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

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Measuring the physical and economic impact of filarial lymphoedema in Chikwawa district, Malawi : a case-control study. / Stanton, Michelle C; Yamauchi, Masato; Mkwanda, Square Z; Ndhlovu, Paul; Matipula, Dorothy Emmie; Mackenzie, Charles; Kelly-Hope, Louise A.

In: Infectious diseases of poverty, Vol. 6, No. 1, 28, 03.04.2017.

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Stanton, MC, Yamauchi, M, Mkwanda, SZ, Ndhlovu, P, Matipula, DE, Mackenzie, C & Kelly-Hope, LA 2017, 'Measuring the physical and economic impact of filarial lymphoedema in Chikwawa district, Malawi: a case-control study', Infectious diseases of poverty, vol. 6, no. 1, 28. https://doi.org/10.1186/s40249-017-0241-2

APA

Stanton, M. C., Yamauchi, M., Mkwanda, S. Z., Ndhlovu, P., Matipula, D. E., Mackenzie, C., & Kelly-Hope, L. A. (2017). Measuring the physical and economic impact of filarial lymphoedema in Chikwawa district, Malawi: a case-control study. Infectious diseases of poverty, 6(1), [28]. https://doi.org/10.1186/s40249-017-0241-2

Vancouver

Stanton MC, Yamauchi M, Mkwanda SZ, Ndhlovu P, Matipula DE, Mackenzie C et al. Measuring the physical and economic impact of filarial lymphoedema in Chikwawa district, Malawi: a case-control study. Infectious diseases of poverty. 2017 Apr 3;6(1). 28. https://doi.org/10.1186/s40249-017-0241-2

Author

Stanton, Michelle C ; Yamauchi, Masato ; Mkwanda, Square Z ; Ndhlovu, Paul ; Matipula, Dorothy Emmie ; Mackenzie, Charles ; Kelly-Hope, Louise A. / Measuring the physical and economic impact of filarial lymphoedema in Chikwawa district, Malawi : a case-control study. In: Infectious diseases of poverty. 2017 ; Vol. 6, No. 1.

Bibtex

@article{f21cb8fd8bae4cd5baf00743edd2aee5,
title = "Measuring the physical and economic impact of filarial lymphoedema in Chikwawa district, Malawi: a case-control study",
abstract = "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 cases-control 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 km2, 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 their unaffected peers, experiencing a lower QoL as confirmed by both subjective and objective mobility measures, and lower income. This study also indicates that objective measures of mobility may be a useful supplement to self-assessed QoL questionnaires when assessing the future impact of lymphoedema management interventions.",
keywords = "Activities of Daily Living, Case-Control Studies, Disability Evaluation, Elephantiasis, Filarial, Female, Humans, Income, Malawi, Male, Middle Aged, Mobility Limitation, Physical Examination, Population Surveillance, Quality of Life, Retrospective Studies, Severity of Illness Index, Socioeconomic Factors, Surveys and Questionnaires, Journal Article",
author = "Stanton, {Michelle C} and Masato Yamauchi and Mkwanda, {Square Z} and Paul Ndhlovu and Matipula, {Dorothy Emmie} and Charles Mackenzie and Kelly-Hope, {Louise A}",
year = "2017",
month = apr,
day = "3",
doi = "10.1186/s40249-017-0241-2",
language = "English",
volume = "6",
journal = "Infectious diseases of poverty",
issn = "2049-9957",
publisher = "BioMed Central Ltd.",
number = "1",

}

RIS

TY - JOUR

T1 - Measuring the physical and economic impact of filarial lymphoedema in Chikwawa district, Malawi

T2 - a case-control study

AU - Stanton, Michelle C

AU - Yamauchi, Masato

AU - Mkwanda, Square Z

AU - Ndhlovu, Paul

AU - Matipula, Dorothy Emmie

AU - Mackenzie, Charles

AU - Kelly-Hope, Louise A

PY - 2017/4/3

Y1 - 2017/4/3

N2 - 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 cases-control 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 km2, 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 their unaffected peers, experiencing a lower QoL as confirmed by both subjective and objective mobility measures, and lower income. This study also indicates that objective measures of mobility may be a useful supplement to self-assessed QoL questionnaires when assessing the future impact of lymphoedema management interventions.

AB - 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 cases-control 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 km2, 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 their unaffected peers, experiencing a lower QoL as confirmed by both subjective and objective mobility measures, and lower income. This study also indicates that objective measures of mobility may be a useful supplement to self-assessed QoL questionnaires when assessing the future impact of lymphoedema management interventions.

KW - Activities of Daily Living

KW - Case-Control Studies

KW - Disability Evaluation

KW - Elephantiasis, Filarial

KW - Female

KW - Humans

KW - Income

KW - Malawi

KW - Male

KW - Middle Aged

KW - Mobility Limitation

KW - Physical Examination

KW - Population Surveillance

KW - Quality of Life

KW - Retrospective Studies

KW - Severity of Illness Index

KW - Socioeconomic Factors

KW - Surveys and Questionnaires

KW - Journal Article

U2 - 10.1186/s40249-017-0241-2

DO - 10.1186/s40249-017-0241-2

M3 - Journal article

C2 - 28366168

VL - 6

JO - Infectious diseases of poverty

JF - Infectious diseases of poverty

SN - 2049-9957

IS - 1

M1 - 28

ER -