1921
Volume 92, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Although podoconiosis is one of the major causes of tropical lymphoedema and is endemic in Ethiopia its epidemiology and risk factors are poorly understood. Individual-level data for 129,959 individuals from 1,315 communities in 659 (districts) were collected for a nationwide integrated survey of lymphatic filariasis and podoconiosis. Blood samples were tested for circulating antigen using immunochromatographic card tests. A clinical algorithm was used to reach a diagnosis of podoconiosis by excluding other potential causes of lymphoedema of the lower limb. Bayesian multilevel models were used to identify individual and environmental risk factors. Overall, 8,110 of 129,959 (6.2%, 95% confidence interval [CI] 6.1–6.4%) surveyed individuals were identified with lymphoedema of the lower limb, of whom 5,253 (4.0%, 95% CI 3.9–4.1%) were confirmed to be podoconiosis cases. In multivariable analysis, being female, older, unmarried, washing the feet less frequently than daily, and being semiskilled or unemployed were significantly associated with increased risk of podoconiosis. Attending formal education and living in a house with a covered floor were associated with decreased risk of podoconiosis. Podoconiosis exhibits marked geographical variation across Ethiopia, with variation in risk associated with variation in rainfall, enhanced vegetation index, and altitude.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.14-0446
2015-01-07
2017-09-22
Loading full text...

Full text loading...

/deliver/fulltext/14761645/92/1/148.html?itemId=/content/journals/10.4269/ajtmh.14-0446&mimeType=html&fmt=ahah

References

  1. Price E, , 1990. Podoconiosis: Non-Filarial Elephantiasis. Oxford: Oxford Medical Publications.
  2. Davey G, GebreHanna E, Adeyemo A, Rotimi C, Newport M, Desta K, , 2007. Podoconiosis: a tropical model for gene-environment interactions? Trans R Soc Trop Med Hyg 101: 9196.[Crossref]
  3. Davey G, , 2009. Recent advances in podoconiosis. Ann Trop Med Parasitol 103: 377382.[Crossref]
  4. Davey G, , 2010. Podoconiosis, non-filarial elephantiasis, and lymphology. Lymphology 43: 168177.
  5. Tekola Ayele F, Adeyemo A, Finan C, Hailu E, Sinnott P, Burlinson ND, Aseffa A, Rotimi CN, Newport MJ, Davey G, , 2012. HLA class II locus and susceptibility to podoconiosis. N Engl J Med 366: 12001208.[Crossref]
  6. Molyneux DH, , 2012. Tropical lymphedemas–control and prevention. N Engl J Med 366: 11691171.[Crossref]
  7. Tekola F, Mariam DH, Davey G, , 2006. Economic costs of endemic non-filarial elephantiasis in Wolaita Zone, Ethiopia. Trop Med Int Health 11: 11361144.[Crossref]
  8. Tora A, Davey G, Tadele G, , 2011. A qualitative study on stigma and coping strategies of patients with podoconiosis in Wolaita zone, southern Ethiopia. In Health 3: 176181.[Crossref]
  9. Yakob B, Deribe K, Davey G, , 2008. High levels of misconceptions and stigma in a community highly endemic for podoconiosis in southern Ethiopia. Trans R Soc Trop Med Hyg 102: 439444.[Crossref]
  10. Deribe K, Tomczyk S, Mousley E, Tamiru A, Davey G, , 2013. Stigma towards a neglected tropical disease: felt and enacted stigma scores among podoconiosis patients in northern Ethiopia. BMC Public Health 13: 1178.[Crossref]
  11. Molla YB, Tomczyk S, Amberbir T, Tamiru A, Davey G, , 2012. Patients' perceptions of podoconiosis causes, prevention and consequences in east and west Gojam, northern Ethiopia. BMC Public Health 12: 828.[Crossref]
  12. Alemu G, Tekola Ayele F, Daniel T, Ahrens C, Davey G, , 2011. Burden of podoconiosis in poor rural communities in Gulliso woreda, west Ethiopia. PLoS Negl Trop 5: e1184.[Crossref]
  13. Geshere Oli G, Tekola Ayele F, Petros B, , 2012. Parasitological, serological, and clinical evidence for high prevalence of podoconiosis (non-filarial elephantiasis) in Midakegn district, central Ethiopia. Trop Med Int Health 17: 722726.[Crossref]
  14. Tekola Ayele F, Alemu G, Davey G, Ahrens C, , 2013. Community-based survey of podoconiosis in Bedele Zuria woreda, west Ethiopia. In Health 5: 119125.[Crossref]
  15. Mousley E, Deribe K, Tamiru A, Davey G, , 2013. The impact of podoconiosis on quality of life in northern Ethiopia. Health Qual Life Outcomes 11: 122.[Crossref]
  16. Sikorski C, Ashine M, Zeleke Z, Davey G, , 2010. Effectiveness of a simple lymphoedema treatment regimen in podoconiosis management in southern Ethiopia: one year follow-up. PLoS Negl Trop Dis 4: e902.[Crossref]
  17. Oomen AP, , 1969. Studies on elephantiasis of the legs in Ethiopia. Trop Geogr Med 21: 3.
  18. Cohen LB, , 1960. Idiopathic lymphoedema of Ethiopia and Kenya. East Afr Med J 37: 5374.
  19. Price EW, , 1974. Endemic elephantiasis of the lower legs in Ethiopia an epidemiological survey. Ethiop Med J 12: 7790.
  20. Price EW, , 1976. Endemic elephantiasis of the lower legs in Rwanda and Burundi. Trop Geogr Med 28: 283290.
  21. Price EW, Henderson WJ, , 1981. Endemic elephantiasis of the lower legs in the United Cameroon Republic. Trop Geogr Med 33: 2329.
  22. Desta K, Ashine M, Davey G, , 2003. Prevalence of podoconiosis (endemic non-filarial elephantiasis) in Wolaitta, southern Ethiopia. Trop Doct 32: 217220.[Crossref]
  23. Molla YB, Tomczyk S, Amberbir T, Tamiru A, Davey G, , 2012. Podoconiosis in east and west Gojam Zones, northern Ethiopia. PLoS Negl Trop Dis 6: e1744.[Crossref]
  24. Onapa AW, Simonsen PE, Pedersen EM, , 2001. Non-filarial elephantiasis in the Mt. Elgon area (Kapchorwa District) of Uganda. Acta Trop 78: 171176.[Crossref]
  25. Wanji S, Tendongfor N, Esum M, Che JN, Mand S, Tanga Mbi C, Enyong P, Hoerauf A, , 2008. Elephantiasis of non-filarial origin (podoconiosis) in the highlands of north-western Cameroon. Ann Trop Med Parasitol 102: 529540.[Crossref]
  26. Molla YB, Le Blond JS, Wardrop N, Baxter P, Atkinson PM, Newport MJ, Davey G, , 2013. Individual correlates of podoconiosis in areas of varying endemicity: a case-control study. PLoS Negl Trop Dis 7: e2554.[Crossref]
  27. Price E, , 1976. The association of endemic elephantiasis of the lower legs in East Africa with soil derived from volcanic rocks. Trans R Soc Trop Med Hyg 4: 288295.[Crossref]
  28. Molla YB, Wardrop NA, Le Blond JS, Baxter P, Newport MJ, Atkinson PM, Davey G, , 2014. Modeling environmental factors correlated with podoconiosis. Int J Health Geogr 13: 24.[Crossref]
  29. Central Statistical Agency (CSA) [Ethiopia], 2008. The 2007 Population and Housing Census of Ethiopia. Statistical Summary Report at National Level. Addis Ababa, Ethiopia: Central Statistical Agency.
  30. Central Statistical Agency (CSA) [Ethiopia], 2009. Statistical Abstract of Ethiopia. Addis Ababa, Ethiopia: Central Statistical Agency.
  31. Central Statistical Agency [Ethiopia], ICF International, 2012. Ethiopia Demographic and Health Survey 2011. Addis Ababa, Ethiopia and Calverton, MD: Central Statistical Agency and ICF International.
  32. World Health Organization, 2000. Operational Guidelines for Rapid Mapping of Bancroftian Filariasis in Africa. (WHO/CDS/CPE/CEE/2000.9). Geneva: WHO.
  33. Tekola F, Ayele Z, Mariam DH, Fuller C, Davey G, , 2008. Development and testing of a de novo clinical staging system for podoconiosis (endemic non-filarial elephantiasis). Trop Med Int Health 13: 12771283.[Crossref]
  34. Amirossadat Z, , 2013. Genesis and classification of soils in Segzi Plain (Iran). IJSRK 1: 112.[Crossref]
  35. Soil Survey Staff, 2006. Keys to Soil Taxonomy. Tenth edition. Washington, DC: U.S. Department of Agriculture, Natural Resources Conservation Service.
  36. Jenny H, , 1941. Factors of Soil Formation. New York: McGraw-Hill.
  37. USGS-SRTM, 2008. SRTM 90m Digital Elevation Data. Available at: http://srtm.csi.cgiar.org. Accessed January 20, 2014.
  38. WorldClim website, 2005. Global Climate Change. Available at: http://www.worldclim.org/download.htm. Accessed January 20, 2014.
  39. Africa Soil Information System, 2009. Available at http://www.africasoils.net/data/datasets. Accessed January 20, 2014.
  40. USGS-SRTM, 2008. Available at: http://srtm.csi.cgiar.org/SELECTION/inputCoord.asp. Accessed January 20, 2014.
  41. Project A, 2014. Available at: http://www.clas.ufl.edu/users/atatem/index_files/demographydata.htm. Accessed January 20, 2014.
  42. Global Rural-Urban Mapping project, (GRUMP v1), 1995. Available at: http://sedac/ciesin.columbia.edu/data/sets/browse. Accessed January 20, 2014.
  43. GGIARCSI, 2008. Available at: http://www.cgiar-csi.org/data/global-aridity-and-pet-database Accessed January 20, 2014.
  44. ISRIC & AfSIS, 2013. Available at: http://www.isric.org/data/soil-property-maps-africa. Accessed January 20, 2014.
  45. FAO, 2000. Available at: http://www.fao.org/geonetwork/srv/en/main.home. Accessed January 20, 2014.
  46. Bartholomew DJ, Steele F, Moustaki I, Galbraith JI, , 2008. Prinicpal components analysis. Analysis of Multivariate Social Science Data. Boca Raton, FL: Taylor & Francis Group, LLC.
  47. Lee S, Batzoglou S, , 2003. Application of independent component analysis to microarrays. Genome Biol 4: R76.[Crossref]
  48. Price EW, , 1974. The relationship between endemic elephantiasis of the lower legs and the local soils and climate. Trop Geogr Med 26: 225230.
  49. Deribe K, Brooker SJ, Pullan RL, Hailu A, Enquselassie F, Reithinger R, Newport M, Davey G, , 2013. Spatial distribution of podoconiosis in relation to environmental factors in Ethiopia: a historical review. PLoS ONE 8: e68330.[Crossref]
  50. Tekola-Ayele F, Alemu G, Davey G, Ahrens G, , 2013. Community-based survey of podoconiosis in Bedele Zuria woreda, west Ethiopia. In Health 5: 119125.[Crossref]
  51. Freeman MC, Ogden S, Jacobson J, Abbott D, Addiss DG, Amnie AG, Beckwith C, Cairncross S, Callejas R, Colford JM, Jr Emerson PM, Fenwick A, Fishman R, Gallo K, Grimes J, Karapetyan G, Keene B, Lammie PJ, Macarthur C, Lochery P, Petach H, Platt J, Prabasi S, Rosenboom JW, Roy S, Saywell D, Schechtman L, Tantri A, Velleman Y, Utzinger J, , 2013. Integration of water, sanitation, and hygiene for the prevention and control of neglected tropical diseases: a rationale for inter-sectoral collaboration. PLoS Negl Trop Dis 7: e2439.[Crossref]
  52. Gebrehanna E, , 2005. The Social Burden of Podoconiosis in Wolaita Zone. Addis Ababa: Addis Ababa University.
  53. Silvester RN, Williams AE, Dalbeth N, Rome K, , 2010. Choosing shoes': a preliminary study into the challenges facing clinicians in assessing footwear for rheumatoid patients. J Foot Ankle Res 3: 24.[Crossref]
  54. Weinert HH, , 1965. Climatic factors affecting the weathering of igneous rocks. Agric Meteorol 2: 2742.[Crossref]
  55. Mathieu E, Deming M, Lammie PJ, McLaughlin SI, Beach MJ, Addis DG, , 2003. Comparison of methods for estimating drug coverage for filariasis elimination, Leogane Commune, Haiti. Trans R Soc Trop Med Hyg 97: 501505.[Crossref]
  56. Hotez PJ, Fenwick A, Savioli L, Molyneux DH, , 2009. Rescuing the “bottom billion” through neglected tropical disease control. Lancet 373: 15701576.[Crossref]
  57. Deribe K, Tomczyk S, Tekola-Ayele F, , 2013. Ten years of podoconiosis research in Ethiopia. PLoS Negl Trop Dis 7: e2301.[Crossref]
  58. Pullan RL, Sturrock HJ, Soares Magalhães RJ, Clements AC, Brooker SJ, , 2012. Spatial parasite ecology and epidemiology: a review of methods and applications. Parasitology 139: 18701887.[Crossref]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.14-0446
Loading
/content/journals/10.4269/ajtmh.14-0446
Loading

Data & Media loading...

Supplementary Data

Supplementary PDF

  • Received : 17 Jul 2014
  • Accepted : 15 Sep 2014

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error