Efficacy and sustainability of a footcare programme in preventing acute attacks of adenolymphangitis in Brugian filariasis

Lymphatic filariasis is associated with considerable disability related to the intensity and frequency of acute adenolymphangitis (ADL) attacks. The global program for elimination of lymphatic filariasis emphasizes the need to combine transmission control with alleviation of disability. Footcare aimed at the prevention of secondary bacterial infections is the mainstay of disability alleviation programs. The authors evaluated the efficacy and sustainability of an unsupervised personal footcare program by examining and interviewing 127 patients who had previously participated in a trial that assessed the efficacy of diethylcarbamazine penicillin and footcare in the prevention of ADL. During the trial period these patients had been educated in footcare and were supervised. During the unsupervised period which lasted 1 year or longer 47 patients developed no ADL occurred less frequently in 72.5%. Most patients were practicing footcare as originally advised unsupervised and without cost which proves that such a program is sustainable and effective. (authors)