02556nas a2200253   4500000000100000008004100001653001400042653002400056653003900080653002500119653002500144653000800169653002600177653005500203653000800258100002500266700001900291700002200310700001300332700001100345245014900356520178400505022001302289       2017                            d10aSri Lanka10aProgrammatic issues10aNeglected tropical diseases (NTDs)10aMorbidity management10aLymphatic filariasis10aELs10aDisability prevention10aAssessment of physical & psychological improvement10aADL1 aChanna Yahathugoda T1 aWeerasooriya M1 aSamarawickrema WA1 aKimura E1 aItoh M00aImpact of two follow-up schemes on morbidity management and disability prevention (MMDP) programme for filarial lymphedema in Matara, Sri Lanka.3 a<p>Alleviating morbidity due to lymphatic filariasis (LF)—especially in elderly patients who are rather ignorant—is presently the biggest challenge for the national filariasis campaign. We introduced two follow-up schemes and compared each other to address three key programmatic issues (1) locating patients, (2) educating patients, family members on practice of lymphoedema self-care (3) well sustained daily self-care. Hundred and seven lymphoedema patients were introduced to the new Community Home Based Care (CHBC) programme as a part of MMDP programme at their homes. Twenty seven of 107 patients were selected by purposive sampling and followed-up under two schemes, 14 in Daily follow-up (DFU) scheme and 13 in Monthly follow-up (MFU) scheme. Impact was assessed using a KAP score, number of entry lesions (EL) and number of ADL episodes, limb volume, its appearance, changes in the quality of life and gained benefits. Visiting patients in their homes to introduce lymphoedema care programme was a success. KAP scores of the more important activities on lymphoedema care were significantly higher in DFU scheme. Number of patients (51.9%; 14/27) who had EL/s at baseline reduced significantly to 18.5% (5/27) at one year follow-up. The mean numbers of ADL episodes/year reduced significantly in both schemes. Six photographs of 27 showed obvious improvement in lymphoedema and its grade. Mean volume of lymphoedema reduced significantly in both schemes at one year no significant difference between schemes. Benefit score at one year revealed that the patients in DFU scheme received significantly higher amount of benefits compared to MFU scheme. In conclusion daily instruction has significantly motivated the patient and his/her family bringing a new hope.</p>
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