Effect of domiciliary limb hygiene alone on lymphoedema volume and locomotor function in filarial lymphoedema patients in Puducherry, India.

Lymphoedema of extremities is a major clinical manifestation of lymphatic filariasis. Recurrent episodes of acute dermato-lymphangioadenitis (ADLA) in these patients lead to progression of the clinical condition. Studies have documented the effectiveness of regular limb hygiene in reduction in frequency and duration of ADLA. However, no data is available on the effectiveness of limb hygiene alone on reduction of lymphoedema volume and locomotor function of the affected extremities. A total of 93 consecutive patients visiting VCRC Filaria Clinic formed a cohort for the study. The limb hygiene kit was supplied monthly free of cost to the patients. Assessments of oedema volume, frequency and duration of ADLA and quantitative assessment of locomotor function were carried out at baseline and after 12 months of intervention. All the 93 patients completed the follow-up. A total of 82 (88%) patients practiced limb hygiene regularly. The practice was higher among patients with higher grades of lymphoedema. The mean frequency of ADLA reduced from pre-intervention level of 2.4 to 0.8 during 12-month period of intervention in grade I cases, from 3.4 to 1.2 in grade II and from 4.8 to 1.8 in grade III cases. The mean duration (in days) for each ADLA episode was reduced from 4 at the rpe-intervention level and 2.5 during the 12-months intervention period. Though 'limb hygiene' practiced in domiciliary settings is feasible. Regular practices resulted in reduction of frequency and duration of ADLA attacks. However, reduction in oedema volume or improvement the locomotor function was not observed during 12 month period.