Seasonal influences on ADL Sample Clauses

Seasonal influences on ADL. There has been evidence for seasonal variation in the incidence of ADL. A randomized control trial exploring the efficacy of ivermectin and DEC combined with a limb-care regimen in Alleppey, India showed a significant increase in the number of ADL episodes [48] during the rainy season. The mean number of ADL episodes per month during the rainy season was 24.4 compared to 13.2 in the dry months (P<0.0001). These results are most likely internally valid because patients were closely followed for two years after treatment assignment, and most ADL episodes were directly observed in a clinic setting. An epidemiologic study on the natural occurrence of ADL in northern Ghana [43] also found a seasonal variation. The number of ADL cases decreased during the dry season and increased during the rainy season. In Xxx’s study of the natural occurrence of ADL among persons in a B. malayi endemic community [11], acute attacks were more frequent during the rainy months of June-September/November compared to the dry months of October and December. The seasonal variation in ADL frequency can be explained by several factors. First, the increased number of episodes during the rainy season points to the presumed etiology of ADL: through fungal and secondary bacterial infections. The constant moisture exposure to the foot/limb during the rainy season predisposes individuals to fungal infections, which then promote the secondary bacterial infection [48]. Also, the mosquito vector population may vary with season, becoming denser during the rains. It is possible that the increase in infective bites during the rainy season contributes to the increased frequency of ADL during that period [43]. Despite these findings however, the seasonal variation of ADL episodes is not consistent among all studies of ADL, with some showing little [42] or no seasonal variation [37].
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