Prevention, Management and control of infection and Morbidity

Prevention, Management and control of infection and Morbidity

Foot hygiene (washing with soap solution and application of anti-fungal cream) was adequate for significant decline in the incidence of AL episodes bancroftian filarial lymphoedema cases.

Repeated courses of DEC with supportive physiotherapeutic measures significantly reduced the oedema volume (in early grade 1: recent oedema cases) and incidence acute disease episodes in brugian filariasis.

Hydrocele and lymphoedema are the predominant manifestations of bancroftian filariasis. Brugian filariasis does not involve the male genitals.

Prevalence of disease is significantly higher in males compared to females in bancroftian filariasis (due to occurrence of hydrocele in males). Brugian filarial disease affects both genders equally.

Incidence of acute disease and prevalence of chronic disease show an age dependent rise. This is useful in deciding the target age class for morbidity control.

Incidence of acute disease is significantly higher in chronic lymphoedema cases compared to hitherto healthy individuals. Lymphodema cases should be targeted for prevention of acute disease.

Hydrocele results due to direct damage to lymphatics by the parasite and is a passive phenomenon. Occurrence and progression of lymphoedema depends on the incidence of acute episodic acute disease.

 

Acute disease incidence increased with the progression in stage of lymphoedema Prevention / proper management of acute disease could be important in the prevention of progression of chronic disease

 

The average time taken for progression of stage 1 to stage 2 is 4 months, and it is 6 years for stage 2 to acquire stage 3 oedema Reflects the time scale of progression The average time taken for progression of stage 1 to stage 2 is 6 months, and it is 13..6 years for stage 2 to acquire stage 3 oedema Decision on time scale of intervention Useful in predictive models

 

A significant positive association was observed between cumulative exposure and prevalence of lymphoedema, and significant negative association with prevalence of hydrocele. Prolonged exposure increases the risk of development of Lymphoedema. Development of hydrocele could be an early response to exposure. Development of lymphoedema and hydrocele follow different pathways.

 

Mathematical models
Development of morbidity control strategy

 

Limb circumference measurement was developed as an alternative to classical water displacement by volumetry for oedema volume measurement in filariasis. There was significant correlation between the two techniques in all stages of lymphoedema Monitoring and evaluation of morbidity management interventions.

 

Myiasis due to Chrysomia rufifacies and Chrysomia bezzianna in bancroftian filariasis lymphoedema cases reported.

 

Significant relationship disease rates detected by Health workers and physicians. Health workers over-estimated prevalence of hydrocele. Detection of filarial disease by Health workers can be used as a RAP, however require adequate training.

Last Updated on : 07/04/2014