sábado, 18 de noviembre de 2023

UNIVERSAL CHILDREN´S DAY 2023 - Declaration of the Rights of the Child – The Right to Health and Healthcare – Children with Lymphedema - Pediatric and Primary Lymphedema – Secondary Lymphedema – Lymphatic Filariasis and Podoconiosis

November 20th is an important date, it is to promote the Declaration of the Rights of the Child. World Children's Day promotes and celebrates children's rights, and one of its main objectives is to improve children's health and welfare.  The Convention on the Rights of the Child was proclaimed and adopted by the United Nations General Assembly in 1989.

 ARTICLE 24 (health and healthcare) of the UN Convention on the Rights of the Child states: States Parties recognize the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health. States Parties shall strive to ensure that no child is deprived of his or her right of access to such health care services.

On behalf of AGL, we want to celebrate World Children's Day to highlight that lymphoedema is not only a disease that affects adults.

Lymphedema (Organic Lymphatic Vessel Diseaseis a chronic and progressive disease due to dysfunction of the lymphatic circulatory system. Lymphedema is a condition that may affect arms, legs, fingers, toes, head, neck, abdomen (belly), genitalia, internal organs, or the whole body, which causes chronic inflammation and swelling in the affected area. Regarding children, it may not only be due to congenital causes (Primary Lymphedema), but it can also appear in childhood due to secondary causes, such as parasite infections (Lymphatic filariasis).

Lymphatic filariasis (LF) is a neglected disease. It is recognized as a common widespread, seriously handicapping disease of adults, and is generally thought to occur only sporadically in children. New advances in diagnostic tests (antigen detection, pulse-wave Doppler ultrasonography, and lymphoscintigraphy examination) have helped to recognize the subclinical pathology caused by this infection and have revealed that LF is often first acquired during childhood, with as many as one-third of children infected before age 5.

Recent studies indicate that medications used in mass drug administration programs are capable of reversing sub-clinical lymphatic damage in children. But when there is permanent irreversible damage to the lymphatic system due to filariasis, it also generally remains subclinical for years or gives rise only to non-specific presentations of adenitis/adenopathy, which will later develop and cause lymphoedema of limbs. 

Clinical manifestations of the disease appear most frequently during early adulthood or later, and without adequate treatment, will then progress to its late severe “elephantiasis Stage”, hydrocele, and consequent acute attacks of dermatolymphangioadenitis. Limb and genital Lymphedema should always be treated in their early stages, and not left undertreated till reaching its severe stages. Read more about the signs, symptoms, and complications of the disease HERE.

Studies have shown that simple hygiene-based measures are necessary and that community and family-based intervention has a positive effect on children who already have irreversible damage to their lymphatics, but these measures alone are not enough for edema reduction and controlAdequate compression treatment and garments are recommended by international scientific societies for the control of long-term clinical manifestations and disease progression. The condition among school children, most of whom in developing countries never received proper medical attention, are found to develop anxiety and psychological concerns about the effect of the disease and their fate.

In consequence, very little attention, if any, has been given to the signs and symptoms of lymphatic filariasis in childhood. Lymphedema whatever the cause or setting, all need the same compression treatment and garments to prevent the development of the elephantiasis stage and later complications and debulking surgeries. International health organizations must implement adequate treatment programs, and emphasize the need for disability-alleviation efforts among children as well as adults. Control of morbidity management with proper compression treatment for established lymphedema should be implemented by national health systems. Read more about what is the best treatment for children with lymphedema HERE.

Recognizing that LF disease starts its development in childhood has immediate practical implications both for the management and prevention of the progression of the disease in individual patients and for the broader public health efforts to overcome all childhood illnesses. For decades, this disease (lymphatic dysfunction) which is treatable, embodies the failures of health systems, governments, and societies to tackle the structural inequalities and injustices that allow this cruel and ignored condition to thrive. In accordance with children's and human rights, all children suffering from lymphatic dysfunction (lymphedema), whatever its cause or setting, should have access to the correct treatment to manage this chronic and progressive disease.



Lymphedema is a serious chronic and progressive disease due to an organic disability. The clinical treatment of lymphedema is neither a cosmetic nor an aesthetic treatment. The treatment of lymphedema is to control its progression and alleviate the symptoms related to dysfunction of the lymphatic circulatory system. To prevent and avoid serious complications associated with treatment, such as the possible displacement of edema to previously unaffected areas when compression therapy is applied for volume reduction, patients should use highly specialized and experienced therapists. 

Professional qualification and instruction delivered remotely online are not the same as live hands-on practical instruction in the clinical training and certification of lymphedema therapists, similar to all other rehabilitation, medical, and surgical training programs, and especially for developing the necessary manual skills to treat a disease as complex as lymphedema. 

Patients should also take special care when choosing a "Multidisciplinary Center of Reference for Lymphedema", as not all countries and centers provide the same treatment options. The best choice is a center of reference that provides “Complete Decongestive Therapy (CDT)”, which is recognized as the “Gold Standard” treatment for lymphedema.

  • Read more about what is the best treatment option for Lymphedema HERE.
  • Read about what are the principal functions of Manual Lymphatic Drainage HERE.
  • Read about what are the main differences between the two principal lymphedema treatment protocols HERE. 
  • Read about what are the strategies for the implementation of low-cost treatment options for Lymphedema HERE.


(Click on the texts to read the research articles)











Print this post