Evaluating the cost of self-care: Impact of enhanced morbidity management protocol on people living with lymphatic filariasis in Bangladesh

Tijana Williams, Mohammad Jahirul Karim, Samid Siddiqui, Fazlur Rahman Akm, Salim Chowdhury, Sharmin Jahan, Sultan Mahmood Ams, Shaun P Forbes, Hannah Betts, Mark J Taylor and Louise A Kelly-Hope

PLOS Neglected Tropical Diseases, 2026, vol. 20, issue 10, 1-21

Abstract: Background: Lymphatic filariasis (LF) causes chronic lymphoedema requiring long-term self-care, often at personal cost. In post-elimination settings such as Bangladesh, understanding the financial burden of self-care is critical for sustaining morbidity management and disability prevention (MMDP). This study evaluated self-care costs and the impact of an enhanced morbidity management protocol among people affected by filarial lymphoedema in Bangladesh. Methodology: A longitudinal cohort study was conducted in Lalmonirhat and Thakurgaon districts (2020–2021). People affected by mild, moderate, and severe lymphoedema (n = 290) were assessed at baseline, trained in an enhanced self-care protocol, and assessed at a 3-month follow-up and a final follow-up conducted at 6 months in Lalmonirhat and 9 months in Thakurgaon. Data were collected on clinical characteristics (lymphoedema stage, acute attacks, pain), self-care items (soap, cream, pain relief), related costs, and adherence. Results: At baseline, participants with mild (11.2–54.7%), moderate (21.9–39.5%), and severe (23.4–49.3%) lymphoedema were included, reflecting variation across districts. Acute attacks were reported by 62.8–79.6% of participants and severe pain by 40.6–54.6%. Following the intervention, acute attacks decreased to 25.2–35.2% and severe pain to 22.4–28.0% (p

Date: 2026
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pntd00:0014812

DOI: 10.1371/journal.pntd.0014812

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