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Exploring hydrocoele surgery accessibility and impact in a lymphatic filariasis endemic area of southern Malawi

Stanton, Michelle ORCID: https://orcid.org/0000-0002-1754-4894, Smith, Emma, Martindale, Sarah, Mkwanda, Square Z and Kelly-Hope, Louise ORCID: https://orcid.org/0000-0002-3330-7629 (2015) 'Exploring hydrocoele surgery accessibility and impact in a lymphatic filariasis endemic area of southern Malawi'. Transactions of the Royal Society of Tropical Medicine and Hygiene, Vol 109, Issue 4, pp. 252-261.

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Abstract

Background
Hydrocoele surgery is the recommended treatment for the common clinical manifestation of lymphatic filariasis in men. This study determined the geographical differences in surgery accessibility, and improvements in the quality of life of patients in Chikwawa district, Malawi.

Methods
Surgery records from Chikwawa District Hospital (CDH), between 2008 and 2013, were used to map surgery rates by village, spatial dependence by census enumeration area and relationship of distance (kilometres) to CDH. A subset of patients were selected to quantify and compare their physical and socio-economic well-being and level of disability pre- and post-surgery using a standardised questionnaire.

Results
A total of 476 hydrocoele surgical cases were identified with 260 cases geo-referenced and mapped. A significant negative relationship between village-level surgery rates and distance to CDH (r=−0.137; 95% CI: −0.47 to −0.26) was found, and clusters of enumeration areas with high surgery rates identified around the CDH. Significant improvements in patients' ability to walk and work were found and the overall level of disability was reduced post-surgery.

Conclusions
Hydrocoele surgery positively impacted on patients, improving their physical and socio-economic output. Surgical services need to scale-up and expand to reach cases that have less access to the best treatment currently available.

Item Type: Article
Uncontrolled Keywords: Hydrocoele; Hydrocoelectomy; Lymphatic filariasis; Malawi; Morbidity; Socio-economic
Subjects: W General Medicine. Health Professions > Health Services. Patients and Patient Advocacy > W 84 Health services. Delivery of health care
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 880 Filariasis and related conditions (General)
WO Surgery > WO 100 General works
Faculty: Department: Biological Sciences > Department of Tropical Disease Biology
Digital Object Identifer (DOI): https://doi.org/10.1093/trstmh/trv009
Depositing User: Jessica Jones
Date Deposited: 01 Feb 2016 10:20
Last Modified: 06 Feb 2018 13:11
URI: http://archive.lstmed.ac.uk/id/eprint/5572

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