Abstract 8. Disability and Health-Related Quality of Life in Lymphatic Filariasis Patients Cristina Thomas Background: Lymphatic filariasis (LF), a mosquito-borne parasitic disease, is the second leading cause of life-long disability worldwide and contributes to more than 4.4 million disability-adjusted life years in men and 1.3 million disability-adjusted life years in women. Besides the physical impairment caused by chronic lymphedema, significant psycho-social damage and social stigma is associated with elephantiasis, a symptom that commonly accompanies the disease. Although several studies have evaluated the impact of lymphatic filariasis on patients’ daily lives, the relationship between disability and health-related quality of life (HRQoL) has not yet been explored. The objectives of this study were to first, assess disability in relation to skin-specific and diseasespecific quality of life and to second, determine demographic and disease characteristics that influence disability and HRQoL. Methods: Disability was evaluated with the World Health Organization’s Disability Assessment Schedule (WHODAS 2.0), and HRQoL was measured with the Dermatology Life Quality Index (DLQI) and the Institute of Applied Dermatology’s LF-specific QoL Instrument. In addition to these questionnaires, subjects were asked to complete a demographic and disease questionnaire. Lymphedema was staged based on the International Society of Lymphology’s staging system. Wilcoxon Rank Sum test was used to compare patient scores with those of controls, and Spearman’s correlation test demonstrated correlation between disability and HRQoL. Results: A total of 36 patients with lymphatic filariasis and 36 controls were enrolled in this study. Twenty-one patients had stage II lymphedema, and fifteen patients had stage III lymphedema. A significant difference was noted between the total scores of patients and controls with the WHODAS 2.0 (P<0.001), DLQI (P<0.001), and LF-specific QoL Instrument (P<0.001). However, scores among patients were not significantly affected by the stage of lymphedema. Disability measurements were positively correlated with DLQI ( r = 0.75, P <0.001) and LFspecific QoL Instrument (r = 0.91, P<0.001) scores. In comparing perceived days of disability, LF patients experienced more days of limited activity than controls (P<0.0001). However, there was no significant difference between the number of days of total inactivity due to health conditions for patients and controls. Additional statistical tests are being performed to determine the benefits of each questionnaire in gauging the impact of LF on patient’s daily lives. Conclusions: Based on our findings, grade II and grade III LF patients experience greater disability and lower HRQoL than the general population. In addition, severity of disability but not stage of lymphedema is correlated with HRQoL. Although patients are not totally debilitated by their disease, lymphatic filariasis does limit the activity a patient can perform. In this way, improvements in disability measures may be an important outcome for treatments that aim to provide LF patients with increased quality of life. Because of the unique psychosocial and physical limitations the disease imposes, disability and HRQoL measures are crucial to determining effective treatments and ensuring maximal integration of lymphatic filariasis patients back into society.
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