Pod.pntd.0002554.pdf (959.48 kB)
Individual correlates of podoconiosis in areas of varying endemicity: a case-control study
journal contribution
posted on 2023-06-08, 17:09 authored by Yordanos B Molla, Jennifer S Le Blond, Nicola Wardrop, Peter Baxter, Peter M Atkinson, Melanie NewportMelanie Newport, Gail DaveyGail DaveyBACKGROUND Podoconiosis is a non-filarial form of elephantiasis resulting in lymphedema of the lower legs. Previous studies have suggested that podoconiosis arises from the interplay of individual and environmental factors. Here, our aim was to understand the individual-level correlates of podoconiosis by comparing 460 podoconiosis-affected individuals and 707 unaffected controls. METHODS/PRINCIPAL FINDINGS This was a case-control study carried out in six kebeles (the lowest governmental administrative unit) in northern Ethiopia. Each kebele was classified into one of three endemicity levels: 'low' (prevalence <1%), 'medium' (1-5%) and 'high' (>5%). A total of 142 (30.7%) households had two or more cases of podoconiosis. Compared to controls, the majority of the cases, especially women, were less educated (OR?=?1.7, 95% CI?=?1.3 to 2.2), were unmarried (OR?=?3.4, 95% CI?=?2.6-4.6) and had lower income (t?=?-4.4, p<0.0001). On average, cases started wearing shoes ten years later than controls. Among cases, age of first wearing shoes was positively correlated with age of onset of podoconiosis (r?=?0.6, t?=?12.5, p<0.0001). Among all study participants average duration of shoe wearing was less than 30 years. Between both cases and controls, people in 'high' and 'medium' endemicity kebeles were less likely than people in 'low' endemicity areas to 'ever' have owned shoes (OR?=?0.5, 95% CI?=?0.4-0.7). CONCLUSIONS Late use of shoes, usually after the onset of podoconiosis, and inequalities in education, income and marriage were found among cases, particularly among females. There were clustering of cases within households, thus interventions against podoconiosis will benefit from household-targeted case tracing. Most importantly, we identified a secular increase in shoe-wearing over recent years, which may give opportunities to promote shoe-wearing without increasing stigma among those at high risk of podoconiosis.
Funding
MRC; MR/J012343/1
History
Publication status
- Published
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- Published version
Journal
PLoS Neglected Tropical DiseasesISSN
1935-2735Publisher
Public Library of ScienceExternal DOI
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12Volume
7Article number
e2554Department affiliated with
- Global Health and Infection Publications
Full text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2014-05-12First Open Access (FOA) Date
2014-06-09First Compliant Deposit (FCD) Date
2014-06-09Usage metrics
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