Situational analysis of lymphatic filariasis morbidity in Ahanta West District of Ghana

Abstract

Abstractobjectives Situational analysis of lymphatic filariasis (LF) morbidity and its management in Ahanta West, Ghana, to identify potential barrier to healthcare for LF patients.methods Lymphoedema and hydrocoele patients were identified by community health workers from a subset of villages, and were interviewed and participated in focus group discussions to determine their attitudes and practices towards managing their morbidity, and their perceived barriers to accessing care. Local health professionals were also interviewed to obtain their views on the availability of morbidity management services in the district.results Sixty-two patients (34 lymphoedema and 28 hydrocoeles) and 13 local health professionals were included in the study. Lymphoedema patients predominantly self-managed their conditions, which included washing with soap and water (61.8%), and exercising the affected area (52.9%). Almost 65% of patients had sought medical assistance at some stage, but support was generally limited to receiving tablets (91%). Local health professionals reported rarely seeing lymphoedema patients, citing stigma and lack of provisions to assist patients as a reason for this. Almost half of hydrocoele patients (44%) chose not to seek medical assistance despite the negative impact it had on their lives. Whilst surgery itself is free with national health insurance, 63% those who had not sought treatment stated that indirect costs of surgery (travel costs, loss of earnings, etc.) were the most prohibitive factor to seeking treatment.conclusions The information obtained from this study should now be used to guide future morbidity strategies in building a stronger relationship between the local health services and LF patients, to ultimately improve patients' physical, psychological and economic wellbeing.

Pathological manifestations in lymphatic filariasis correlate with lack of inhibitory properties of IgG4 antibodies on IgE-activated granulocytes

“…Even though the sample size is relatively small due to the difficulty to recruit patients that have received no anti-filarial treatment after extensive mass drug administration programs and the significant reduction of the disease burden in this region [89,90], the current study extends previous findings suggesting that expression of IgG4 in asymptomatic Mf+ individuals is associated with inhibition of granulocyte functions [10,91,92] and suggests that prominent IgA expression in EN also affects granulocytes’ functions. Our data also provide new insights on a possible role of functional modulation of IgG4 antibodies in CP-patients, providing possible novel clarifications of the mechanisms through which tolerance or pathology is induced in LF, and suggest that IgA and IgG4 may represent meaningful candidates for targeted therapy against LF.…”

Mobile Technology for Empowering Health Workers in Underserved Communities: New Approaches to Facilitate the Elimination of Neglected Tropical Diseases

“…The MeasureSMS-Morbidity reporting tool is used to improve information on LF patient numbers, including location, age, sex, clinical condition (ie, lymphedema, hydrocele), and details about severity of condition (ie, mild, moderate, severe) and episodes of acute attacks [ 10 ]. Data are sent in as a simple SMS message (one message per patient) by health workers during a community cross-sectional survey and are collated into a national disease database that is accessible by national and district health teams via a Web browser, secured with a username and password.…”

“…The first two programmatic areas use the MeasureSMS system to collate and report MDA treatment numbers (MeasureSMS-MDA) and morbidity information (MeasureSMS-Morbidity), including lymphedema and hydrocele cases, at the village and health center levels [ 10 ]. The second two programmatic areas make use of mobile phone apps to coordinate the distribution of lymphedema management supplies (LyMSS-lymphedema management supply system) and provide the most up-to-date health information to frontline health workers (HealthFront) and their supervisors.…”

Economic benefits and costs of surgery for filarial hydrocele in Malawi

“…The principal obstacles to undergoing hydrocelectomy reported by men in resource-poor countries include its substantial cost and lack of nearby surgical facilities. [26] Filarial hydrocele disproportionately affects poor men, for whom the cost of hydrocelectomy can be prohibitive. Men in rural areas have less access to surgical facilities and less correct information about the effectiveness of surgery.…”