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BMJ Open. 2016 Sep 26;6(9):e012308. doi: 10.1136/bmjopen-2016-012308.

Burden assessment of podoconiosis in Wayu Tuka woreda, east Wollega zone, western Ethiopia: a community-based cross-sectional study.

BMJ open

Kenate Bekele, Kebede Deribe, Tsige Amberbir, Geleta Tadele, Gail Davey, Abdi Samuel


  1. Department of Microbiology, Wollega University, College of Medical and Health Sciences, Nekemte, Ethiopia.
  2. Wellcome Trust Brighton & Sussex Centre for Global Health Research, Brighton & Sussex Medical School, Falmer, Brighton, UK Addis Ababa University, School of Public Health, Addis Ababa, Ethiopia.
  3. International Orthodox Christian Charities (IOCC), Addis Ababa, Ethiopia.
  4. Department of Parasitological, Wollega University, College of Medical and Health Sciences, Nekemte, Ethiopia.
  5. Wellcome Trust Brighton & Sussex Centre for Global Health Research, Brighton & Sussex Medical School, Falmer, Brighton, UK.

PMID: 27670520 PMCID: PMC5051403 DOI: 10.1136/bmjopen-2016-012308


OBJECTIVE: Podoconiosis is a neglected tropical disease characterised by a slowly progressive swelling of the foot and lower leg. It is prevalent among subsistence barefoot farmers who live and work in highland areas of the tropics. This study was conducted in Wayu Tuka 'woreda' (district), western Ethiopia to determine the prevalence of podoconiosis and assess factors associated with acute adenolymphangitis (ALA) episodes.

METHODS AND ANALYSIS: A two phase, community-based cross-sectional study was conducted between January and March 2015. First, all households in the district were surveyed to determine the prevalence of podoconiosis. This was followed by a second phase in which 366 people with podoconiosis from four randomly selected 'kebeles' (subdistricts) were assessed for clinical features of the disease, shoe-wearing habits, personal hygiene, social stigma and functional impairment. Data entered into Epi DATA were then exported to SPSS. Logistic regression analysis was conducted to identify factors associated with ALA.

RESULTS: Prevalence of podoconiosis in the population was 3.05% (1197/39 256) (95% CI 2.9% to 3.2%). The prevalence was significantly higher among women than men (3.67% vs 2.4%). Most (92.2%) people with podoconiosis were in the economically active age group (15-64 years) in the first phase survey. Of participants in the second phase of the study, 43% had stage 2 disease and 38.1% had 'moss'-like skin changes. On average, people with podoconiosis had 23.3 episodes of ALA/year and each person with podoconiosis lost 149.5 days of activity/year. Never walking barefoot and daily foot washing were both associated with decreased odds of ALA (AOR=0.23; 95% CI 0.06 to 0.80 and 0.09; 95% CI 0.01 to 0.75, respectively).

CONCLUSIONS: A relatively high prevalence of podoconiosis, frequent ALA episodes and considerable decreases in daily activities were identified in this district. Footwear use and daily foot hygiene were associated with decreased odds of ALA. We recommend prevention and morbidity management interventions to address this developmental challenge.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Keywords: Acute adenolymphangitis; Ethiopia; Podoconiosis; elephantiasis


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