Economic Costs and Benefits of a Community-Based Lymphedema Management Program for Lymphatic Filariasis in Odisha State, India

Abstract

Lymphatic filariasis afflicts 68 million people in 73 countries, including 17 million persons living with chronic lymphedema. The Global Programme to Eliminate Lymphatic Filariasis aims to stop new infections and to provide care for persons already affected, but morbidity management programs have been initiated in only 24 endemic countries. We examine the economic costs and benefits of alleviating chronic lymphedema and its effects through a simple limb-care program. For Khurda District, Odisha State, India, we estimated lifetime medical costs and earnings losses due to chronic lymphedema and acute dermatolymphangioadenitis (ADLA) with and without a community-based limb-care program. The program would reduce economic costs of lymphedema and ADLA over 60 years by 55%. Savings of US$1,648 for each affected person in the workforce are equivalent to 1,258 days of labor. Per-person savings are more than 130 times the per-person cost of the program. Chronic lymphedema and ADLA impose a substantial physical and economic burden on the population in filariasis-endemic areas. Low-cost programs for lymphedema management based on limb washing and topical medication for infection are effective in reducing the number of ADLA episodes and stopping progression of disabling and disfiguring lymphedema. With reduced disability, people are able to work longer hours, more days per year, and in more strenuous, higher-paying jobs, resulting in an important economic benefit to themselves, their families, and their communities. Mitigating the severity of lymphedema and ADLA also reduces out-of-pocket medical expense.

Gender-related factors affecting health seeking for neglected tropical diseases: findings from a qualitative study in Ethiopia

“…Although the economic costs of NTDs, such as loss of earnings due to disability, have been documented [60,61] there is a lack of evidence on how this may impact different genders and factor into relational gender dynamics and health seeking behaviours.…”

Economic benefits and costs of surgery for filarial hydrocele in Malawi

“…[13][14][15] An economic study of such a community program in Odisha, India estimated that the lifetime benefits of disability prevented, restored work capacity, and reduced medical expense would be 130 times the cost of the intervention. [16] In regions endemic with W. bancrofti, the most common manifestation of LF is hydrocele. [17] Hydrocele is the accumulation of fluid around the testis in the tunica vaginalis, expanding the fluid volume within the scrotal sac due to blockage or dysfunction of the lymphatic vessels.…”

New Perspective of Lymphatic Filariasis-Towards Elimination

“…Around estimated 36 million are chronically disabled that constitutes a leading cause of physical disability globally. Almost 19 million are affected by scrotal hydrocele in men, and some 17 million by lymphedema (3). The lymphedema mainly affects lower limbs and also arms, breasts and scrotum.…”