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Reporting an alliance using an integrative approach to the management of lymphedema in India
Terence J Ryan1, Saravu R Narahari
1Oxford University and Oxford Brookes University, Oxford, Oxfordshire, UK.
In India 553 million persons are estimated to live in areas endemic for LF; approximately 21 million have symptomatic filariasis. Of the approximately 16.02 million cases of lymphedema caused by LF globally, 7.44 million (46.4%) are in India. India had seen diethyl carbamizine, and/or albendazole, delivered to whole populations, beginning the project to eliminate the disease. But new populations have developed the infection. In 2003 the need in resource-poor countries for morbidity control of lymphatic filariasis (LF) became clear, prompting the study by the Institute of Applied Dermatology in Kerala, India. Under this study,self help and family members assisted in home-based care, combining compression bandaging, yoga exercises, heat therapy using steaming, and skin care according to Ayurvedic medicine. Lymphedema presents with different patterns in the skin with gross changes in the epidermis, dermis, or subcutaneous tissue. Skilled and time-consuming counselling is important to give patients support. An almost immediate reduction in inflammatory episodes from 80.4% to 8.6% shows up within 2 or 3 weeks, and therefore, intake of antibiotics can be stopped. The second major response is reduction in the size of the limb. Volume reduction for large-sized limbs at 3 months is 39%, with a confidence interval of 4.9 to 5.9 L.
In India 553 million persons are estimated to live in areas endemic for LF; approximately 21 million have symptomatic filariasis. Of the approximately 16.02 million cases of lymphedema caused by LF globally, 7.44 million (46.4%) are in India. India had seen diethyl carbamizine, and/or albendazole, delivered to whole populations, beginning the project to eliminate the disease. But new populations have developed the infection. In 2003 the need in resource-poor countries for morbidity control of lymphatic filariasis (LF) became clear, prompting the study by the Institute of Applied Dermatology in Kerala, India. Under this study,self help and family members assisted in home-based care, combining compression bandaging, yoga exercises, heat therapy using steaming, and skin care according to Ayurvedic medicine. Lymphedema presents with different patterns in the skin with gross changes in the epidermis, dermis, or subcutaneous tissue. Skilled and time-consuming counselling is important to give patients support. An almost immediate reduction in inflammatory episodes from 80.4% to 8.6% shows up within 2 or 3 weeks, and therefore, intake of antibiotics can be stopped. The second major response is reduction in the size of the limb. Volume reduction for large-sized limbs at 3 months is 39%, with a confidence interval of 4.9 to 5.9 L.
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