Authors

O Eneanya¹; T Garske¹; C Donnelly¹;  ¹ Imperial College London

Discussion

Introduction - Lymphatic filariasis (LF) is a mosquito-borne parasitic disease and a leading cause of disability worldwide. To better understand requirements for morbidity management, it is important to evaluate the needs of sufferers. This study aimed to quantify the physical, social and economic impact of LF in two endemic rural communities in Nigeria. Methods - This is a matched case-control study. Cases were identified with the help of district health officers and community-directed distributors (CDDs) of mass drug administration (MDA) programmes. Seemingly disease-free Controls were selected from similar population as Cases, matched by age and sex. Logistic regression was performed in R.
Main findings - 52 Cases and 52 Controls participated in this study. Among Cases, 48 presented with various stages of lower limb lymphedema, and 4 with scrotal elephantiasis. 40% of all Cases reported to feel stigma and were 10 times (95% CI: [1.7, 55.7]) more likely to avoid forms of social participation. Cases were 7 times (95% CI: [0.3, 135.5]) more likely to be divorced and 20 times (95% CI: [2.9 to 142.5]) more likely to remain unmarried. Cases were 68% (95% CI: [0.06, 1.6]) less likely to have skilled employment and spent significantly less time engaging in income generating activities. The economic effect of lower income was exacerbated by health expenditure as Cases were 55 times (OR 55.7, 95% CI 16.8 to 184.3) more likely to spend over $100 on their last healthcare payment.
Conclusion - As the push for elimination of LF as a public health problem intensifies, morbidity management requirements needs to be better understood so that most essential support is provided to sufferers.