Does the morbidity management and disability prevention (MMDP) clinic serve the filarial lymphedema (FLE) patients’ preeminent expectation?

@#Advocacy and training on “Home care” for filarial lymphoedma (FLE) patients are provided through morbidity management and disability prevention (MMDP) clinic commonly known as filariasis clinic and clinical improvement is assessed by follow-up visits. While the physicians aim at reducing the recurrent ADL (coined as ADLA in 1997) episodes, the patients expect reduction in LE volume. The objective of the present study was to know whether the MMDP clinic serves the primary expectation of the FLE patients. LE patients who attended the clinic for at least four follow-up consultations and had LE volume measurements at three points of time during the one year period of observation were considered for analysis. Clinical assessment was done for LE grading and LE volume was measured by water displacement volumetry. Sixty-three patients who fulfilled the follow up criteria were included. It was observed that the median LE volume was 914ml (IQR 269 – 1935) at first visit of the observation period which reduced to 645ml (IQR 2151666) and 752ml (IQR 215 – 1720) at first and second follow-up visits respectively. Over all, in short span of one year, 21 of the 63 patients (33.3%) who visited MMDP clinic at least four times in a year were benefitted through the MMDP advocacy and the National filariasis control programme need to emphasise on the importance of follow up visits to FLE patients.

Influence of recall period on estimates of diarrhoea morbidity in infants in rural Tamilnadu.

Data collected on 689 infants, in a study to assess the incidence of diarrhoea and acute respiratory infections during infancy, is used here to quantify the extent of under-reporting in diarrhoea morbidity surveys. The study area consisted of two contiguous primary health centres in Villupuram health unit district in Tamil Nadu, South India. Each day of infancy was assigned a recal period and proportion of diarrhoeal days for various recall period computed. The proportion of diarrhoea was 11.3%, 12.0% and 11.2% for zero, one and two days of recall period, respectively, after which the proportion decreased. The under-reporting of diarrhoea was approximately 15%, 26% and 45% with three, six and 7-13 days of recall period, respectively. As there is considerable under-reporting of diarrhoea morbidity when recall period exceeds three days, it would be best to collect information on diarrhoea at least twice a week in diarrhoeal morbidity surveys.

Influence of recall period on estimates of diarrhoea morbidity in infants in rural Tamil Nadu.

Data collected on 689 infants, in a study to assess the incidence of diarrhoea during infancy, is used here to quantify the extent of under-reporting in diarrhoea morbidity surveys. The study area consisted of two contiguous primary health centres in Villupuram health unit district in Tamil Nadu, south India. Each day of infancy was assigned a recall period and proportion of diarrhoeal days for various recall period computed. The proportion of diarrhoea was 11.3%, 12.0% and 11.2% for zero, one and two days of recall period, respectively, (mean 11.5%) after which the proportion decreased. The under-reporting of diarrhoea was approximately 15%, 26% and 45% with three, six and 7-13 days of recall period, respectively compared to mean. As there is considerable under-reporting of diarrhoea morbidity when recall period exceeds three days, it would be better to collect information on diarrhoea twice a week in diarrhoeal morbidity surveys.