PODOCONIOSIS IN ETHIOPIA: FROM NEGLECT TO PRIORITY PUBLIC HEALTH PROBLEM

Authors

  • Kebede Deribe 1 Wellcome Trust Brighton & Sussex Centre for Global Health Research, Brighton & Sussex Medical School, Falmer, Brighton, UK 2. Federal Ministry of Health, Addis Ababa, Ethiopia 3 Addis Ababa University, School of Public Health, Addis Ababa, Ethiopia 4 RTI International, Addis Ababa, Ethiopia http://orcid.org/0000-0002-8526-6996
  • Biruck Kebede Federal Ministry of Health, Addis Ababa Ethiopia
  • Belete Mengistu Federal Ministry of Health, Addis Ababa Ethiopia
  • Henok Negussie Wellcome Trust Brighton & Sussex Centre for Global Health Research, Brighton & Sussex Medical School, Falmer, Brighton, UK
  • Biruk Kebede RTI International, Addis Ababa, Ethiopia
  • Mesfin Sileshi 1. Federal Ministry of Health, Addis Ababa Ethiopia 2. RTI International, Addis Ababa, Ethiopia
  • Mossie Tamiru Federal Ministry of Health, Addis Ababa Ethiopia
  • Sara Tomczyk Institute of Tropical Medicine, Antwerp, Belgium
  • Fasil Tekola-Ayele Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, Maryland, USA
  • Gail Davey Wellcome Trust Brighton & Sussex Centre for Global Health Research, Brighton & Sussex Medical School, Falmer, Brighton, UK
  • Amha Fentaye Federal Ministry of Health, Addis Ababa Ethiopia

Abstract

Podoconiosis is a geochemical disease occurring in individuals exposed to red clay soil of volcanic origin. This Neglected Tropical Disease (NTD) is highly prevalent in Ethiopia. According to the nationwide mapping in 2013, the disease is endemic in 345 districts, where an estimated 35 million people live. The government of Ethiopia prioritized podoconiosis as one of eight priority NTDs and included it in the national integrated masterplan for NTDs. An integrated lymphedema management guideline has been developed.  Service expansion has continued in the last few years and lymphoedema management services have been expanded to over one hundred endemic districts. The last few years have been critical in generating evidence about the distribution, burden and effective interventions for podoconiosis in Ethiopia. Although the extent of the problem within Ethiopia is considerable, the country is well positioned to now scale-up elimination efforts. Given the extraordinary progress of the past ten years and the current commitment of government, private and third sectors, Ethiopia seems to be on course for the elimination of podoconiosis in our lifetime. We need continued strong partner commitment, evidence-building, and scale-up of activities to accomplish this.

Key words:  NTDs, Podoconiosis, Ethiopia.

 

References

Price E. Podoconiosis: Non-filarial Elephantiasis. Oxford Medical Publications, Oxford. 1990.

Davey G, Tekola F, Newport MJ. Podoconiosis: non-infectious geochemical elephantiasis. Trans R Soc Trop Med Hyg. 2007 101(12):1175-80.

Davey G, GebreHanna E, Adeyemo A, Rotimi C, Newport M, Desta K. Podoconiosis: a Tropical Model for gene-environment interactions? . Trans R Soc Trop Med Hyg. 2007;101(1):91-6.

Tekola Ayele F, Adeyemo A, Finan C, et al. HLA class II locus and susceptibility to podoconiosis. N Engl J Med 2012;366(13):1200-8.

Tekola F, Mariam DH, Davey G. Economic costs of endemic non-filarial elephantiasis in Wolaita Zone, Ethiopia. Trop Med Int Health. 2006;11(7):1136-44.

Molla YB, Tomczyk S, Amberbir T, Tamiru A, Davey G. Podoconiosis in East and West Gojam zones, Northern Ethiopia. PLoS Negl Trop Dis. 2012;6(7):e1744.

Addiss DG. Global elimination of Lymphatic Filariasis: Addressing the public health problem. PLoS Negl Trop Dis. 2010;4(6):e741.

Tora A, Davey G, Tadele G. A qualitative study on stigma and coping strategies of patients with podoconiosis in Wolaita zone, Southern Ethiopia. Int Health. 2011;3(3):176-81.

Yakob B, Deribe K, Davey G. High levels of misconceptions and stigma in a community highly endemic for podoconiosis in southern Ethiopia. Trans R Soc Trop Med Hyg. 2008;102(5):439-44.

Yakob B, Deribe K, Davey G. Health professionals' attitudes and misconceptions regarding podoconiosis: potential impact on integration of care in southern Ethiopia. Trans R Soc Trop Med Hyg. 2010;104(1):42-7.

Deribe K, Tomczyk S, Tekola-Ayele F. Ten years of podoconiosis research in Ethiopia. PLoS Negl Trop Dis. 2013 7(10):e2301.

Desta K, Ashine M, Davey G. Prevalence of podoconiosis (endemic non-filarial elephantiasis) in Wolaitta, Southern Ethiopia. Tropical Doctor. 2003;33(4):217-20.

Alemu G, Tekola Ayele F, Daniel T, Ahrens C, Davey G. Burden of podoconiosis in poor rural communities in Gulliso woreda, West Ethiopia. PLoS Negl Trop Dis. 2011;5(6):e1184.

Tekola Ayele F, Alemu G, Davey G, Ahrens C. Community-based survey of podoconiosis in Bedele Zuria woreda, southwest Ethiopia. Int Health. 2013; 5(2):119-25.

Tekola F, Ayele Z, Mariam DH, Fuller C, Davey G. Development and testing of a de novo clinical staging system for podoconiosis (endemic non-filarial elephantiasis). Trop Med Int Health. 2008;13(10):1277-83.

Tekola F, Bull S, Farsides B, et al. Impact of social stigma on the process of obtaining informed consent for genetic research on podoconiosis: a qualitative study. BMC Med Ethics. 2009;10:13(13).

Deribe K, Tomczyk S, Mousley E, Tamiru A, Davey G. Stigma towards a Neglected Tropical Disease: Felt and enacted Stigma Scores among Podoconiosis Patients in Northern Ethiopia. BMC Public Health. 2013;13(1178).

Mousley E, Deribe K, Tamiru A, Davey G. The impact of podoconiosis on quality of life in Northern Ethiopia. Health Qual Life Outcomes. 2013;11(122).

Legesse H , Davey G. Validation of the Dermatology Life Quality Index among patients with podoconiosis in southern Ethiopia. British Journal of Dermatology. 2008;159(4 ):903-6.

Deribe K, Brooker SJ, Pullan RL, et al. Epidemiology and individual, household and geographical risk factors of podoconiosis in Ethiopia: results from the first nationwide mapping. Am J Trop Med Hyg. 2014:In press.

Molla YB, Wardrop NA, Le Blond JS, et al. Modeling environmental factors correlated with podoconiosis. Int J Health Geogr. 2014;13(1):24.

Deribe K, Brooker SJ, Pullan RL, et al. Epidemiology and individual, household and geographical risk factors of podoconiosis in Ethiopia: results from the first nationwide mapping. Am J Trop Med Hyg. 2015;92(1):148–58.

Deribe K, Cano J, Newport MJ, et al. Mapping and modeling the geographical distribution and environmental limits of podoconiosis in Ethiopia. PLoS Negl Trop Dis 2015;9(7):e0003946.

Sime H, Deribe K, Assefa A, et al. Integrated mapping of lymphatic Filariasis and podoconiosis: lessons learnt from Ethiopia. Parasit Vectors. 2014;7(1):397.

Negussie H, Kassahun MM, Fegan G, et al. Podoconiosis treatment in northern Ethiopia (GoLBet): study protocol for a randomised controlled trial. Trials. 2015;16(16):307.

Mengitsu B, Shafi O, Kebede B, et al. Ethiopia and its steps to mobilize resources to achieve 2020 elimination and control goals for neglected tropical diseases: Spider webs joined can tie a lion. International Health 2016;8:I34-I52.

Davey G, Bockarie M, Wanji S AD, et al. Launch of the International Podoconiosis Initiative. Lancet. 2012; 379 (9820):1004.

Davey G, Newport M. Podoconiosis: the most neglected tropical disease? . Lancet. 2007;369:888-9.

Federal Democratic Republic of Ethiopia Ministry of Health. Ethiopia National Master Plan For Neglected Tropical Diseases. Avaiable at http://ntdenvision.org/resource/ethiopia_national_master_plan_for_neglected_tropical_diseases Acessed on 03-04-2014. 2013.

Gebrehanna E. The social burden of podoconiosis in Wolaita zone. Addis Ababa: Addis Ababa University; 2005.

Molla YB, Tomczyk S, Amberbir T, Tamiru A, Davey G. Patients' perceptions of podoconiosis causes, prevention and consequences in East and West Gojam, Northern Ethiopia. BMC Public Health. 2012;12:828.

Tora A, Franklin H, Deribe K, Reda AA, Davey G. Extent of podoconiosis-related stigma in Wolaita Zone, Southern Ethiopia: a cross-sectional study. Springerplus 2014;3:647.

Henok L, Davey G. Validation of the Dermatology Life Quality Index among patients with podoconiosis in southern Ethiopia. Br J Dermatol. 2008;159(4):903-6.

Mousley E, Deribe K, Tamiru A, Tomczyk S, Hanlon C, Davey G. Mental distress and podoconiosis in Northern Ethiopia: a comparative cross-sectional study. Int Health. 2015;7(1):16-25.

Tamiru A, Tsegay G, Wubie M, Gedefaw M, Tomczyk S, Tekola-Ayele F. Podoconiosis patients' willingness to pay for treatment services in Northwest Ethiopia: potential for cost recovery. BMC Public Health. 2014;14:259.

Davey G, Burridge E. Community-based control of a neglected tropical disease: the mossy foot treatment and prevention association. PLoS Negl Trop Dis. 2009;3(5):e424.

Price EW. The management of endemic (non-filarial) elephantiasis of the lower legs Trop Doct 1975;5:70-5.

Sikorski C, Ashine M, Zeleke Z, Davey G. Effectiveness of a simple lymphoedema treatment regimen in podoconiosis management in southern Ethiopia: one year follow-up. PLoS Negl Trop Dis. 2010;4(11):e902.

Geshere Oli G, Tekola Ayele F, Petros B. Parasitological, serological, and clinical evidence for high prevalence of podoconiosis (non-filarial elephantiasis) in Midakegn district, central Ethiopia. Trop Med Int Health. 2012;17(6):722-6. doi: 10.1111/j.1365-3156.2012.02978.

Kloos H, Kello AB, Addus A. Podoconiosis (endemic non-filarial elephantiasis) in two resettlement schemes in western Ethiopia. Tropical Doctor. 1992; 22(3):109-12.

Price E. The association of endemic elephantiasis of the lower legs in East Africa with soil derived from volcanic rocks. Trans R Soc Trop Med Hyg. 1976;4:288- 95.

Price EW. The pathology of non-filarial elephantiasis of the lower legs. Trans R Soc Trop Med Hyg 1972;66(1):150-9.

Price EW, Henderson WJ. The elemental content of lymphatic tissues of barefooted people in Ethiopia, with reference to endemic elephantiasis of the lower legs. Trans R Soc Trop Med Hyg 1978;72(2): 132-6.

Wendemagegn E, Tirumalae R, Böer-Auer A. Histopathological and immunohistochemical features of nodular podoconiosis. J Cutan Pathol. 2015;42(3):178-81.

Addisu S, El-Metwally TH, Davey G, Worku Y, Titheradge MA. The role of transforming growth factor-beta1 and oxidative stress in podoconiosis pathogenesis. Br J Dermatol. 2010;162(5):998-1003.

Ferguson JS, Yeshanehe WE, Matts PJ, Davey G, Mortimer PS, Fuller LC. Assessment of skin barrier function in podoconiosis: measurement of stratum corneum hydration and transepidermal water loss. Br J Dermatol. 2013;168(3):550-5544.

Davey G. Podoconiosis: Let Ethiopia lead the way. Ethiopian Journal of Health Development 2008;22:1-2.

Deribe K, Wanji S, Shafi O, et al. The feasibility of eliminating podoconiosis. Bull World Health Organ. 2015;93(10):712-8.

Deribe K, Wanji S, Shafi O, et al. Measuring elimination of podoconiosis, endemicity classifications, case definition and targets: an international Delphi exercise. Int Health. 7(5):306-16.

Tomczyk S, Tamiru A, Davey G. Addressing the neglected tropical disease podoconiosis in Northern Ethiopia: lessons learned from a new community podoconiosis program. PLoS Negl Trop Dis. 2012;6(3):e1560.

Bartlett J, Deribe K, Tamiru A, et al. Depression and disability in people with podoconiosis: a comparative cross-sectional study in rural Northern Ethiopia. Int Health. 2016;8(2):124-31.

Downloads

Published

2017-08-01

Issue

Section

Original Article