Health-Seeking Behaviors and Self-Care Practices of People with Filarial Lymphoedema in Nepal: A Qualitative Study

Abstract

Background. Lymphatic filariasis is endemic in Nepal. This study aimed to investigate health-seeking behaviors and self-care practices of people with filarial Lymphoedema in Nepal. Methods. A cross-sectional study was conducted using qualitative methods in three endemic districts. Twenty-three patients with current Lymphoedema were recruited in the study. Results. Hydrocele was found to be a well-known condition and a major health problem in the studied communities. People with Lymphoedema primarily sought health care from traditional healers, whereas sometimes home-based care was their first treatment. Later Ayurvedic and allopathic hospital-based care were sought. Respondents reported various psychological problems such as difficulty in engaging in sexual intercourse, anxiety, worry and stress, depression, low self-esteem, feeling weak, fear of being abandoned, and fear of transmitting disease to the children. Standard foot care practices except washing were largely absent. Conclusions. Lymphoedema in the limbs and hydrocele were found to be major health problems. The traditional health care providers were the first contact of care for the majority of respondents. Only a few patients had been practicing standard foot care practices.

Health beliefs and health seeking behavior towards lymphatic filariasis morbidity management and disability prevention services in Luangwa District, Zambia: Community and provider perspectives

“…Some of the perceived causes of hydrocele and lymphedema included witchcraft, direct contact with infected individuals or objects as well as it being heritable, which matches results from similar studies [ 10 – 12 ]. This poor understanding of the connection between mosquitoes as the causes of filarial infection and the advanced stages of the disease has also been found elsewhere [ 10 , 13 , 14 ]. Further, knowledge of morbidity management practices and services was shown to be very minimal, which calls for increased demand generation efforts as these services help to ease the burden of disability and improve the quality of life [ 15 ].…”

Exploring determinants of hydrocele surgery coverage related to Lymphatic Filariasis in Nepal: An implementation research study

“…All the patients reported to trying home remedies, with some even seeking faith healers before going to medical practitioners. A recent study in Nepal reports similar findings of LF patients visiting traditional faith healers and practicing home remedies before seeking medical help [15]. We can argue that it could be due to not knowing the disease etiology nor about the role of mosquitoes in the transmission of LF and attributing this to the prevalent beliefs in the society.…”

“…One study in Nepal found little to no information on insights of healthcare seeking behavior, access to care, and self-care practice of LF patients. The active case finding, referral, and treatment of the LF patients are further complicated by the lack of integrated reporting of private hospitals [15]. This study aimed at understanding the barriers and enablers to accessing hydrocele surgery to facilitate and expedite the national LF elimination goal with necessary policy recommendations and thereby integrating hydrocele patients into society free from disease and disability.…”

“…A low level of knowledge among the target population acted as an obstacle among many control interventions [24]. Surgery was avoided in some cases because it was associated with perceived complications such as infertility, impotence, decreased physical strength, and even death [15]. This lack of knowledge of the free surgery camps, poor knowledge of hydrocele surgery procedures are further aggravated by the fact that generally, patients had some level of mistrust in government services.…”

Association between echinococcosis-specific health literacy and behavioural intention to prevent echinococcosis among herdsmen on the Tibet Plateau in China: a cross-sectional study

“…At present, self-management ability has been widely concerned in the management of chronic diseases [ 27 – 29 ]. Many studies have also shown that self-management interventions have benefits for the prevention of infectious diseases, such as AIDS [ 30 ], tuberculosis [ 31 ], hepatitis C [ 32 ] and filariasis [ 33 ]. Furthermore, it has been found that health literacy domain “active managing of one’s health” in HLQ was closely related to the health risk behaviours of Danish adults, including physically inactive, unhealthy diet and smoking [ 34 ], as well as the oral health-promoting behaviours of Slovak adults [ 25 ].…”