Lymphatic filariasis (LF)-associated lymphedema and elephantiasis of the leg affect an estimated 15 million persons worldwide. Alleviating the disability and suffering of these persons is a major goal of a new global program to eliminate lymphatic filariasis. However, lymphedema treatment is generally unavailable in filariasis-endemic areas. Ste. Croix Hospital, in Leogane Haiti, established a filarial lymphedema treatment program in 1995. More than 600 patients, from all major filariasis-endemic areas of Haiti, have been treated. Mean patient age is 34 years (range, 9-90); 82% are female. Treatment has evolved from the hospital, where compressive bandaging was emphasized and patients were relatively passive recipients of care, to the community, where patient self-reliance is encouraged. Patient self-care now focuses on preventing painful acute bacterial infections through scrupulous hygiene and skin care, and on mobilization of lymph fluid through simple exercises and elevation of the leg. Program costs have been reduced considerably. Reported frequency of bacterial infections has decreased from 2.1 per year to 0.6 per year. Patient instructional booklets and a “soap-opera” radio series have increased patient knowledge and self-efficacy with lymphedema care. Patient support groups have reinforced self-care and provided an environment for shared experiences. Approximately ¼ of patients continue to have acute bacterial infections and progression of lymphedema; they have more advanced lymphedema and are less well-educated. Our experience suggests that making self-care available to persons with filarial lymphedema dramatically enhances quality of life and improves community acceptance of mass drug distribution to interrupt transmission of the filarial parasite.
Learning Objectives: N/A
Keywords: Women's Health, Community Health
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.