Burden assessment of podoconiosis in Wayu Tuka woreda, east Wollega zone, western Ethiopia: a community-based cross-sectional study

Abstract

ObjectivePodoconiosis is a neglected tropical disease characterised by a slowly progressive swelling of the foot and lower leg. It is prevalent among subsistence barefoot farmers who live and work in highland areas of the tropics. This study was conducted in Wayu Tuka ‘woreda’ (district), western Ethiopia to determine the prevalence of podoconiosis and assess factors associated with acute adenolymphangitis (ALA) episodes.Methods and analysisA two phase, community-based cross-sectional study was conducted between January and March 2015. First, all households in the district were surveyed to determine the prevalence of podoconiosis. This was followed by a second phase in which 366 people with podoconiosis from four randomly selected ‘kebeles’ (subdistricts) were assessed for clinical features of the disease, shoe-wearing habits, personal hygiene, social stigma and functional impairment. Data entered into Epi DATA were then exported to SPSS. Logistic regression analysis was conducted to identify factors associated with ALA.ResultsPrevalence of podoconiosis in the population was 3.05% (1197/39 256) (95% CI 2.9% to 3.2%). The prevalence was significantly higher among women than men (3.67% vs 2.4%). Most (92.2%) people with podoconiosis were in the economically active age group (15–64 years) in the first phase survey. Of participants in the second phase of the study, 43% had stage 2 disease and 38.1% had ‘moss’-like skin changes. On average, people with podoconiosis had 23.3 episodes of ALA/year and each person with podoconiosis lost 149.5 days of activity/year. Never walking barefoot and daily foot washing were both associated with decreased odds of ALA (AOR=0.23; 95% CI 0.06 to 0.80 and 0.09; 95% CI 0.01 to 0.75, respectively).ConclusionsA relatively high prevalence of podoconiosis, frequent ALA episodes and considerable decreases in daily activities were identified in this district. Footwear use and daily foot hygiene were associated with decreased odds of ALA. We recommend prevention and morbidity management interventions to address this developmental challenge.

The impact of leprosy, podoconiosis and lymphatic filariasis on family quality of life: A qualitative study in Northwest Ethiopia

“…These findings are similar to other studies conducted in Africa. In studies among persons affected by leprosy in Nigeria and Mozambique [43][44][45], persons affected by lymphatic filariasis in Nigeria, Ghana and Malawi [46][47][48][49][50], and persons affected by podoconiosis in Ethiopia [51,52], those interviewed also reported (severe) social participation restrictions. This was often linked to stigmatisation of persons affected [43][44][45][46][47]50,52].…”

Global epidemiology of podoconiosis: A systematic review

“…This results in oedematous feet and legs and subsequently progresses to elephantiasis, including nodular skin changes [ 3 ]. These changes are themselves disabling, and painful intermittent acute inflammatory episodes cause further debility[ 4 ].…”

Community Involvement in the Care of Persons Affected by Podoconiosis—A Lesson for Other Skin NTDs

“…Although rarely a direct cause of mortality, podoconiosis disables those affected through progressive leg swelling and repeated episodes of acute dermatolymphangioadenitis. These acute episodes occur frequently (reports vary from five [ 5 ] to 23 [ 6 ] episodes per year), and contribute substantially to the disability and social impact associated with podoconiosis [ 7 , 8 ]. Research has explored the enormous economic burden of podoconiosis on affected communities.…”