The wider societal benefits of surgical interventions for lymphatic filariasis morbidity management and disability prevention

Introduction Lymphatic filariasis (LF) is targeted for global elimination as a public health problem by interrupting transmission with mass drug administration and providing an essential package of care to people affected by the debilitating lymphedema and hydrocoele conditions [1]. In recent years, many LF endemic countries have scaled up their morbidity management and disability prevention (MMDP) programmes with a new focus on universal health coverage, primary healthcare strengthening, and integrated management of skin neglected tropical diseases (NTDs), with the aim of fully integrating quality services for LF MMDP into national health systems to ensure sustainability [2]. Evidence from the field Ethics statement Ethical approval was obtained from the Malawi National Health Sciences Research Committee (Protocol 15/3/1406) and the Liverpool School of Tropical Medicine Research Ethics Committee (Protocol 15.047). Methods To provide evidence of the wider societal benefits of surgical intervention, we extended the study in Malawi by Betts and colleagues [4] to include a small retrospective survey on caregivers, 6 months postsurgical intervention, to better understand their (i) characteristics and relationship to the hydrocoele patient; (ii) level of assistance provided: number and type of physical activities they assisted with; (iii) impact on time and work: number of days per month they provided care and took off work; (iv) impact on the quality of life in relation to their usual activities (3 questions), social issues (3 questions), and psychological health (4 questions) using a similar scale-based scoring system, adapted from the Lymphatic Filariasis Quality of Life Questionnaire (LFSQQ) [12,13] to quantify problems, i.e., no problem = 0, mild = 1, moderate = 2, and severe = 3, with individual total scores ranging from 0 = no problem to 30 = severe problem in all 10 questions.