title: Situational analysis of lymphatic filariasis morbidity in Ahanta West District of Ghana.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK.
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Stanton
authors.affiliation: Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK.
authors.forename: Abigail
authors.initials: A
authors.lastname: Best
authors.affiliation: Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Cliffe
authors.affiliation: Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK.
authors.forename: Louise
authors.initials: L
authors.lastname: Kelly-Hope
authors.affiliation: National Neglected Tropical Diseases Programme, Ghana Health Service, Accra, Ghana.
authors.forename: Nana-Kwadwo
authors.initials: NK
authors.lastname: Biritwum
authors.affiliation: Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
authors.forename: Linda
authors.initials: L
authors.lastname: Batsa
authors.affiliation: Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
authors.forename: Alex
authors.initials: A
authors.lastname: Debrah
mesh_terms: D003365:Costs and Cost Analysis; D019468:Disease Management; D004605:Elephantiasis, Filarial / Q000150:complications / Q000628:therapy*; D005260:Female; D017144:Focus Groups; D005869:Ghana; D005102:Health Expenditures; D006282:Health Personnel; D006296:Health Services; D006297:Health Services Accessibility; D006801:Humans; D008209:Lymphedema / Q000209:etiology / Q000628:therapy; D008297:Male; D009017:Morbidity; D010342:Patient Acceptance of Health Care; D012648:Self Care; D006848:Testicular Hydrocele / Q000209:etiology / Q000628:therapy
keywords: Ghana; acceso; access; accès; barreras; barriers; barrières; filariose lymphatique; filariosis linfática, manejo de morbilidad; lymphatic filariasis; morbidity management; prise en charge de la morbidité