From neglect to empowerment: impact of vocational rehabilitation on quality of life among disabled filarial lymphoedema patients in a brugian-endemic region of South India-a mixed methods evaluation

Trans R Soc Trop Med Hyg. 2026 Mar 5:trag015. doi: 10.1093/trstmh/trag015. Online ahead of print.

Abstract

Background: Brugian filariasis continues to affect marginalized populations in central coastal Kerala, causing chronic disability despite effective disease control. To address this, a vocational rehabilitation initiative under the Morbidity Management and Disability Prevention program was launched in Cherthala taluk to promote economic self-reliance and dignity through microfinancing and livelihood support. The objective of this study was to determine the impact of this initiative on the quality of life (QoL) of disabled filarial lymphoedema patients in Cherthala taluk, South India.

Methods: A sequential explanatory mixed methods study was conducted among disabled filarial lymphoedema patients across eight different localities of Cherthala taluk. Appropriate statistical tests were used to analyse the quantitative data while a thematic framework approach was used to assess the qualitative data.

Results: The study included 40 disabled filarial lymphoedema patients whose mean age was 65.03±7.3 y and 52.5% were females. The mean QoL scores showed a significant difference compared with those with moderate-grade lymphoedema in the Lymphatic Filariasis Specific Quality of Life Questionnaire domains of usual activities and disease burden. After rehabilitation, there was a statistically significant increase in the monthly income of the beneficiaries. The main themes that emerged following the qualitative analysis were economic impact, psychological impact and social impact.

Conclusions: The vocational rehabilitation initiative significantly enhanced the QoL of filarial lymphoedema patients by fostering economic independence, psychological well-being and social inclusion. These findings highlight the need for holistic, community-based approaches in chronic disease rehabilitation and reintegration efforts.

Keywords: disability; filariasis; mixed methods; quality of life; tertiary prevention; vocational rehabilitation.