INTEGRATED MANAGEMENT OF FILARIAL LYMPHEDEMA FOR RURAL COMMUNITIES

Abstract

he Global Alliance for the Elimination of Lymphatic Filariasis (GAELF) hasrecommended exploring local health traditions of skin care and a low cost treatment paradigmfor rural communities has been proposed by Vaqas and Ryan. Our case study incorporates thesepromising treatments for use in treating filariasis in rural communities. Patients havinglymphedema of one or both lower limbs (skin: normal, thickened or with trophic/warty changes)received treatment components from ayurveda, yoga and biomedicine simultaneously: includingsoap wash, phanta soaking, Indian manual lymph drainage (IMLD), pre- and post-IMLD yogaexercises, and compression using bandages for 194 days, along with diet restrictions and oralherbal medicines indicated for “elephantiasis” in Ayurveda. Entry points when infected weretreated with biomedical drugs. The study was conducted in the reverse pharmacology design.112 patients and 149 lower limbs completed 194 days of treatment during 2003-2006. Significantimprovements were observed in the limb circumference measurements and the frequency of acutedermatolymphangioadenitis, use of preventive antibiotics and reduction in the number of entrypoints were also improved. The objective to obtain significant benefit for a common problemusing locally available, sustainable and affordable means has been achieved. It has not been ourpurpose to show that the regimen employed is better than another but the results do pose thequestion–“Are there components of Ayurvedic medicine that deserve further study?” It isimportant to understand that the regimen has been delivered mostly at home and thatparticipants we have treated, representing a population suffering from a common problem, havenot had access to effective conservative therapy that is culturally acceptable, safe, andefficacious