lunes, 1 de abril de 2019

WHY IS ELEPHANTIASIS A FORGOTTEN AND NEGLECTED DISEASE – Pediatric and Primary Lymphedema - Secondary Lymphaedema - Lymphatic Filariasis and Podoconiosis - Rare Disease

Neglected diseases like Lymphedema stand in stark contrast to other chronic diseases like diabetes, which receive the life-long drug treatments they need. Severe complications due to lack of access to therapy and compression garments, lead to more chances of lymphedema progressing to cellulitis, life-threatening complications such as lymphangiosarcoma, or sepsis (due to resistance to antibiotics).
Across the world, people suffer from neglected diseases, conditions that prevail in many countries lacking good health care services, and medical resources. Diseases like Lymphedema typically do not kill immediately, but instead, it slowly becomes severe and disabling, leading to terrible suffering, creating losses of capital, worker productivity, and economic growth. 

Advanced lymphedema (lymphatic elephantiasis), is characterized by fibrosis and fatty induration of the tissues, which become much more difficult to reduce than in the early stages, where the swelling is more characteristically due to protein-rich fluid. So to reduce limb volume, more intervention is required at an earlier stage, much more than is currently indicated by some international organizations. Read more information on why the world is not treating a treatable disease like Lymphedema HERE

With regard to filarial lymphedema (Lymphatic Filariasis), it is very important that at the present moment and by means of drugs, there is a goal and campaign of eliminating filariasis, to prevent the next generations of people from being infected. But there should also be a goal and campaigns, for the treatment of the present generations, who are already affected and suffering, from the consequent established lymphatic edema. The same happens with lymphedema due to Podoconiosis (lymphatic podoconiosis), which also needs reduction treatment and compression garments, in order to control its progression. 

Lymphatic edema without treatment or inadequately treated is more likely to develop very serious or even lethal complications such as erysipelas, adenolymphangitis, dermatolymphangioadenitis - DLA (cellulitis), necrotizing fasciitis, septicemia (sepsis), lymphangiosarcoma, etc. Elephantiasis whatever its cause or setting will never be eradicated from the world, whilst there are still people that don't have access to proper specialized treatment options for lymphedema. Read more information on what is the best treatment for Lymphedema HERE

Lymphedema is universally recognized as a neglected and severely debilitating disease, even though it already has effective treatments. In spite of this, many national health systems, even in modern and industrialized countries, allocate little or nothing to treating and preventing Lymphedema, in contrast to the full coverage given to other chronic diseases. 

No drug or surgical procedure exists that can permanently cure Lymphedema, but this is not an excuse for not funding public health treatments. Funding physical therapy and compression garments could help in the final push for the eradication of lymphatic elephantiasis (Stage-III-lymphedema) in the world.

Primary and Secondary lymphedema collectively, affect millions of people across the world, most in the poorest areas of the poorest countries. All lymphedema whatever the cause and setting, can drift towards severe deformity, leading to increased disability in men, women, and children of all ages. Furthermore, inflammation and infections in young people, lead to absences from school, reduced future quality of life, and labor productivity. 

However, lymphedema can be successfully treated, what’s more, preventing its progression and complications in the first place is completely achievable through increased awareness, and early-stage preventive treatment programs. See the video about the best treatment results for Stage III lymphedema/Elephantiasis HERE

The U.S. spends over $8,000 per person per year on health expenditures, in comparison, the minimum yearly needs of most lymphedema patients are two weeks of intensive physical therapy, and 2 compression garments. This opens the door to a critique, of the disparities in health resources that are dedicated to lymphedema. Even so, the medical/ethical excuse used by some national health systems and international organizations, is that even though "Gold Standard" conservative treatment is safe and effective, it is expensive, time-consuming, and needs certified therapists. Read more about which country has the best public healthcare coverage of lymphedema HERE.

Without drastic increases in funding and medical, public, and political awareness, the plight of people affected by lymphedema is unlikely to budge anytime soon.

Less than 20 percent of the world’s population lives in some of the most developed and economically high-functioning countries, and nearly 90 percent of the world’s total financial resources are devoted to the citizens of these nations. This situation does not benefit or reflect the reality of patients suffering from lymphedema in these countries since most of them are untreated or undertreated. Many High-tech counties are implementing cheap, modified, and simple versions of treatment with little supporting evidence, so as not to fund good treatment options. Read more information on the simple modified treatments HERE.

The worst situation for access to treatment is for the low-income countries, where national health systems and policies are doing little to nothing about it. Conversely, some global health experts estimate that for every dollar spent on neglected disease control, we get back over $50 in increased productivity. By increasing awareness and funding of treatments for neglected diseases, the world economies will be making one of the best global investments possible. Read more about what is the current management perspective and situation of Lymphatic Filariasis and Podoconiosis HERE.


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