Physical and psychosocial burden due to lymphatic filariasis as perceived by patients and medical experts

Abstract

Summary Patients with lymphatic filariasis (LF) face considerable physical, psychological and social disabilities. Morbidity management and control are important components of the Global Programme to Eliminate Lymphatic Filariasis. But information on the various disabilities caused by LF is scanty. We measured the severity levels of seven health states of LF in the physical and psychosocial domains of health from the perspective of patients and medical experts, using a 7‐domain 5‐level (7D5L) descriptive system. Adenolymphangitis had the highest severity levels in all domains of health followed by lymphoedema grade 4 (L4), lymphoedema grade 3 (L3), hydrocele grade 2 (H2), lymphoedema grade 2 (L2), lymphoedema grade1 (L1) and hydrocele grade 1 (H1). People with higher grades of lymphoedema and hydrocele had more severe psychosocial problems than physical ones. Severity levels assessed by medical experts were lower than those reported by sufferers. These findings indicate that LF has considerable impact on the physical, mental and social domains of health. Morbidity management programmes should be broadened to include counselling, rehabilitation and health education to manage the psychosocial problems caused by LF.

Physical disability and psychosocial impact due to chronic filarial lymphoedema in Sri Lanka

“…As only patients can assess the exact extent of disability, their perceptions are important in planning and implementing morbidity control programmes for LF [14]. This study demonstrates the significant physical disability and psychosocial problems as perceived by patients affected by chronic filarial lymphoedema in an endemic urban area of Sri Lanka.…”

“…Unlike the physical disabilities that are visible, the psychosocial disabilities caused by LF tend to be unrecognized [14]. There is growing interest in the role of mental and social health in promoting positive health and good quality of life [14].…”

“…Unlike the physical disabilities that are visible, the psychosocial disabilities caused by LF tend to be unrecognized [14]. There is growing interest in the role of mental and social health in promoting positive health and good quality of life [14]. Previous studies have shown that LF causes severe disability and considerable treatment costs due to acute and chronic disease in India [5,9,10,13,17,18] and Ghana [12].…”

“…It has been shown that medical experts assigned lower severity levels to patients' physical and psychosocial disability than the sufferers, indicating that experts are able to perceive the extent of disability to a certain extent only [14]. As only patients can assess the exact extent of disability, their perceptions are important in planning and implementing morbidity control programmes for LF [14].…”

“…Studies done in India and Ghana have demonstrated the functional impairment, disability [9], economic burden [10-12] and psychosocial burden [13,14] caused by chronic filarial lymphoedema on affected individuals, their families and communities.…”