The experience of living with chronic manifestations of Lymphatic Filariasis among patients 15 years and older in developing countries: a systematic review

Background Lymphatic filariasis is considered a disease of the poor with painful and profoundly disfiguring consequences. It is transmitted by the mosquito. Lymphatic filariasis is found among persons residing in rural areas and at the periphery of communities predominantly in developing countries in the tropics. Objectives To present the best evidence regarding the experiences of persons living with chronic manifestations of lymphatic filariasis, their experiences of treatment strategies and how the condition influences their social relationships within the context of developing countries. Inclusion criteria Type of participants Study subjects were persons 15 years and older with chronic lymphatic filariasis living in developing countries. Phenomena of interest Publications that were selected considered the experiences of persons living with chronic lymphatic filariasis, their experiences of treatment measures and their social relationships. Types of studies Qualitative research papers (including but not limited to: phenomenology, grounded theory, action research, narrative studies, descriptive studies, ethnographies, cultural studies, behavioral studies, case studies and feminist research) exploring the experiences of persons living with chronic manifestations of lymphatic filariasis within the context of developing countries Search strategy A three-step search strategy was utilised to search for published and unpublished studies over the period of 1980-2007. MEDLINE and CINAHL were initially searched for keywords and index terms that were then used to search across all the other data bases and finally the reference list of identified studies. Methodological quality Eligible publications were assessed by two independent reviewers for methodological validity using the standardised critical appraisal tools of the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) Data extraction Data extraction was conducted using the standardised data extraction tools of the JBI-QARI. Extracted information consisted of details on relevant aspects of the identified studies. Data synthesis Study findings were categorised according to the JBI-QARI degrees of credibility scale, and placed in categories of similar meaning. Categories were finally meta-synthesised. Results Six (6) included studies yielded 41 findings that were placed in 8 categories and finally meta-synthesised into 3 synthesised findings: 1. Effective care for adults living with chronic manifestations of lymphatic filariasis will be achieved if health care professionals and the health-care community are aware of the profound effect of the illness upon the existence and self identity of sufferers. 2. Effective care for adults living with chronic manifestations of lymphatic filariasis will be achieved if health professionals and the health-care community are aware of the large impact of societal factors on the well-being of such patients. 3. Treatment decisions should be made balancing the pros and cons of conservative and surgical treatment options with sufficient counseling and patient education on anaesthetics. Conclusion Policy guidelines on chronic lymphatic filariasis management need to provide a holistic approach with the involvement of communities.