Lymphoedema management knowledge and practices among patients attending filariasis clinics in the Gampaha District, Sri Lanka

Abstract

INTRODUCTION: Little information is available on methods of treatment practiced by Sri Lankan patients with filarial lymphoedema. The burden of acute dermatolymphagioadenitis (ADLA) attacks in these patients is also unclear. OBJECTIVES: To determine knowledge, perceptions and practices regarding lymphoedema management and the burden of ADLA attacks among patients with lymphoedema attending filariasis clinics. METHODS: The survey was carried out in the Gampaha district. Semi structured questionnaires were deployed to assess knowledge, practices and perceptions regarding morbidity alleviation in filarial lymphoedema. The burden of ADLA attacks was estimated using one-year recall data. RESULTS: 66 patients (22 males: 44 females) mean age 51.18 years SD 13.9% were studied. Almost two thirds of the population was aware of the importance of skin and nail hygiene, limb elevation and use of footwear. Washing was practiced"bn a daily and twice daily basis by 40.9% and 48.5% respectively. However limb elevation, exercise and use of footwear were practiced by 21 -42.4% (while seated and lying down), 6% and 34.8% respectively. Regular intake of DEC was considered important by the majority (n=61. 92.4%). Most (65.2%) had received health education from the filariasis clinics. Among patients who sought private care (n~48) the average cost of treatment of an ADLA attack was Rs. 737.91. Only 18.2% had feelings of isolation and reported community reactions ranging from sympathy to fear and ridicule. CONCLUSIONS: Filariasis clinics seem to play an important role in the dissemination of knowledge regarding morbidity control. Referral of lymphoedema patients to morbidity control clinics is recommended.