title: Evaluating the Burden of Lymphedema Due to Lymphatic Filariasis in 2005 in Khurda District, Odisha State, India.
abstract: Over 1.1 billion people worldwide are at risk for lymphatic filariasis (LF), and the global burden of LF-associated lymphedema is estimated at 16 million affected people, yet country-specific estimates are poor.
  
  
  
  A house-to-house morbidity census was conducted to assess the burden and severity of lymphedema in a population of 1,298,576 persons living in the LF-endemic district of Khurda in Odisha State, India. The burden of lymphedema in Khurda is widespread geographically, and 1.3% (17,036) of the total population report lymphedema. 51.3% of the patients reporting lymphedema were female, mean age 49.4 years (1-99). Early lymphedema (Dreyer stages 1 & 2) was reported in two-thirds of the patients. Poisson regression analysis was conducted in order to determine risk factors for advanced lymphedema (Dreyer stages 4-7). Increasing age was significantly associated with advanced lymphedema, and persons 70 years and older had a prevalence three times greater than individuals ages 15-29 (aPR: 3.21, 95% CI 2.45, 4.21). The number of adenolymphangitis (ADL) episodes reported in the previous year was also significantly associated with advanced lymphedema (aPR 4.65, 95% CI 2.97-7.30). This analysis is one of the first to look at potential risk factors for advanced lymphedema using morbidity census data from an entire district in Odisha State, India.
  
  
  
  These data highlight the magnitude of lymphedema in LF-endemic areas and emphasize the need to develop robust estimates of numbers of individuals with lymphedema in order to identify the extent of lymphedema management services needed in these regions.
authors.affiliation: Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Victoria
authors.initials: V
authors.lastname: Walsh
authors.affiliation: Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Kristen
authors.initials: K
authors.lastname: Little
authors.affiliation: Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Ryan
authors.initials: R
authors.lastname: Wiegand
authors.affiliation: Church's Auxiliary for Social Action, Odisha, India.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Rout
authors.affiliation: Parasitic Diseases Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: LeAnne M
authors.initials: LM
authors.lastname: Fox
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019352:Censuses; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D004605:Elephantiasis, Filarial / Q000150:complications / Q000453:epidemiology* / Q000469:parasitology; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008205:Lymphangitis / Q000453:epidemiology; D008209:Lymphedema / Q000453:epidemiology* / Q000209:etiology / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D015995:Prevalence; D012044:Regression Analysis; D055815:Young Adult