Centre for Neglected Tropical Diseases, Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, UK.
Nepal Leprosy Trust, Kathmandu, Nepal.
BMC Public Health. 2018 Jan 30;18(1):201. doi: 10.1186/s12889-018-5099-0.
BACKGROUND: Lymphatic filariasis (LF) and leprosy are disabling infectious diseases endemic in Nepal. LF infection can lead to lymphoedema and hydrocoele, while secondary effects of leprosy infection include impairments to hands, eyes and feet. The disabling effects of both conditions can be managed through self-care and the supportive effects of self-help groups (SHGs). A network of SHGs exists for people affected by leprosy in four districts in Nepal's Central Development Region, however no such service exists for people affected by LF. The aim of this study was to determine the feasibility of integrating LF affected people into existing leprosy SHGs in this area. METHODS: A survey was conducted using a semi-structured questionnaire to elicit information on: (i) participant characteristics, clinical manifestation and disease burden; (ii) participants' knowledge of management of their condition and access to services; and (iii) participants' knowledge and perceptions of the alternate condition (LF affected participants' knowledge of leprosy and vice versa) and attitudes towards integration. RESULTS: A total of 52 LF affected and 53 leprosy affected participants were interviewed from 14 SHGs. On average, leprosy affected participants were shown to have 1.8 times greater knowledge of self-care techniques, and practiced 2.5 times more frequently than LF affected participants. Only a quarter of LF affected participants had accessed a health service for their condition, compared with 94.3% of leprosy affected people accessing a service (including SHGs), at least once a week. High levels of stigma were perceived by both groups towards the alternate condition, however, the majority of LF (79%) and leprosy (94.3%) affected participants stated that they would consider attending an integrated SHG. CONCLUSIONS: LF affected participants need to increase their knowledge of self-care and access to health services. Despite stigma being a potential barrier, attitudes towards integration were positive, suggesting that the SHGs may be a good platform for LF affected people to start self-care in this area. TRIAL REGISTRATION: This is not a registered trial.
背景：淋巴丝虫病（LF）和麻风病是尼泊尔地方性传染病。LF 感染可导致淋巴水肿和阴囊积水，而麻风病感染的继发性影响包括手部、眼部和足部损伤。这两种疾病的致残影响都可以通过自我护理和自助团体（SHG）的支持来管理。尼泊尔中部发展区的四个地区都有为麻风病患者设立的 SHG 网络，但没有针对 LF 患者的此类服务。本研究旨在确定将 LF 患者纳入该地区现有麻风病 SHG 的可行性。
方法：采用半结构式问卷进行调查，以获取以下信息：（i）参与者特征、临床表现和疾病负担；（ii）参与者对其病情管理和服务获取的了解；以及（iii）参与者对替代疾病（LF 受影响者对麻风病的了解和反之亦然）的了解和看法以及对整合的态度。
结果：共从 14 个 SHG 中采访了 52 名 LF 受影响者和 53 名麻风病受影响者。平均而言，麻风病受影响者的自我护理技术知识要多出 1.8 倍，而且练习的频率要高出 LF 受影响者 2.5 倍。只有四分之一的 LF 受影响者曾因该病就诊，而 94.3%的麻风病受影响者（包括 SHG）至少每周一次就诊（包括 SHG）。两个群体都对替代疾病存在高度的污名化，但大多数 LF（79%）和麻风病（94.3%）受影响者表示，他们会考虑参加一个综合的 SHG。
结论：LF 受影响者需要增加自我护理知识和获得卫生服务的机会。尽管污名化是一个潜在的障碍，但对整合的态度是积极的，这表明 SHG 可能是 LF 受影响者在该地区开始自我护理的良好平台。
注：这是一个研究报告的摘要，仅供参考。
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