Podoconiosis (Endemic Non-Filarial Elephantiasis) in Two Resettlement Schemes in Western Ethiopia

Kloos, Helmut; Kello, Abdulhamid Bedri; Addus, Abdulaziz

doi:10.1177/004947559202200306

Cited by 38 publications

(41 citation statements)

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“…It is also higher than the prevalence documented in Burundi (1.0%) and in Rwanda (0.6%) in the 1970s [14]. More recent studies included in the current analysis have indicated prevalences of 5.5% in Wolaita, southern Ethiopia [16], 5.4% in Ocholo [25], southwestern Ethiopia, 7.0% in Pawe [24], 7.5% in Gera and Didessa [21] and 5.2% in Gulisso [17], western Ethiopia, and 7.4% in central Ethiopia [18]. Absence of information from Addis Ababa, Afar and Somali regions and the diagnostic methods used reduces the precision of the estimate.…”

Section: Discussionmentioning

confidence: 59%

“…Without doubt, podoconiosis is one of the neglected tropical diseases (NTDs) with the greatest potential for elimination as a public health problem [20], [21]: it is preventable if shoes are consistently worn, and early stages can be successfully treated using a simple lymphoedema regimen [22]. While one million people are estimated to be affected with podoconiosis in Ethiopia [7], and a further 11 million to be at risk [23], control efforts are hampered by a lack of information on geographical distribution.…”

Section: Introductionmentioning

confidence: 99%

“…While one million people are estimated to be affected with podoconiosis in Ethiopia [7], and a further 11 million to be at risk [23], control efforts are hampered by a lack of information on geographical distribution. Aside from isolated studies [16], [17], [18], [19], [21], [24], [25], [26], the only previous mapping of this disease was based on market and school surveys in the 1970s [15], [26], [27]. Except for a few observational studies conducted in the early 1970s, there have been no systematic studies to identify the environmental correlates of podoconiosis [1], [2].…”

Section: Introductionmentioning

confidence: 99%

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Spatial Distribution of Podoconiosis in Relation to Environmental Factors in Ethiopia: A Historical Review

et al. 2013

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BackgroundAn up-to-date and reliable map of podoconiosis is needed to design geographically targeted and cost-effective intervention in Ethiopia. Identifying the ecological correlates of the distribution of podoconiosis is the first step for distribution and risk maps. The objective of this study was to investigate the spatial distribution and ecological correlates of podoconiosis using historical and contemporary survey data.MethodsData on the observed prevalence of podoconiosis were abstracted from published and unpublished literature into a standardized database, according to strict inclusion and exclusion criteria. In total, 10 studies conducted between 1969 and 2012 were included, and data were available for 401,674 individuals older than 15 years of age from 229 locations. A range of high resolution environmental factors were investigated to determine their association with podoconiosis prevalence, using logistic regression.ResultsThe prevalence of podoconiosis in Ethiopia was estimated at 3.4% (95% CI 3.3%–3.4%) with marked regional variation. We identified significant associations between mean annual Land Surface Temperature (LST), mean annual precipitation, topography of the land and fine soil texture and high prevalence of podoconiosis. The derived maps indicate both widespread occurrence of podoconiosis and a marked variability in prevalence of podoconiosis, with prevalence typically highest at altitudes >1500 m above sea level (masl), with >1500 mm annual rainfall and mean annual LST of 19–21°C. No (or very little) podoconiosis occurred at altitudes <1225 masl, with annual rainfall <900 mm, and mean annual LST of >24°C.ConclusionPodoconiosis remains a public health problem in Ethiopia over considerable areas of the country, but exhibits marked geographical variation associated in part with key environmental factors. This is work in progress and the results presented here will be refined in future work.

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Section: Discussionmentioning

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Spatial Distribution of Podoconiosis in Relation to Environmental Factors in Ethiopia: A Historical Review

et al. 2013

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“…An epidemiological study in resettlement schemes of west Ethiopia showed that the prevalence of podoconiosis is higher in indigenous (9%) people than in settlers (5%). People from non-endemic areas develop disease on average 9 years after being moved to an endemic area [21]. Apart from this, there are no recent studies on podoconiosis in west Ethiopia in general and in West Wollega zone in particular where podoconiosis is common.…”

Section: Introductionmentioning

confidence: 99%

Burden of Podoconiosis in Poor Rural Communities in Gulliso woreda, West Ethiopia

et al. 2011

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BackgroundPodoconiosis is an environmental lymphoedema affecting people living and working barefoot on irritant red clay soil. Podoconiosis is relatively well described in southern Ethiopia, but remains neglected in other parts of the Ethiopian highlands. This study aimed to assess the burden of podoconiosis in rural communities in western Ethiopia.Methodology/Principal FindingsA cross-sectional study was conducted in Gulliso woreda (district), west Ethiopia. A household survey in the 26 rural kebeles (villages) of this district was conducted to identify podoconiosis patients and to measure disease prevalence. A more detailed study was done in six randomly selected kebeles to describe clinical features of the disease, patients' experiences of foot hygiene, and shoe wearing practice. 1,935 cases of podoconiosis were registered, giving a prevalence of 2.8%. The prevalence was higher in those aged 15–64 years (5.2%) and in females than males (prevalence ratio 2.6∶1). 90.3% of patients were in the 15–64 year age group. In the detailed study, 335 cases were interviewed and their feet assessed. The majority of patients were farmers, uneducated, and poor. Two-third of patients developed the disease before the age of thirty. Almost all patients (97.0%) had experienced adenolymphangitis (ALA - red, hot legs, swollen and painful groin) at least once during the previous year. Patients experienced an average of 5.5 ALA episodes annually, each of average 4.4 days, thus 24 working days were lost annually. The incidence of ALA in podoconiosis patients was higher than that reported for filariasis in other countries. Shoe wearing was limited mainly due to financial problems.ConclusionsWe have documented high podoconiosis prevalence, frequent adenolymphangitis and high disease-related morbidity in west Ethiopia. Interventions must be developed to prevent, treat and control podoconiosis, one of the core neglected tropical diseases in Ethiopia.

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“…In addition to quartz, several papers hypothesize that the disease is linked to the presence of clay minerals ([7]), organic matter or elevated levels of Zr and Be ([8]) in the soils. Price ([4]) found inorganic ‘microparticles’ (described as being 0.5–2 μm in diameter, and mostly silicates) in the lymphatic tissues in both patients with and without podoconiosis, a statistically significant difference was observed in the form of the phyllosilicate within the lymph tissues of podoconiosis patients by analysing the elemental ratio of Al/Si from the particles.…”

Section: Introductionmentioning

confidence: 99%

Haemolytic activity of soil from areas of varying podoconiosis endemicity in Ethiopia

et al. 2017

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BackgroundPodoconiosis, non-filarial elephantiasis, is a non-infectious disease found in tropical regions such as Ethiopia, localized in highland areas with volcanic soils cultivated by barefoot subsistence farmers. It is thought that soil particles can pass through the soles of the feet and taken up by the lymphatic system, leading to the characteristic chronic oedema of the lower legs that becomes disfiguring and disabling over time.MethodsThe close association of the disease with volcanic soils led us to investigate the characteristics of soil samples in an endemic area in Ethiopia to identify the potential causal constituents. We used the in vitro haemolysis assay and compared haemolytic activity (HA) with soil samples collected in a non-endemic region of the same area in Ethiopia. We included soil samples that had been previously characterized, in addition we present other data describing the characteristics of the soil and include pure phase mineral standards as comparisons.ResultsThe bulk chemical composition of the soils were statistically significantly different between the podoconiosis-endemic and non-endemic areas, with the exception of CaO and Cr. Likewise, the soil mineralogy was statistically significant for iron oxide, feldspars, mica and chlorite. Smectite and kaolinite clays were widely present and elicited a strong HA, as did quartz, in comparison to other mineral phases tested, although no strong difference was found in HA between soils from the two areas. The relationship was further investigated with principle component analysis (PCA), which showed that a combination of an increase in Y, Zr and Al2O3, and a concurrent increase Fe2O3, TiO2, MnO and Ba in the soils increased HA.ConclusionThe mineralogy and chemistry of the soils influenced the HA, although the interplay between the components is complex. Further research should consider the variable biopersistance, hygroscopicity and hardness of the minerals and further characterize the nano-scale particles.

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Podoconiosis (Endemic Non-Filarial Elephantiasis) in Two Resettlement Schemes in Western Ethiopia

Cited by 38 publications

References 1 publication

Spatial Distribution of Podoconiosis in Relation to Environmental Factors in Ethiopia: A Historical Review

Spatial Distribution of Podoconiosis in Relation to Environmental Factors in Ethiopia: A Historical Review

Burden of Podoconiosis in Poor Rural Communities in Gulliso woreda, West Ethiopia

Haemolytic activity of soil from areas of varying podoconiosis endemicity in Ethiopia

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