Validation of the Dermatology Life Quality Index among patients with podoconiosis in southern Ethiopia

BACKGROUND Podoconiosis is a geochemical elephantiasis common among subsistence farmers in Ethiopia. It is completely preventable but, untreated, leads to considerable physical disability, social stigma and economic disadvantage. Quality of life has to date not been assessed among patients with podoconiosis. OBJECTIVES We aimed to assess the feasibility, internal consistency and concurrent validity of an Amharic translation of the Cardiff Dermatology Life Quality Index (DLQI) among patients with podoconiosis in southern Ethiopia. METHODS We performed a comparative cross-sectional study among 74 new patients and 74 patients treated for at least 3 months at outreach clinics of the Mossy Foot Treatment and Prevention Association, a nongovernment organization providing services for more than 30,000 patients annually in southern Ethiopia. RESULTS The DLQI was quick and simple to use, taking on average 4 min to administer. It distinguished successfully between new and treated patients (median scores 13 vs. 3, P < 0.001). The inter-item correlation averaged 0.44, and Cronbach's alpha was 0.90, indicating high internal consistency. The mean DLQI score for all patients was 8.42, and the highest score was for item 2 (feeling self-conscious). The item with the highest score among new patients was item 1 (pain), while that among treated patients was item 4 (clothes choice). CONCLUSIONS The Amharic DLQI appears feasible, reliable and valid among patients with podoconiosis in southern Ethiopia. The DLQI will play an important role in assessing the physical and social interventions available locally and in guiding the roll-out of these interventions to much larger groups of patients throughout Ethiopia.