Evaluating the cost of self-care: Impact of enhanced morbidity management protocol on people living with lymphatic filariasis in Bangladesh

Background: Lymphatic filariasis (LF) causes chronic lymphoedema requiring long-term self-care, often at personal cost. In post-elimination settings such as Bangladesh, understanding the financial burden of self-care is critical for sustaining morbidity management and disability prevention (MMDP). This study evaluated self-care costs and the impact of an enhanced morbidity management protocol among people affected by filarial lymphoedema in Bangladesh. Methodology: A longitudinal cohort study was conducted in Lalmonirhat and Thakurgaon districts (2020–2021). People affected by mild, moderate, and severe lymphoedema (n = 290) were assessed at baseline, trained in an enhanced self-care protocol, and assessed at a 3-month follow-up and a final follow-up conducted at 6 months in Lalmonirhat and 9 months in Thakurgaon. Data were collected on clinical characteristics (lymphoedema stage, acute attacks, pain), self-care items (soap, cream, pain relief), related costs, and adherence. Results: At baseline, participants with mild (11.2–54.7%), moderate (21.9–39.5%), and severe (23.4–49.3%) lymphoedema were included, reflecting variation across districts. Acute attacks were reported by 62.8–79.6% of participants and severe pain by 40.6–54.6%. Following the intervention, acute attacks decreased to 25.2–35.2% and severe pain to 22.4–28.0% (p