title: Treatment-seeking behavior and treatment practices of lymphatic filariasis patients with lymphoedema in the Colombo district, Sri Lanka.
abstract: This cross-sectional, descriptive study describes the treatment-seeking behavior of 413 lymphoedema patients attending 2 filariasis clinics in the Colombo district, Sri Lanka. A pretested, interviewer-administered questionnaire obtained information regarding sources and types of treatment taken, time taken for diagnosis, and details regarding diethylcarbamazine citrate (DEC) treatment. There was a mean delay of 2.37 years (SD 1.37) in diagnosing filariasis after the first appearance of limb swelling. General practitioners were the most frequent first-contact health care providers and the most visited source overall, followed by government hospitals and Ayurvedic practitioners. Approximately 95% of patients were on DEC treatment ranging from 10 days to 43 years (mean 2.5 years SD +/- 1.1). Sixty-one percent of patients reported always having taken the recommended DEC course. Nonsteroidal anti-inflammatory drugs, diuretics, and antibiotics were liberally prescribed. Approximately 97% had sought treatment from a medical practitioner for an acute adenolymphangitis attack. Despite the area being endemic for filariasis, there was a delay in treatment and inappropriate use of DEC in patients with chronic filarial lymphoedema.
authors.affiliation: Department of Parasitology, University of Sri Jayawardenepura, Gangodawila, Nugegoda, Sri Lanka. rushiwije@yahoo.com
authors.forename: Rushika Shalindri
authors.initials: RS
authors.lastname: Wijesinghe
authors.forename: Ananda Rajitha
authors.initials: AR
authors.lastname: Wickremasinghe
authors.forename: Sriyani
authors.initials: S
authors.lastname: Ekanayake
authors.forename: Marian Shanthy Antoinette
authors.initials: MS
authors.lastname: Perera
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003430:Cross-Sectional Studies; D004049:Diethylcarbamazine / Q000008:administration & dosage; D004605:Elephantiasis, Filarial / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008205:Lymphangitis / Q000209:etiology; D008209:Lymphedema / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010349:Patient Compliance / Q000706:statistics & numerical data; D013188:Sri Lanka; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult
chemical_list: D004049:Diethylcarbamazine