title: Self care integrative treatment demonstrated in rural community setting improves health related quality of life of lymphatic filariasis patients in endemic villages.
abstract: This study assessed impact of community based self care integrative treatment provided through mass camps in villages of three districts of Kerala, India endemic for lymphatic filariasis (LF). Two most endemic Primary Health centres (PHCs) were selected from each of the three districts, where maximum concentration of LF patients is recorded. Fourteen one day LF camps, each attended by 30-40 patients were conducted. Trained Accredited Social Health Activists encouraged LF patients to attend camps. Skin wash and drying, care of bacterial entry points using dermatology drugs, and simple yoga and breathing exercises were demonstrated in these camps. Patients were advised to continue these self care activities daily at home for six months. The quality of life (QoL) of LF patients was determined for Indian life style domains using validated and pretested specific questionnaire (LF-specific QoL questionnaire-LFSQQ). It addressed conditions and state of individuals with reference to LF. The questionnaire had 7 domains and each domain consisted of a series of questions with likert scale (no problem, mild, moderate, severe, most severe). 446 patients attended one day camps to get training on integrative self care treatment. 425 patients (95.3%) were followed up after six months and QoL was reassessed. Each patient's QoL in mobility, self care, usual activity, pain and discomfort and social relationship significantly improved (P value <0.01). Psychological health showed no significant change. The disease burden, for the purpose of the study was measured by asking questions about history of painful redness, swelling and cellulitis of legs (filarial fever), foul smell (odor), itching (eczema/discharge from limb), wound (non healing ulcer) and weight/size of the limb. The difference in disease burden as recorded during the sixth month follow up was measured using dependent t test, reduced significantly (P value <0.01) in 409 (96.2%) patients. 103 (24.2%) patients experienced fever during follow up. Severity of inflammatory episodes reduced from severe problem to no problem, after six months of home based self care. There was significant relation between treatment regularity and QoL status (P value=0.003). The community based one day camps that trained LF patients on skin care and daily yoga and breathing practices improved QoL.
authors.affiliation: Institute of Applied Dermatology, IAD Junction, Uliyathadka, Madhur Road, Kasaragod, Kerala 671124, India. drgurumadhur@yahoo.co.in
authors.forename: Madhur Guruprasad
authors.initials: MG
authors.lastname: Aggithaya
authors.forename: Saravu R
authors.initials: SR
authors.lastname: Narahari
authors.forename: Sudha
authors.initials: S
authors.lastname: Vayalil
authors.forename: Mohammed
authors.initials: M
authors.lastname: Shefuvan
authors.forename: Neethu K
authors.initials: NK
authors.lastname: Jacob
authors.forename: Kandathu Valappil
authors.initials: KV
authors.lastname: Sushma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004605:Elephantiasis, Filarial / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006266:Health Education / Q000379:methods*; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012424:Rural Population; D012648:Self Care / Q000379:methods*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult