Epidemiology and sex differences of podoconiosis in Ethiopia: A systemic review and meta-analysis

Abstract

Objectives Podoconiosis is a poorly understood neglected tropical disease which results in a high socio-economic burden. In Ethiopia, despite the high prevalence, morbidity, and socio-economic impacts, little information is available about the disease. Thus, this review aimed to assess the effect of sex differences and pooled prevalence of podoconiosis in Ethiopia. Study setting Ethiopia is a country located in East Africa. Methods Published literature on the prevalence of podoconiosis in Ethiopia was searched through MEDLINE/PubMed, Cochrane Library, Goggle scholar, and Global Health. Studies conducted in humans, open access, and met 50% threshold on the quality assessment checklist score adopted from Joanna Briggs Institute were eligible for inclusion. Data were extracted using first author, year of publication, participants' population, setting (urban/rural), study design, podoconiosis infection among males, the total number of males, podoconiosis infection among females, the total number of females, and context using Microsoft™ Excel. R statistical software version 3.6.1 was utilized to carry out the meta-analysis. The protocol of this review is registered in the PROSPERO international prospective register of systematic reviews and assigned a registration number of CRD 42020154697. Results We performed heterogeneity, sensitivity, and publication bias analysis for the included articles. We identified 229 records, of which 11 studies met the inclusion criteria. The pooled prevalence of podoconiosis in Ethiopia was 6% [95% CI: 5%; 6%]. Subgroup analysis by setting indicated slightly higher prevalence in rural settings. The odds of podoconiosis infection among female is 1.15 times that of males" The effect of sex on podoconiosis was sub-grouped by study setting and the odds of females were 1.29 times at increased risk of acquiring podoconiosis than males (p < 0.01) in rural settings. Conclusions The prevalence of podoconiosis in Ethiopia is high. This review suggested that females are at higher risk of developing podoconiosis than males, particularly in rural communities which has health promotion and awareness implications regarding protective wear.

Burden of neglected tropical diseases and access to medicine and diagnostics in Ethiopia: a scoping review

“…We identified 31 articles that report the burden of prioritized NTDs in Ethiopia [ 3 , 10 , 11 , 20 – 47 ]. Most were systematic reviews and meta-analyses on trachoma [ 20 ], leishmaniasis [ 21 – 25 ], soil-transmitted helminthiasis (STH) [ 26 – 30 ], schistosomiasis [ 30 – 33 ], scabies [ 34 ], lymphatic filariasis (LF) and podoconiosis [ 35 – 38 ], review on onchocerciasis [ 40 ], and historical review of the overall NTDs in Ethiopia (1941–2019) [ 39 ]. Trachoma, podoconiosis and leishmaniasis [ 3 , 11 ], onchocerciasis, LF, schistosomiasis, STH, and scabies [ 3 ] are three common NTDs in Ethiopia.…”

“…Thirteen relevant articles were identified [ 10 , 35 , 37 , 48 – 56 ], which report the burden of podoconiosis and/or LF in Ethiopia [ 35 , 52 , 53 ]. The burden of podoconiosis is widespread in Africa which ranged from 0.1 to 8.1%, where Ethiopia registered the second highest prevalence rate (7.5%) next to Cameroon (8.1%) [ 10 , 37 , 38 , 48 , 50 ]. Podoconiosis has gained attention recently in Ethiopia after evidence emerged that it is a preventable noninfectious geochemical form of lymphedema caused by exposure of bare feet to irritant alkalic clay soil [ 49 , 50 ].…”

Burden of neglected tropical diseases and access to medicine and diagnostics in Ethiopia: A scoping review

“…We identi ed 31 articles that report the burden of prioritized NTDs in Ethiopia (3, 9, 26-35, 11, 36-45, 19, 46, 20-25). Most were systematic reviews and metaanalyses on trachoma (19), leishmaniasis (20)(21)(22)(23)(24), soil transmitted helminthiasis (STH) (25)(26)(27)(28)(29), schistosomiasis (29)(30)(31)(32), scabies (33); LF and podoconiosis (34)(35)(36)(37), review on onchocerciasis (39), and historical review of NTDs in Ethiopia (1941-2019) (38). Trachoma, podoconiosis and leishmaniasis are three common NTDs in Ethiopia (3,11).…”

“…Thirteen relevant articles were identi ed (9,34,54,55,36,(47)(48)(49)(50)(51)(52)(53), that report the burden of podoconiosis or LF in Ethiopia (34,51,52). The burden of podoconiosis ranged from 0.1-8.1%, and cases of podoconiosis are widespread in Africa, where Ethiopia registered the second highest prevalence rate (7.5%), next to Cameroon (8.1%) (9,36,37,47,49). Podoconiosis has gained attention recently in Ethiopia after evidence emerged that it is a preventable non-infectious geochemical form of lymphoedema caused by exposure of bare feet to irritant alkalic clay soil (48,49).…”

“We all think boots are meant for men”: A community-based participatory assessment of rural women’s barriers to preventing podoconiosis in Rwanda

“…Although men and women are equally susceptible to the disease, women in Rwanda are disproportionately affected, with a prevalence of 89 cases versus 43 cases per 100,000 among women and men, respectively [4,5]. This gender disparity is not unique to Rwanda and has also been observed elsewhere in sub-Saharan Africa (SSA) [6]. Women in SSA are thought to be at higher risk of podoconiosis due to extended periods of time spent cultivating and due to societal, cultural, and economic barriers that discourage wearing protective footwear [2,7].…”