Bontha V Babu, Abhay N Nayak, Anna S Kerketta
Division of Epidemiology, Regional Medical Research Centre, Indian Council of Medical Research,Bhubaneswar-751 023, India.
Trop Biomed. 2007 Dec;24(2):7-14.
The study is to investigate the foot care practices among filarial lymphoedema patients, which is relevant to strengthen the second pillar of the Programme to Eliminate Lymphatic Filariasis (PELF). The patients are drawn randomly from a clinic as well as from the community. After getting verbal consent, each patient was subjected to an in-depth interview by using a structured questionnaire on how she/he dealt with lymphoedema and probed about various foot care practices. Of the six foot care measures, most of the patients are practising one or two measures only. Substantial numbers of patients are practising the washing the affected limb regularly. Though majority use normal footwear, none of the patients use specially made footwear. Other foot care practices like, massaging, elevation and exercising of affected, limb and use of bandage are practised by a few patients. The patients' education and lymphoedema grade had significant influence on number of foot care practices adopted. The present results are not surprising, but disappointing, as a few patients are practising the measures specifically aimed to ameliorate the lymphoedema condition. Though the present study area is covered by the mass drug administration under PELF, no serious attempts are made to alleviate disability and morbidity control. Appropriate care of affected limb at early stage can help in prevention or reversal of the progression of the disease, in addition to decrease in frequency of acute lymphangitis attacks. PELF is one of the functions of primary healthcare (PHC) system and hence, peripheral level health institutions of PHC system including primary health centres, health sub-centres and their health workers should take lead in encouraging the patients to modify their behaviour with foot care practices.
该研究旨在调查丝虫性淋巴水肿患者的足部护理行为，这对于加强消除淋巴丝虫病计划（PELF）的第二支柱至关重要。患者从诊所和社区中随机抽取。在获得口头同意后，使用结构化问卷对每位患者进行深入访谈，询问其如何应对淋巴水肿以及各种足部护理行为。在六项足部护理措施中，大多数患者仅采取一两项措施。相当多的患者经常清洗患侧肢体。虽然大多数患者穿普通鞋子，但没有患者使用特制的鞋子。少数患者会采取其他足部护理行为，如按摩、抬高和锻炼患侧肢体以及使用绷带。患者的教育程度和淋巴水肿分级对所采取的足部护理行为数量有显著影响。目前的结果并不令人惊讶，但令人失望，因为只有少数患者采取了专门旨在改善淋巴水肿状况的措施。尽管目前的研究区域已纳入PELF的大规模药物给药范围，但并未认真尝试减轻残疾和控制发病率。早期对患侧肢体进行适当护理，除了可减少急性淋巴管炎发作的频率外，还有助于预防或逆转疾病进展。PELF是初级卫生保健（PHC）系统的职能之一，因此，PHC系统的基层卫生机构，包括初级卫生中心、卫生分中心及其卫生工作者，应带头鼓励患者改变足部护理行为。
