13:40 〜 15:20
[IS-5] Morbidity control of lymphedema due to lymphatic filariasis in Bangladesh
Lymphatic filariasis(LF) is endemic in more than 80 countries in tropical and subtropical regions. Adult worm produce millions of microfilariae that circulate in the blood. They are transmitted by mosquito bites from infected human to uninfected human. Adult worms lodge in the human lymphatic system and disrupt the immune system. Dilated lymph vessels by adult worms cause abnormal lymph flow because of one-way valve dysfunction. It leads to lymphedema and hydrocele of scrotum. Such body deformities also cause psychological and social problems such as depression and discrimination and so on.
World health organization(WHO) launched Global Program to Eliminate Lymphatic Filariasis(GPELF) in 2000 with the aim of eliminating LF as a public-health problem by 2020. There are two key components in GPELF. The one is mass drug administration(MDA) for stopping transmission. The other is morbidity control(MC) for prevention of deterioration of lymphedema.
Bangladesh is one of the endemic countries. Japanese government has been dispatching Japan overseas cooperation volunteers(JOCV) to Bangladesh for supporting its LF elimination program from 2003. I was working in Bangladesh as a member of JOCV from 2010 to 2011. I spread the information of MDA to whole district by cooperating with local health workers. I supervised drug distributers during MDA and checked its coverage by conducting post MDA survey. The MDA coverage of Panchagarh district in 2010 was only 48.5%.
I educated patients and local health workers about MC of lymphedema to reduce the risk of cellulitis based on WHO guideline. Main component of MC is washing edematous area meticulously with soap and water to keep it clean. However almost all health workers are not interested in MC and they did not want to touch patients directly. Therefore almost all patients could not understand the importance of MC.
World health organization(WHO) launched Global Program to Eliminate Lymphatic Filariasis(GPELF) in 2000 with the aim of eliminating LF as a public-health problem by 2020. There are two key components in GPELF. The one is mass drug administration(MDA) for stopping transmission. The other is morbidity control(MC) for prevention of deterioration of lymphedema.
Bangladesh is one of the endemic countries. Japanese government has been dispatching Japan overseas cooperation volunteers(JOCV) to Bangladesh for supporting its LF elimination program from 2003. I was working in Bangladesh as a member of JOCV from 2010 to 2011. I spread the information of MDA to whole district by cooperating with local health workers. I supervised drug distributers during MDA and checked its coverage by conducting post MDA survey. The MDA coverage of Panchagarh district in 2010 was only 48.5%.
I educated patients and local health workers about MC of lymphedema to reduce the risk of cellulitis based on WHO guideline. Main component of MC is washing edematous area meticulously with soap and water to keep it clean. However almost all health workers are not interested in MC and they did not want to touch patients directly. Therefore almost all patients could not understand the importance of MC.