Surgical debulking of podoconiosis nodules and its impact on quality of life in Ethiopia

Background In Ethiopia, severe lymphedema and acute dermato-lymphangio-adenitis (ADLA) of the legs as a consequence of podoconiosis affects approximately 1.5 million people. In some this condition may lead to woody-hard fibrotic nodules, which are resistant to conventional treatment. We present a series of patients who underwent surgical nodulectomy in a resource-limited setting and their outcome. Methods In two teaching hospitals, we offered surgical nodulectomies under local anaesthesia to patients with persisting significant fibrotic nodules due to podoconiosis. Excisions after nodulectomy were left to heal by secondary intention with compression bandaging. As outcome, we recorded time to re-epithelialization after surgery, change in number of ADLA episodes, change in quality of life measured with the Dermatology Quality of Live Index (DQLI) questionnaire, and recurrence rate one year after surgery. Results 37nodulectomy operations were performed on 21 patients. All wounds re-reepithelialised within 21 days (range 17–42). 4 patients developed clinically relevant wound infections. The DLQI values were significantly better six months after surgery than before surgery (P<0.0001). Also the number of ADLA episodes per three months was significantly lower six months after surgery than before surgery (P<0.0001). Conclusion Nodulectomy in podoconiosis patients leads to a significant improvement in the quality of life with no serious complications, and we recommend this to be a standard procedure in resource-poor settings.

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Quality of Life of Epileptic Patients in Resource Limited Setting

SSRN Electronic Journal ◽

10.2139/ssrn.3269609 ◽

2018 ◽

Author(s):

Esileman Muche ◽

Mohammed Biset Ayalew

Keyword(s):

Quality Of Life ◽

Resource Limited Setting ◽

Resource Limited ◽

Epileptic Patients ◽

Limited Setting

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Patient-Reported Quality of Life Following Laparotomy in a Resource-Limited Setting

World Journal of Surgery ◽

10.1007/s00268-021-06050-2 ◽

2021 ◽

Author(s):

Laura N. Purcell ◽

Rachel Reiss ◽

Mercy Mtalimanja ◽

Patricia Kuyenda ◽

Vanessa Msosa ◽

...

Keyword(s):

Quality Of Life ◽

Resource Limited Setting ◽

Resource Limited ◽

Patient Reported ◽

Limited Setting

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Patient-Reported Quality of Life after Major Abdominal Operation in a Resource-Limited Setting

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2020.07.245 ◽

2020 ◽

Vol 231 (4) ◽

pp. S127-S128

Author(s):

Laura N. Purcell ◽

Rachel Reiss ◽

Vanessa J. Msosa ◽

Kate D. Westmoreland ◽

Anthony G. Charles

Keyword(s):

Quality Of Life ◽

Resource Limited Setting ◽

Abdominal Operation ◽

Resource Limited ◽

Patient Reported ◽

Major Abdominal Operation ◽

Limited Setting

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Thyroid Surgery in a Resource-Limited Setting: Feasibility and Analysis of Short- and Long-term Outcomes

Otolaryngology ◽

10.1177/0194599816684097 ◽

2016 ◽

Vol 156 (3) ◽

pp. 464-471 ◽

Cited By ~ 9

Author(s):

Aria Jafari ◽

David Campbell ◽

Bruce H. Campbell ◽

Henry Nono Ngoitsi ◽

Titus M. Sisenda ◽

...

Keyword(s):

Quality Of Life ◽

Thyroid Surgery ◽

Outcomes Research ◽

Chart Review ◽

Resource Limited Setting ◽

Resource Limited ◽

Sf 36 ◽

Limited Setting

Objective The present study reviews a series of patients who underwent thyroid surgery in Eldoret, Kenya, to demonstrate the feasibility of conducting long-term (>1 year) outcomes research in a resource-limited setting, impact on the quality of life of the recipient population, and inform future humanitarian collaborations. Study Design Case series with chart review. Setting Tertiary public referral hospital in Eldoret, Kenya. Subjects and Methods Twenty-one patients were enrolled during the study period. A retrospective chart review was performed for all adult patients who underwent thyroid surgery during humanitarian trips (2010-2015). Patients were contacted by mobile telephone. Medical history and physical examination, including laryngoscopy, were performed, and the SF-36 was administered (a quality-of-life questionnaire). Laboratory measurements of thyroid function and neck ultrasound were obtained. Results The mean follow-up was 33.6 ± 20.2 months after surgery: 37.5% of subtotal thyroidectomy patients and 15.4% of lobectomy patients were hypothyroid postoperatively according to serologic studies. There were no cases of goiter recurrence or malignancy. All patients reported postoperative symptomatic improvement and collectively showed positive pre- and postoperative score differences on the SF-36. Conclusion Although limited by a small sample size and the retrospective nature, our study demonstrates the feasibility of long-term surgical and quality-of-life outcomes research in a resource-limited setting. The low complication rates suggest minimal adverse effects of performing surgery in this context. Despite a considerable rate of postoperative hypothyroidism, it is in accordance with prior studies and emphasizes the need for individualized, longitudinal, and multidisciplinary care. Quality-of-life score improvements suggest benefit to the recipient population.

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