Podoconiosis – From known to unknown: Obstacles to tackle

Wanji, Samuel; Deribe, Kebede; Minich, Jessica; Debrah, Alexander Yaw; Kalinga, Akili; Kroidl, Inge; Luguet, Ambre; Hoerauf, Achim; Ritter, Manuel

doi:10.1016/j.actatropica.2021.105918

Cited by 18 publications

(18 citation statements)

References 94 publications

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“…It is advised that, healthcare workers should request for ICT in cases of podoconiosis to rule out any infection of lymphatic lariasis and to aid early identi cation and treatment. A review of studies on non-larial lymphoedema or podoconiosis in Africa indicated that a combination of both laboratory test and geochemical investigations are important in understanding the pathogenesis of the condition, and subsequently developing mechanisms to eradicate lymphoedema [54].…”

Section: Discussionmentioning

confidence: 99%

Developing practice points for healthcare workers to optimise lymphoedema care in low and middle-income countries: a nominal group technique

Torgbenu

Luckett

Buhagiar

et al. 2022

Preprint

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Background: Lymphoedema is a common, distressing, and debilitating condition affecting over 200 million people globally. While the World Health Organization has developed a Wound and Lymphoedema Management guidance document to support lymphoedema care in low- and middle-income countries (LMIC), it mainly focuses on lymphoedema caused by wounds and infectious filariasis and has limited content on lymphoedema diagnosis and assessment. Several lymphoedema clinical practice guidelines have been developed for high-income countries (HIC), but some recommendations are unlikely to be feasible in low-resource settings. Aim: To develop practice points for healthcare workers that optimise lymphoedema care in LMIC. Methods: A nominal group technique (NGT) was undertaken to gain consensus on which content from HIC guidelines are important and feasible to include in practice points for LMIC, plus other important advice or recommendations. Participants included experts, clinicians, and volunteers involved in lymphoedema care in LMIC. The NGT followed five key stages: silent ‘ideas’ generation, round-robin rationale, clarification, refinement and verification. The first, fourth and fifth stages were completed via email, and the second and third during a video meeting. Practice points were divided into prevention, assessment, diagnosis, and management of lymphoedema in LMIC. Results: Of 16 participants invited, 10 members completed stage 1 of the NGT (ideas generation), of whom six contributed to stages 2 (round-robin) and 3 (clarification). All those who completed stage 1 also completed stages 4 (refinement) and 5 (verification). Practice points unanimously agreed on included Complex Decongestive Therapy (CDT) and good skin care, with management to be determined by lymphoedema stage. For podoconiosis-endemic areas, the use of socks and shoes was identified as very important in the prevention of non-filarial lymphoedema and other lymphoedema-causing conditions. Participants indicated that diagnosing lymphoedema using the lymphoscintigraphy and Indocyanine green (ICG) fluorescent lymphography was not possible due to unavailability and cost in LMIC. Surgical procedures for lymphoedema management were unanimously eliminated due to the unavailability of technology, limited workforce, and expensive cost in LMIC. Conclusion: The consensus-based practice points generated by this project provide healthcare workers with guidance on caring for people with lymphoedema in LMIC. Further development of workforce capacity is needed.

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Section: Discussionmentioning

confidence: 99%

Developing practice points for healthcare workers to optimise lymphoedema care in low and middle-income countries: a nominal group technique

Torgbenu

Luckett

Buhagiar

et al. 2022

Preprint

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“…The association between volcanic soils and speci c professions directly and frequently in contact with soil strengthened the mineral-related hypothesis. Agricultural workers are frequent examples as they work daily in elds where bare feet are in constant contact with the soil, and thus with the particles believed to induce podoconiosis (Price & Bailey, 1984;Wanji et al, 2021).…”

Section: Mineralogical and Geochemical Backgroundmentioning

confidence: 99%

A Geochemical and Mineralogical Characterization of Soils Associated with Podoconiosis

Cooper

Nick

2023

Preprint

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Podoconiosis is a disease that causes swelling and disfiguration of the lower legs that can be found in several developing countries where shoes are not regularly worn. The current model for the etiology of the disease proposes that mineralogical agents enter the lymph system through the skin leading to inflammation that causes swelling of the feet and legs. We collected 125 soil samples from 21 towns known to be associated with podoconiosis, 8 towns cited as unassociated with Podoconiosis as controls, and 3 towns of unknown status. Data collected for each soil sample included color, particle size, mineralogy, and geochemistry to distinguish unique components within the podoconiosis-associated soils. Our results indicate that podoconiosis-associated soils are more highly weathered than non-podoconiosis associated soils. The enrichment of kaolinite and gibbsite suggests that these minerals, their surface chemistry, and trace elements associated with them should be prioritized in future podoconiosis research. In addition, we found that color may be a valuable tool to identify soils that are of greater risk for inducing podoconiosis.

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“…Even then, podoconiosis only develops in vulnerable individuals due to socio-economic deprivation and poor access to foot hygiene and shoes. 1–3 It is one of the leading causes of lymphoedema in Africa. 4 The disease significantly reduces quality of life 5 and productivity through decreased mobility and associated morbidity.…”

Section: Introductionmentioning

confidence: 99%

“…Podoconiosis is amenable to prevention through simple public health interventions 3 , 8 such as consistent use of footwear from an early age, regular foot hygiene and covering housing floors. 9 For those with the disease, the WHO recommends hygiene-based lymphoedema management, which includes foot hygiene, foot care, wound care, compression, exercises and foot elevation, treatment of ‘acute attacks’ (painful episodes of an inflammatory condition known as acute dermatolymphangioadenitis) and use of shoes and socks to reduce further exposure to the irritant soil.…”

Section: Introductionmentioning

confidence: 99%

Geostatistical modelling of the distribution, risk and burden of podoconiosis in Kenya

Deribe

Okoyo

Omondi

et al. 2022

Transactions of the Royal Society of Tropical Medicine and Hygiene

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Background Understanding and accurately predicting the environmental limits, population at risk and burden of podoconiosis are critical for delivering targeted and equitable prevention and treatment services, planning control and elimination programs and implementing tailored case finding and surveillance activities. Methods This is secondary analysis of a nationwide podoconiosis mapping survey in Kenya. We combined national representative prevalence survey data of podoconiosis with climate and environmental data, overlayed with population figures in a geostatistical modelling framework, to predict the environmental suitability, population living in at-risk areas and number of cases of podoconiosis in Kenya. Results In 2020, the number of people living with podoconiosis in Kenya was estimated to be 9344 (95% uncertainty interval 4222 to 17 962). The distribution of podoconiosis varies by geography and three regions (Eastern, Nyanza and Western) represent >90% of the absolute number of cases. High environmental suitability for podoconiosis was predicted in four regions of Kenya (Coastal, Eastern, Nyanza and Western). In total, 2.2 million people live in at-risk areas and 4.2% of the total landmass of Kenya is environmentally predisposed for podoconiosis. Conclusions The burden of podoconiosis is relatively low in Kenya and is mostly restricted to certain small geographical areas. Our results will help guide targeted prevention and treatment approaches through local planning, spatial targeting and tailored surveillance activities.

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Podoconiosis – From known to unknown: Obstacles to tackle

Cited by 18 publications

References 94 publications

Developing practice points for healthcare workers to optimise lymphoedema care in low and middle-income countries: a nominal group technique

Developing practice points for healthcare workers to optimise lymphoedema care in low and middle-income countries: a nominal group technique

A Geochemical and Mineralogical Characterization of Soils Associated with Podoconiosis

Geostatistical modelling of the distribution, risk and burden of podoconiosis in Kenya

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