Quality of life of people living with lymphoedema: A cross sectional community based study in selected districts of Nepal

Abstract

Introduction: Lymphatic Filariasis (LF) is the second most common cause of physical disability worldwide with 40 million people chronically disabled by the disease and about twice that number suffering from covert lymphatic changes or kidney diseases. The most common chronic manifestations of the disease are lymphoedema and hydrocele. The objective of this study is to evaluate the quality of life (QOL) of lymphoedema patients in Nepal.

Methods: We sought the help of female community health volunteers, health workers working in peripheral health centers in selected sentinel surveillance sites in listing out the names of patients with lymphoedema. The researcher obtained details of 205 cases of lymphoedema (49 cases of Elephantiasis and 156 cases of hydrocele) in three districts (Dhading 74, Kapilbastu 78, Kailali 53). A total of 205 healthy individuals were selected from the same locality (Dhading 68, Kapilbastu 66, Kailali 71) for comparison. World Health Organization Quality of Life questionnaire brief version (WHO QOL-BREF) was used for data collection.

Results: The mean age of the respondents was 45.95 years with a standard deviation of 17.96 years. In four domains, the physical domain scored highest (14.28±2.52) and the environmental domain scored lowest (12.19±1.69). Patients with lymphoedema had significantly low QOL scores in physical (p<0.001), psychological (p<0.001), social relationship (p<0.001), and environmental (p<0.001) compared to their healthy counterparts. Similarly, the overall QOL score was lower in patients with lymphoedema than in healthy control, and it was statistically significant (p<0.001).

Conclusion: This study reports significantly low QOL scores in all four domains in patient with lymphoedema denoting low quality of life compared to their healthy counterparts. It is recommended that the current Lymphatic Filariasis elimination program of Nepal should focus to initiate morbidity management program specifically to patients with lymphoedema and hydrocele.