Measuring the physical and economic impact of filarial lymphoedema in Chikwawa district,Malawi:a case-control study  

作　　者：Michelle C.Stanton Masato Yamauchi Square Z.Mkwanda Paul Ndhlovu Dorothy Emmie Matipula Charles Mackenzie Louise A.Kelly-Hope 

机构地区：[1]Department of Parasitology,Liverpool School of Tropical Medicine,Liverpool,UK [2]Ministry of Health,Lilongwe,Malawi [3]Chikwawa District Health Office,Chikwawa,Malawi [4]Chiradzulu District Health Office,Chiradzulu,Malawi [5]Department of Pathobiology and Diagnostic Investigation,Michigan State University,East Lansing,USA

出　　处：《Infectious Diseases of Poverty》2017年第1期234-242,共9页贫困所致传染病（英文）

基　　金：Liverpool School of Tropical Medicine with grant support from the UK Department for International Development(DFID);The funder did not have any role in any aspect of this study.

摘　　要：Background:Lymphatic filariasis(LF)is one of the primary causes of lymphoedema in sub-Saharan Africa,and has a significant impact on the quality of life(QoL)of those affected.In this paper we assess the relative impact of lymphoedema on mobility and income in Chikwawa district,Malawi.Methods:A random sample of 31 people with lymphoedema and 31 matched controls completed a QoL questionnaire from which both an overall and a mobility-specific score were calculated.Two mobility tests were undertaken,namely the 10 m walking test[10MWT]and timed up and go[TUG]test,and a subset of 10 casescontrol pairs wore GPS data loggers for 3 weeks to measure their mobility in a more natural setting.Retrospective economic data was collected from all 31 case-control pairs,and each participant undertaking the GPS activity recorded daily earnings and health expenditure throughout the observation period.Results:Cases had a significantly poorer overall QoL(cases=32.2,controls=6.0,P<0.01)and mobility-specific(cases=43.1,controls=7.4,P<0.01)scores in comparison to controls.Cases were also significantly slower(P<0.01)at completing the timed mobility tests,e.g.mean 10MWT speed of 0.83 m/s in comparison to 1.10 m/s for controls.An inconsistent relationship was observed between mobility-specific QoL scores and the timed test results for cases(10MWT correlation=−0.06,95%CI=(−0.41,0.30)),indicating that their perceived disability differed from their measured disability,whereas the results were consistent for controls(10MWT correlation=−0.61,95%CI=(−0.79,−0.34)).GPS summaries indicated that cases generally walk shorter distances at slower speeds than control,covering a smaller geographical area(median area by kernel smoothing:cases=1.25 km2,controls=2.10 km^(2),P=0.16).Cases reported earning less than half that earned by controls per week(cases=$0.70,controls=$1.86,P=0.064),with a smaller proportion of their earnings(16%vs 22%,P=0.461)being spent on healthcare.Conclusions:Those affected by lymphoedema are at a clear disadvantage to thei

关 键 词：Lymphatic filariasis LYMPHOEDEMA MORBIDITY Malawi GPS MOBILITY Quality of life 

分 类 号：R53[医药卫生—内科学]