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This tool provides multi-country experiences in implementing a direct inspection protocol, a situation analysis, and collecting hydrocele and lymphedema patient estimates.
The World Health Organization (WHO) estimates there are 40 million people globally who suffer from the debilitating morbidity and disability caused by lymphatic filariasis (LF). This includes swelling of the limbs and breast, termed lymphedema (elephantiasis in its most severe form), and swelling of the scrotum, termed hydrocele.1 Those with lymphedema and hydrocele often face great stigma and isolation due to their condition. Without care and treatment, the disease can further progress and ultimately diminish the health and productivity of individuals, families, communities, and nations. In all LF-endemic areas where there are known hydrocele and lymphedema patients, national LF elimination programs aim to provide treatment and care through morbidity management and disability prevention (MMDP). MMDP services consist of limb hygiene, elevation, and exercise for lymphedema, and corrective surgery for hydrocele. These activities are delivered through the health system and are a key tenet of the strategy for the WHO Global Programme to Eliminate Lymphatic Filariasis (GPELF). To help countries quantify the estimated number of patients and gather information to help plan for and assess LF MMDP services, the following methods and tools have been developed by the WHO, in collaboration with partners. They are published in the 2nd Edition Lymphatic Filariasis MMDP AideMemoire for National Programme Managers: 1) Methods for Estimating the Number of Hydrocele and Lymphedema Patients (Web Annex B), 2) Situation Analysis (Web Annex B), and 3) Direct Inspection Protocol (Web Annex A).1 Use of these methods and tools by LF-endemic countries generates information needed for WHO’s validation of the elimination of LF as a public health problem.2
