Epidemiology of podoconiosis in sub-Saharan Africa: A systematic review and meta-analysis

Abstract

Objective: Podoconiosis, one of the neglected tropical diseases (NTDs), affects barefoot people in impoverished regions and contributes to poverty by having negative impacts on economic output, education, and disability. People who have the disease waste nearly half of all of their productive workdays. There is limited evidence available on prevalence of podoconiosis in sub-Saharan Africa (SSA). Therefore, the aim of this research was to determine the pooled prevalence of podoconiosis in the SSA over the last 10 years. Methods: Studies were retrieved from PubMed, Embase, Web of Science, Scopus, Google Scholar, and Google by using a combination of search terms with Boolean operators. All authors independently assessed each study’s quality using the modified Newcastle–Ottawa Scale for cross-sectional studies. STATA Version 14 was used to conduct the statistical analysis. The random-effect approach of meta-analysis was used. To test for heterogeneity, I-Squared ( I2) statistics were employed and sensitivity analysis with a leave-one-out was done. Result: In this systematic review and meta-analysis, a total of 16 publications with 2,195,722 individuals were included. The pooled prevalence of podoconiosis was 2.66 (95% confidence interval (CI): 2.24, 3.10) with heterogeneity index ( I2) of 99.9%. Walking barefoot adjusted odd ratio (AOR) 5.35 (95% CI: 1.65, 9.05), p = 0.001, not washing feet with soap and water regularly AOR 2.8 (95% CI: 1.16, 4.44, p = 0.001), and an increased age AOR 2.23 (95% CI: 1.25, 5.58) were factors significantly associated with the prevalence of podoconiosis. Conclusion: This study revealed that pooled prevalence of podoconiosis was considerable in SSA. Age, being barefoot, and failing to wash one’s feet with soap and water have been identified to be factors that were significantly associated with the prevalence of podoconiosis. Therefore, creating awareness on shoe wearing and providing shoes in communication with supporting organizations in podoconiosis prevalent areas, and early diagnosis based on family history are needed for the prevention of podoconiosis

Sero-antigen prevalence of lymphatic filariasis and risk factors of podoconiosis in Busiriba sub-county, Kamwenge district, Southwestern Uganda, August–September 2018

“…Walking barefoot was identified as a risk factor for podoconiosis. This is consistent with findings from studies in other sub-Saharan Africana countries including Ethiopia and Kenya [ 15 – 19 ]. Walking barefoot is known to predispose to irritant volcanic red clay soils [ 6 ].…”

“…In our study, older participants showed higher odds of podoconiosis compared to those under 25 years old. This aligns with findings from studies in sub-Saharan Africa [ 15 , 18 , 19 , 21 ]. This trend may be attributed to prolonged exposure to irritant soils as individuals age.…”