedema and ADLA diminish productivity. [4][5][6][7][8][9][10][11][12] Community programs to promote leg hygiene have been successful at trivial cost. [13][14][15] An economic study of such a community program in Odisha, India estimated that the lifetime benefits of disability prevented, restored work capacity, and reduced medical expense would be 130 times the cost of the intervention.…”

Section: Lymphatic Filariasis and Its Sequelaementioning

confidence: 99%

Economic benefits and costs of surgery for filarial hydrocele in Malawi

et al. 2020

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Background Lymphatic filariasis (LF) is endemic in 72 countries of Africa, Asia, Oceania, and the Americas. An estimated 25 million men live with the disabling effects of filarial hydrocele. Hydrocele can be corrected with surgery with few complications. For most men, hydrocelectomy reduces or corrects filarial hydrocele and permits them to resume regular activities of daily living and gainful employment. Methodology and principal findings This study measures the economic loss due to filarial hydrocele and the benefits of hydrocelectomy and is based on pre-and post-operative surveys of patients in southern Malawi. We find the average number of days of work lost due to filarial hydrocele and daily earnings for men in rural Malawi. We calculate average annual lost earnings and find the present discounted value for all years from the time of surgery to the end of working life. We estimate the total costs of surgery. We compare the benefit of the work capacity restored to the costs of surgery to determine the benefit-cost ratio. For men younger than 65 years old, the average annual earnings loss attributed to hydrocele

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Impact of basic lymphedema management and antifilarial treatment on acute dermatolymphangioadenitis episodes and filarial antigenaemia

Cited by 14 publications

References 24 publications

Economic Costs and Benefits of a Community-Based Lymphedema Management Program for Lymphatic Filariasis in Odisha State, India

Economic Costs and Benefits of a Community-Based Lymphedema Management Program for Lymphatic Filariasis in Odisha State, India

Economic Costs and Benefits of Community-Based Lymphedema-Management Programs for Lymphatic Filariasis in India

Economic benefits and costs of surgery for filarial hydrocele in Malawi

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