title: Physicians' management of filarial lymphoedema and hydrocele in Pondicherry, India.
abstract: Many countries have implemented mass drug administration programmes to eliminate lymphatic filariasis, but few have also implemented morbidity management programmes to help patients with chronic lymphoedema or hydrocele due to the infection. A study was carried out to assess current morbidity management by physicians in Pondicherry, India. Fifty-two physicians were interviewed, using a semi-structured questionnaire. For the management of hydrocele, all physicians referred hydrocele patients for surgery and 83% prescribed diethylcarbamazine (DEC). For the management of chronic lymphoedema patients, most doctors (75%) prescribed DEC and 56% mentioned the possibility of surgery. Only 10% of the physicians gave advice about limb hygiene, although recent research has shown the importance of hygiene measures to prevent further progression of lymphoedema. For the management of lymphoedema patients presenting with acute attacks, all physicians prescribed DEC and antibiotics and only 15% gave advice about limb hygiene. We conclude that limb hygiene instruction for home care should be more strongly emphasised to optimize management of lymphoedema patients in Pondicherry.
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands.
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Schellekens
authors.forename: Shanthi
authors.initials: S
authors.lastname: Ananthakrishnan
authors.forename: Wilma A
authors.initials: WA
authors.lastname: Stolk
authors.forename: J Dik F
authors.initials: JD
authors.lastname: Habbema
authors.forename: R
authors.initials: R
authors.lastname: Ravi
mesh_terms: D000208:Acute Disease; D002908:Chronic Disease; D004049:Diethylcarbamazine / Q000627:therapeutic use; D004605:Elephantiasis, Filarial / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery; D005369:Filaricides / Q000627:therapeutic use; D006801:Humans; D006920:Hygiene; D007194:India / Q000453:epidemiology; D008297:Male; D009017:Morbidity; D011379:Prognosis; D006848:Testicular Hydrocele / Q000188:drug therapy* / Q000453:epidemiology / Q000601:surgery
chemical_list: D005369:Filaricides; D004049:Diethylcarbamazine