Factors affecting the quality of life of lymphoedema patients in the Western Province of Sri Lanka

Abstract

BACKGROUND: Information on the impact of lymphoedema, an important consequence of bancroftian filariasis, on the quality of life (QOL) of Sri Lankans is limited. The Dermatological Life Quality Index (DLQI) is a validated tool that can be used to monitor QOL. OBJECTIVES: To study the factors affecting QOL of lymphoedema patients in the Western Province of Sri Lanka. METHODS: Lymphoedema patients attending two filariasis clinics (Colombo and Kiribathgoda) and the Outpatients Dept of the Colombo North Teaching Hospital, were studied. Lymphoedema was graded using recommended criteria. QOL was assessed using the DLQI, modified to focus on lymphoedema, and scored from 0 (normal) to 30 (affects QOL severely). A semi-structured questionnaire was used to assess the patient's socio-economic status, frequency of acute adenolymphangitis attacks (ADLA) and measures to alleviate morbidity. RESULTS: Ninety one patients (62 females, 29 males, mean age 50.4 years) were studied. A single lower limb, both lower limbs and a single upper limb were affected in 78 (85.7%), 10 (10.9%) and 3 (3.2%) patients respectively. Severity of lymphoedema ranged from Grades 1 (mild) to 6 (severe); 87.5% were in Grades 1-3. The mean DLQI was 8.2 (SD5.2, range 1-20). DLQI correlated significantly with lymphoedema, number of ADLA attacks and age (correlation co-efficients of 0.69,0.39 and -0.1 respectively). There was no significant association between DLQI and socio-economic status or type of treatment practiced. CONCLUSIONS: Increasing disease severity, frequency of ADLA and early onset lymphedema significantly worsens quality of life for patients with filarial lymphoedema.