Post-Acute Care Management of Patients with Angiostrongyliasis: A Guideline in Caring for Patients Who Suffer Long Term Sequelae of Rat Lungworm Disease

Abstract

Angiostrongyliasis, also known as rat lungworm disease (RLWD), is a parasitic infection caused by the nematode Angiostrongylus cantonensis. Anecdotal experience in Hawaii has shown that many patients diagnosed with RLWD develop chronic neurological sequelae which can last for years and possibly a lifetime (Hawaii’s Joint Task Force, 2018). Currently, there is no available literature or guidelines on chronic care treatment of RLWD. Previous and current literature focuses on RLWD acute manifestation and treatments. Through a rigorous literature search and critical analysis of evidence-based information on possible treatment options of the chronic symptoms of RLWD, an evidence-based guideline was created. Ten Hawaii island primary care providers participated in a project aimed at educating providers on the guideline. The providers’ knowledge level of RLWD chronic care management strategies was assessed before and after the guideline was presented to them. Data analysis showed increased knowledge in all participants. Ninety percent of participants stated that the guideline was significantly effective in increasing their knowledge about the long-term sequelae of RLWD. Limitations of the project included a small sample size and participants’ limited practice experience. Primary care providers who are not familiar with RLWD or are new to the Hawaii community should familiarize themselves with the chronic health effects of RLWD, especially those practicing in endemic regions such as East Hawaii. This evidence-based guideline could serve as a basic introduction to the chronic care aspect of RLWD.