Community's knowledge and perceptions about filarial elephantiasis and hydrocele in coastal Orissa, India

This study assesses people's knowledge and perceptions on transmission, prevention and eradication of elephantiasis and hydrocele, common manifestations of chronic lymphatic filariasis (LF). The assessment was done during mass drug administration (MDA) of the programme to eliminate LF in the State of Orissa, India. A household survey with pre-tested interview questionnaire was conducted in four LF endemic districts of Orissa state, India, where the MDA has been taken place. The sampling units (clusters of households) of the household survey are taken based on (1) urban/rural and (2) type of or absence of health facility. A total of 1,448 respondents were selected randomly. Majority of the respondents heard about elephantiasis and hydrocele. About one third of them know that mosquito bite is the cause of elephantiasis but very few people know about hydrocele. Around 50% of the respondent believed that elephantiasis could be cured completely, while almost 60% said that it could be totally removed from the community. But for hydrocele, more than 80% of respondents showed a positive approach for cure and nearly about 70% said that hydrocele could totally be eradicated from community. Various causes and methods of cure and prevention were suggested. Around 55% of respondents suggested that elephantiasis can be eradicated by taking medicine, but only 40% felt that hydrocele can be cured by taking medicine. Basic knowledge on LF is poor and relatively low proportion of people knows that LF can be eliminated by taking medicine. As there are plans to undertake further rounds of MDA in Orissa, people's knowledge has to be strengthened and perception and attitudes have to be addressed to achieve positive behavioural change, which eventually lead to higher compliance of MDA.     

"Can it be that god does not remember me": a qualitative study on the psychological distress, suffering, and coping of Dominican women with chronic filarial lymphedema and elephantiasis of the leg

The psychological states of Dominican women with chronic lymphedema and elephantiasis of the leg and the coping strategies they used to ameliorate the negative psychological effects of this condition were explored using modified precepts of grounded theory method. Qualitative data were gathered through in-depth interviewing and focus group discussions held in the Dominican Republic. Thematic results found that compounding their physical disfigurement, functional limitations, and social losses were feelings of depression, embarrassment, social isolation, and despair. Adaptive problem solving and emotion-focused coping strategies that emerged during analysis also are discussed. It is recommended that management of psychological distress should be a significant component of lymphedema management programs in developing countries.     

The burden of non-filarial elephantiasis in Ethiopia

Although known for many years, non-filarial elephantiasis remains a public health problem in tropical Africa, including the farming community of Ethiopia. The problem may be exacerbated in women who shoulder most of the burden of agricultural labour in the countryside. The intention of this brief review is to emphasise the burden of the disease and to alert researchers and organisations concerned with health care and prevention.     

The treatment of leg length discrepancy using Phemister's method of epiphysiodesis]

A retrospective study is reported of the results of epiphysiodesis in 67 children. In 47 patients (70%) the final inequality was less than or equal to 1.0 cm. In 9 patients the final inequality was greater than or equal to 1.6 cm. The average leg length inequality could be reduced from 3.2 cm preoperatively to 1.2 cm at maturity. Technical errors were minimal. Failures (9 patients) resulted mainly from problems in timing epiphysiodesis.