Supargiyono

Filariasis is a chronic infectious disease caused by filarial worms. Swelling in the legs in patients with filariasis can result in a significantly lower quality of life. The recommended treatments for patients who experience swelling or lymphoedema are lymphoedema exercises and foot elevation. This research is a quantitative study with a quasi-experimental design including pre- and posttreatment tests with a control group. This study used a cluster sampling method, which is a nonprobability sampling technique. The samples in this study were 48 respondents divided into two groups: 24 respondents from the Nebe Village comprising the intervention group and 24 respondents from the Bangkoor Village comprising the control group. The intervention group conducted lymphoedema exercises and foot elevation three times a week for 15-20 min for 1 month and measured their quality of life using the LFSQQ questionnaire. Measurements of pitting edema and ankle diameter were also carried out. Paired t-test revealed an improvement in the quality of life between pretest and posttest in the intervention and control groups (p=0.001). The quality of life in the pre-post intervention group improved from 67.42 to 81.58. In addition, the quality of life in the pre-post control group only improved from 62.50 to 72.58. The level of pitting edema decreased from severe (+++) to moderate (++) and from mild (+) to normal (0), and there was no difference in ankle diameter in each group (p=1.000). The quality of life improved before and after the administration of lymphoedema exercises and foot elevation for each group. Pitting edema decreased before and after lymphoedema exercises and foot elevation for each group. There was no decrease in ankle diameter after lymphoedema exercises and foot elevation in the intervention and control groups.

Background: In order to improve malaria burden estimates in low transmission settings, more sensitive tools and efficient sampling strategies are required. This study evaluated the use of serological measures from repeated health facility-based cross-sectional surveys to investigate Plasmodium falciparum and Plasmodium vivax transmission dynamics in an area nearing elimination in Indonesia. Methods: Quarterly surveys were conducted in eight public health facilities in Kulon Progo District, Indonesia, from May 2017 to April 2018. Demographic data were collected from all clinic patients and their companions, with household coordinates collected using participatory mapping methods. In addition to standard microscopy tests, bead-based serological assays were performed on finger-prick bloodspot samples from 9453 people. Seroconversion rates (SCR, i.e. the proportion of people in the population who are expected to seroconvert per year) were estimated by fitting a simple reversible catalytic model to seroprevalence data. Mixed effects logistic regression was used to examine factors associated with malaria exposure, and spatial analysis was performed to identify areas with clustering of high antibody responses. Results: Parasite prevalence by microscopy was extremely low (0.06% (95% confidence interval 0.03–0.14, n = 6) and 0 for P. vivax and P. falciparum, respectively). However, spatial analysis of P. vivax antibody responses identified high-risk areas that were subsequently the site of a P. vivax outbreak in August 2017 (62 cases detected through passive and reactive detection systems). These areas overlapped with P. falciparum high-risk areas and were detected in each survey. General low transmission was confirmed by the SCR estimated from a pool of the four surveys in people aged 15 years old and under (0.020 (95% confidence interval 0.017–0.024) and 0.005 (95% confidence interval 0.003–0.008) for P. vivax and P. falciparum, respectively). The SCR estimates in those over 15 years old were 0.066 (95% confidence interval 0.041–0.105) and 0.032 (95% confidence interval 0.015–0.069) for P. vivax and P. falciparum, respectively. Conclusions: These findings demonstrate the potential use of health facility-based serological surveillance to better identify and target areas still receptive to malaria in an elimination setting. Further implementation research is needed to enable integration of these methods with existing surveillance systems.