{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T22:42:54Z","timestamp":1785883374536,"version":"3.56.0"},"update-to":[{"DOI":"10.1371\/journal.pntd.0009167","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T00:00:00Z","timestamp":1614643200000}}],"reference-count":67,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2021,2,18]],"date-time":"2021-02-18T00:00:00Z","timestamp":1613606400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010156","name":"Netherlands Leprosy Relief","doi-asserted-by":"crossref","award":["705.17.30"],"award-info":[{"award-number":["705.17.30"]}],"id":[{"id":"10.13039\/100010156","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>A key issue for persons with leprosy-, lymphatic filariasis- and podoconiosis-related disabilities is the life-long need to practice self-management routines. This is difficult to sustain without regular encouragement and support of others. Family-based support may be a sustainable and feasible strategy to practice self-management routines. This proof of concept study aimed to develop and pilot a family-based intervention to support prevention and self-management of leprosy, lymphatic filariasis and podoconiosis-related disabilities in Ethiopia.<\/jats:p>\n<jats:p>We used a quasi-experimental pre\/post intervention study design with a mixed methods approach. The study population included persons affected by leprosy, lymphatic filariasis and podoconiosis and their family members. All persons affected had visible impairments due to their condition. We collected physical impairment outcomes, data on activity limitations, stigma and family quality of life using the SALSA scale (range 0\u201380), the SARI stigma scale (range 0\u201363) and the Beach Centre Family Quality of Life scale (range 0\u2013125) and conducted in-depth interviews and focus group discussions. Quantitative data were analysed using paired t-tests, unequal variances t-tests, linear regression and binary logistic regression. Qualitative data were coded using open, inductive coding and content analysis.<\/jats:p>\n<jats:p>The family-based intervention consisted of self-management of disabilities, awareness raising and socio-economic empowerment. The intervention was delivered over several monthly group meetings over the course of several months. A total of 275 (100%) persons affected attended at least one session with a family member, and 215 (78%) attended at least three sessions. There was no significant improvement in eye and hand problems after the intervention. However, foot and leg impairments, number of acute attacks, lymphedema and shoe wearing all significantly improved at follow-up. In addition, family quality of life significantly improved from 67.4 at baseline to 89.9 at follow-up for family members and from 76.9 to 84.1 for persons affected (p&lt;0.001). Stigma levels significantly decreased from 24.0 at baseline to 16.7 at follow-up (p&lt;0.001). Activity levels improved, but not significantly.<\/jats:p>\n<jats:p>This proof of concept study showed that the family-based intervention had a positive effect on impairments and self-management of disabilities, family quality of life and stigma. We recommend a large-scale efficacy trial, using a randomised controlled trial and validated measurement tools, to determine its effectiveness and long-term sustainability.<\/jats:p>","DOI":"10.1371\/journal.pntd.0009167","type":"journal-article","created":{"date-parts":[[2021,2,18]],"date-time":"2021-02-18T20:10:01Z","timestamp":1613679001000},"page":"e0009167","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":20,"title":["A family-based intervention for prevention and self-management of disabilities due to leprosy, podoconiosis and lymphatic filariasis in Ethiopia: A proof of concept study"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6415-1057","authenticated-orcid":true,"given":"Anna T.","family":"van\u2018t Noordende","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3512-9440","authenticated-orcid":true,"given":"Moges","family":"Wubie Aycheh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tesfaye","family":"Tadesse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanny","family":"Hagens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5599-2196","authenticated-orcid":true,"given":"Eva","family":"Haverkort","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6376-1718","authenticated-orcid":true,"given":"Alice P.","family":"Schippers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,2,18]]},"reference":[{"key":"pntd.0009167.ref001","doi-asserted-by":"crossref","first-page":"e0005136","DOI":"10.1371\/journal.pntd.0005136","article-title":"Integrated Control and Management of Neglected Tropical Skin Diseases.","volume":"11","author":"O Mitj\u00e0","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0009167.ref002","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1111\/j.1346-8138.2011.01370.x","article-title":"Current status of leprosy: epidemiology, basic science and clinical perspectives","volume":"39","author":"K Suzuki","year":"2012","journal-title":"J Dermatol"},{"key":"pntd.0009167.ref003","first-page":"168","article-title":"Podoconiosis, non-filarial elephantiasis, and lymphology.","volume":"43","author":"G Davey","year":"2010","journal-title":"Lymphology"},{"key":"pntd.0009167.ref004","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1111\/pim.12081","article-title":"Immunology of lymphatic filariasis","volume":"36","author":"S Babu","year":"2014","journal-title":"Parasite Immunol"},{"key":"pntd.0009167.ref005","first-page":"1","article-title":"With Bare Feet in the Soil: Podoconiosis, a Neglected Cause of Tropical Lymphoedema.","volume":"2020","author":"DJ Chandler","journal-title":"Dermatology"},{"key":"pntd.0009167.ref006","first-page":"218","article-title":"Lymphoedema.","volume":"31","author":"OTA Lyons","year":"2013","journal-title":"Surg"},{"key":"pntd.0009167.ref007","doi-asserted-by":"crossref","first-page":"18394","DOI":"10.3402\/gha.v5i0.18394","article-title":"Disability in people affected by leprosy: the role of impairment, activity, social participation, stigma and discrimination.","volume":"5","author":"WH Van Brakel","year":"2012","journal-title":"Glob Health Action"},{"key":"pntd.0009167.ref008","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1186\/2193-1801-3-647","article-title":"Extent of podoconiosis-related stigma in Wolaita Zone, Southern Ethiopia: a cross-sectional study.","volume":"3","author":"A Tora","year":"2014","journal-title":"Springerplus"},{"key":"pntd.0009167.ref009","author":"LM Zeldenryk","year":"2011","journal-title":"The Emerging Story of Disability Associated with Lymphatic Filariasis: A Critical Review"},{"key":"pntd.0009167.ref010","first-page":"89","article-title":"Stigma and socio-economic reintegration of leprosy sufferers in Nigeria.","volume":"10","author":"N Awofeso","year":"1996","journal-title":"Acta Leprol"},{"key":"pntd.0009167.ref011","first-page":"27","article-title":"Emotional difficulties and experiences of stigma among persons with lymphatic filariasis in Plateau State, Nigeria.","volume":"20","author":"J Abdulmalik","year":"2018","journal-title":"Health Hum Rights"},{"key":"pntd.0009167.ref012","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.socscimed.2008.09.040","article-title":"Health-related stigma among women with lymphatic filariasis from the Dominican Republic and Ghana.","volume":"68","author":"B Person","year":"2009","journal-title":"Soc Sci Med"},{"key":"pntd.0009167.ref013","doi-asserted-by":"crossref","first-page":"e0008173","DOI":"10.1371\/journal.pntd.0008173","article-title":"The impact of leprosy, podoconiosis and lymphatic filariasis on family quality of life: A qualitative study in Northwest Ethiopia.","volume":"14","author":"AT van\u2018t Noordende","year":"2020","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0009167.ref014","volume-title":"Systematic review: skin and wound management interventions related to skin-neglected tropical diseases","author":"B Jansen","year":"2017"},{"key":"pntd.0009167.ref015","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1186\/s12889-018-5099-0","article-title":"Assessing the feasibility of integration of self-care for filarial lymphoedema into existing community leprosy self-help groups in Nepal.","volume":"18","author":"J Pryce","year":"2018","journal-title":"BMC Public Health"},{"key":"pntd.0009167.ref016","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1093\/trstmh\/trt054","article-title":"Community level morbidity control of lymphoedema using self care and integrative treatment in two lymphatic filariasis endemic districts of South India: A non randomized interventional study","volume":"107","author":"SR Narahari","year":"2013","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"pntd.0009167.ref017","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0004740","article-title":"Self-care for management of secondary lymphedema: a systematic review.","volume":"10","author":"J Douglass","year":"2016","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0009167.ref018","first-page":"311","article-title":"The experience of self-care groups with people affected by leprosy: ALERT, Ethiopia.","volume":"72","author":"C Benbow","year":"2001","journal-title":"Lepr Rev"},{"key":"pntd.0009167.ref019","doi-asserted-by":"crossref","first-page":"283","DOI":"10.47276\/lr.84.4.283","article-title":"Self-care groups of leprosy-affected people in Mozambique.","volume":"84","author":"S Deepak","year":"2013","journal-title":"Lepr Rev"},{"key":"pntd.0009167.ref020","doi-asserted-by":"crossref","first-page":"187","DOI":"10.47276\/lr.80.2.187","article-title":"Self care groups and Ulcer prevention in Okegbala Nigeria.","volume":"80","author":"J Ebenso","year":"2009","journal-title":"Lepr Rev"},{"key":"pntd.0009167.ref021","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1016\/j.outlook.2006.06.004","article-title":"A framework for the study of self-and family management of chronic conditions.","volume":"54","author":"M Grey","year":"2006","journal-title":"Nurs Outlook"},{"key":"pntd.0009167.ref022","doi-asserted-by":"crossref","first-page":"110","DOI":"10.47276\/lr.79.1.110","article-title":"The sustainability of self-care in two counties of Guizhou Province, Peoples\u2019 Republic of China.","volume":"79","author":"J Li","year":"2008","journal-title":"Lepr Rev"},{"key":"pntd.0009167.ref023","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1097\/01.JCN.0000305093.20012.b8","article-title":"Family influences on heart failure self-care and outcomes","volume":"23","author":"SB Dunbar","year":"2008","journal-title":"J Cardiovasc Nurs"},{"key":"pntd.0009167.ref024","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1186\/1477-7525-10-138","article-title":"Quality of life of people with mental health problems: a synthesis of qualitative research.","volume":"10","author":"J Connell","year":"2012","journal-title":"Health Qual Life Outcomes"},{"key":"pntd.0009167.ref025","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1037\/0033-2909.117.3.497","article-title":"The need to belong: desire for interpersonal attachments as a fundamental human motivation.","volume":"117","author":"RF Baumeister","year":"1995","journal-title":"Psychol Bull"},{"key":"pntd.0009167.ref026","first-page":"547","volume-title":"Close personal relationships and health outcomes: A key to the role of social support. Handb Pers Relationships Theory, Res Interv (2nd Ed) Chichester","author":"R Gurung","year":"1997"},{"key":"pntd.0009167.ref027","doi-asserted-by":"crossref","first-page":"652","DOI":"10.2471\/BLT.16.189399","article-title":"Integrated morbidity management for lymphatic filariasis and podoconiosis, Ethiopia","volume":"95","author":"K Deribe","year":"2017","journal-title":"Bull World Health Organ"},{"key":"pntd.0009167.ref028","unstructured":"ILEP. ILEP Learning Guide four: How to prevent disability in leprosy. 2006."},{"key":"pntd.0009167.ref029","unstructured":"World Health Organization. Weekly Epidemiological Record, 31 August 2018. Global leprosy update, 2017: reducing the disease burden due to leprosy. vol. 93. 2018."},{"key":"pntd.0009167.ref030","unstructured":"World Health Organization. Weekly Epidemiological Record, 2 November 2018. Global programme to eliminate lymphatic filariasis: progress report, 2017. vol. 93. 2018."},{"key":"pntd.0009167.ref031","doi-asserted-by":"crossref","first-page":"e0006324","DOI":"10.1371\/journal.pntd.0006324","article-title":"Global epidemiology of podoconiosis: A systematic review.","volume":"12","author":"K Deribe","year":"2018","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0009167.ref032","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1002\/nur.20247","article-title":"Considerations in determining sample size for pilot studies.","volume":"31","author":"MA Hertzog","year":"2008","journal-title":"Res Nurs Health"},{"key":"pntd.0009167.ref033","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1111\/j.1741-3737.2006.00314.x","article-title":"Assessing family outcomes: Psychometric evaluation of the beach center family quality of life scale.","volume":"68","author":"L Hoffman","year":"2006","journal-title":"J Marriage Fam"},{"key":"pntd.0009167.ref034","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1080\/09638280600926587","article-title":"The development of a short questionnaire for screening of activity limitation and safety awareness (SALSA) in clients affected by leprosy or diabetes.","volume":"29","author":"SCS Group","year":"2007","journal-title":"Disabil Rehabil"},{"key":"pntd.0009167.ref035","volume-title":"Examining the validity of the SALSA scale as a generic measure of activity","author":"S Mol","year":"2010"},{"key":"pntd.0009167.ref036","doi-asserted-by":"crossref","first-page":"13","DOI":"10.47276\/lr.84.1.13","article-title":"The concurrent validity of the Amharic version of Screening of Activity Limitation and Safety Awareness (SALSA) in persons affected by leprosy.","volume":"84","author":"U Wijk","year":"2013","journal-title":"Lepr Rev"},{"key":"pntd.0009167.ref037","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1080\/13548500600595160","article-title":"Measuring health-related stigma\u2014a literature review.","volume":"11","author":"WH Van Brakel","year":"2006","journal-title":"Psychol Health Med"},{"key":"pntd.0009167.ref038","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1016\/j.actatropica.2013.02.022","article-title":"Self care integrative treatment demonstrated in rural community setting improves health related quality of life of lymphatic filariasis patients in endemic villages","volume":"3","author":"MG Aggithaya","year":"2013","journal-title":"Acta Trop"},{"key":"pntd.0009167.ref039","first-page":"353","article-title":"Sustainable leprosy related disability care within integrated general health services: findings from Salem District, India.","volume":"78","author":"K Madhavan","year":"2007","journal-title":"Lepr Rev"},{"key":"pntd.0009167.ref040","first-page":"330","article-title":"Experiences from a collaborative project on the prevention of disability in leprosy patients in Shandong Province, the People\u2019s Republic of China.","volume":"72","author":"S Chen","year":"2001","journal-title":"Lepr Rev"},{"key":"pntd.0009167.ref041","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.jegh.2013.11.001","article-title":"Final program evaluation methods and results of a National Lymphedema Management Program in Togo, West Africa.","volume":"4","author":"J Ziperstein","year":"2014","journal-title":"J Epidemiol Glob Health"},{"key":"pntd.0009167.ref042","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0000668","article-title":"Feasibility and effectiveness of basic lymphedema management in Leogane, Haiti, an area endemic for bancroftian filariasis.","volume":"4","author":"DG Addiss","year":"2010","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0009167.ref043","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/j.parint.2017.11.005","article-title":"Impact of two follow-up schemes on morbidity management and disability prevention (MMDP) programme for filarial lymphedema in Matara, Sri Lanka.","volume":"67","author":"TC Yahathugoda","year":"2018","journal-title":"Parasitol Int"},{"key":"pntd.0009167.ref044","doi-asserted-by":"crossref","first-page":"S55","DOI":"10.1016\/j.actatropica.2011.03.007","article-title":"Efficacy of home-based lymphoedema management in reducing acute attacks in subjects with lymphatic filariasis in Burkina Faso","volume":"120","author":"P Jullien","year":"2011","journal-title":"Acta Trop"},{"key":"pntd.0009167.ref045","first-page":"417","article-title":"Lymphatic filariasis: progress of disability prevention activities","volume":"79","author":"WH Organization","year":"2004","journal-title":"Wkly Epidemiol Rec Relev \u00c9pid\u00e9miologique Hebd"},{"key":"pntd.0009167.ref046","first-page":"e20180045","article-title":"Practices for self-care in Hansen\u2019s disease: face, hands and feet.","volume":"39","author":"V Lima MC","year":"2018","journal-title":"Rev Ga\u00facha Enferm"},{"key":"pntd.0009167.ref047","doi-asserted-by":"crossref","first-page":"321","DOI":"10.47276\/lr.78.4.321","article-title":"The prevention of disability for people affected by leprosy: whose attitude needs to change?","volume":"78","author":"H Cross","year":"2007","journal-title":"Lepr Rev"},{"key":"pntd.0009167.ref048","first-page":"53","article-title":"A human right to shoes? Establishing rights and duties in the prevention and treatment of podoconiosis.","volume":"20","author":"A Shahvisi","year":"2018","journal-title":"Health Hum Rights"},{"key":"pntd.0009167.ref049","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.4269\/ajtmh.17-0931","article-title":"A comparative analysis of economic cost of podoconiosis and leprosy on affected households in the northwest region of Cameroon","volume":"98","author":"AM Tembei","year":"2018","journal-title":"Am J Trop Med Hyg"},{"key":"pntd.0009167.ref050","doi-asserted-by":"crossref","first-page":"e0008058","DOI":"10.1371\/journal.pntd.0008058","article-title":"Quantifying the socio-economic impact of leg lymphoedema on patient caregivers in a lymphatic filariasis and podoconiosis co-endemic district of Ethiopia.","volume":"14","author":"T Caprioli","year":"2020","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0009167.ref051","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1046\/j.1365-3156.2002.00914.x","article-title":"Efficacy and sustainability of a footcare programme in preventing acute attacks of adenolymphangitis in Brugian filariasis","volume":"7","author":"TK Suma","year":"2002","journal-title":"Trop Med Int Heal"},{"key":"pntd.0009167.ref052","doi-asserted-by":"crossref","first-page":"327","DOI":"10.47276\/lr.75.4.327","article-title":"Experiencing leprosy: perceiving and coping with leprosy and its treatment. A qualitative study conducted in Nepal.","volume":"75","author":"ML Heijnders","year":"2004","journal-title":"Lepr Rev"},{"key":"pntd.0009167.ref053","doi-asserted-by":"crossref","first-page":"119","DOI":"10.47276\/lr.76.2.119","article-title":"Curing the stigma of leprosy.","volume":"76","author":"J Rafferty","year":"2005","journal-title":"Lepr Rev"},{"key":"pntd.0009167.ref054","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.pt.2012.03.001","article-title":"Neglected tropical diseases and mental health: a perspective on comorbidity","volume":"28","author":"E Litt","year":"2012","journal-title":"Trends Parasitol"},{"key":"pntd.0009167.ref055","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/j.schres.2009.06.015","article-title":"Stigma moderates the associations of insight with depressed mood, low self-esteem, and low quality of life in patients with schizophrenia spectrum disorders","volume":"115","author":"ABP Staring","year":"2009","journal-title":"Schizophr Res"},{"key":"pntd.0009167.ref056","doi-asserted-by":"crossref","first-page":"99","DOI":"10.47276\/lr.81.2.99","article-title":"\u201cMoney is the vehicle of interaction\u201d: insight into social integration of people affected by leprosy in northern Nigeria.","volume":"81","author":"B Ebenso","year":"2010","journal-title":"Lepr Rev"},{"key":"pntd.0009167.ref057","doi-asserted-by":"crossref","first-page":"2","DOI":"10.47276\/lr.88.1.2","article-title":"Impact of socio-economic development, contact and peer counselling on stigma against persons affected by leprosy in Cirebon, Indonesia\u2013a randomised controlled trial.","volume":"88","author":"D Dadun","year":"2017","journal-title":"Lepr Rev"},{"key":"pntd.0009167.ref058","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1177\/001440290206800201","article-title":"Impacts of poverty on quality of life in families of children with disabilities.","volume":"68","author":"J Park","year":"2002","journal-title":"Except Child"},{"key":"pntd.0009167.ref059","first-page":"507","article-title":"Prevention of impairment in leprosy; results from a collaborative project in China.","volume":"63","author":"W Smith","year":"1995","journal-title":"Int J Lepr Other Mycobact Dis"},{"key":"pntd.0009167.ref060","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1177\/0091217415582173","article-title":"Perception of social exclusion, neuropathy, and quality of life among Hansen\u2019s disease patients.","volume":"49","author":"R Borges-de-Oliveira","year":"2015","journal-title":"Int J Psychiatry Med"},{"key":"pntd.0009167.ref061","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1590\/S0037-86822011000500019","article-title":"The impact of leprosy on health-related quality of life.","volume":"44","author":"AA Lustosa","year":"2011","journal-title":"Rev Soc Bras Med Trop"},{"key":"pntd.0009167.ref062","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1111\/j.1742-4801.2005.00066.x","article-title":"Health-related quality of life with lymphoedema: a review of the literature.","volume":"2","author":"PA Morgan","year":"2005","journal-title":"Int Wound J"},{"key":"pntd.0009167.ref063","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1186\/1477-7525-11-122","article-title":"The impact of podoconiosis on quality of life in Northern Ethiopia.","volume":"11","author":"E Mousley","year":"2013","journal-title":"Health Qual Life Outcomes"},{"key":"pntd.0009167.ref064","doi-asserted-by":"crossref","first-page":"2443","DOI":"10.1016\/j.socscimed.2007.02.014","article-title":"The quality of life, mental health, and perceived stigma of leprosy patients in Bangladesh.","volume":"64","author":"A Tsutsumi","year":"2007","journal-title":"Soc Sci Med"},{"key":"pntd.0009167.ref065","doi-asserted-by":"crossref","first-page":"e0003900","DOI":"10.1371\/journal.pntd.0003900","article-title":"Functional activity limitation and quality of life of leprosy cases in an endemic area in Northeastern Brazil.","volume":"9","author":"VS Santos","year":"2015","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0009167.ref066","doi-asserted-by":"crossref","first-page":"e2716","DOI":"10.1371\/journal.pntd.0002716","article-title":"Comparison of three quality of life instruments in lymphatic filariasis: DLQI, WHODAS 2.0, and LFSQQ.","volume":"8","author":"C Thomas","year":"2014","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0009167.ref067","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/1475-2883-6-8","article-title":"Health Related Quality of Life, an appropriate indicator to assess the impact of morbidity management and disability prevention activities towards elimination of lymphatic filariasis.","volume":"6","author":"AK Kumari","year":"2007","journal-title":"Filaria J"}],"updated-by":[{"DOI":"10.1371\/journal.pntd.0009167","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T00:00:00Z","timestamp":1614643200000}}],"container-title":["PLOS Neglected Tropical Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0009167","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,2]],"date-time":"2021-03-02T18:54:37Z","timestamp":1614711277000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pntd.0009167"}},"subtitle":[],"editor":[{"given":"Jessica K.","family":"Fairley","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,2,18]]},"references-count":67,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,2,18]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pntd.0009167","relation":{"new_version":[{"id-type":"doi","id":"10.1371\/journal.pntd.0009167","asserted-by":"object"}]},"ISSN":["1935-2735"],"issn-type":[{"value":"1935-2735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,18]]}}}