The University of Southampton
University of Southampton Institutional Repository

Individual correlates of Podoconiosis in areas of varying endemicity: a case-control study

Individual correlates of Podoconiosis in areas of varying endemicity: a case-control study
Individual correlates of Podoconiosis in areas of varying endemicity: a case-control study
Background
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.
1935-2735
e2554-[11pp]
Molla, Yordanos
5d9a30e1-c3d2-45d8-9bf8-44c3b326a644
Le Blond, Jennifer
8e5b009e-2e8e-413f-a8d6-e2c664529c0f
Wardrop, Nicola A.
8f3a8171-0727-4375-bc68-10e7d616e176
Baxter, Peter
0e58b63b-ba61-44de-8ee3-1714d86a8134
Atkinson, Peter M.
96e96579-56fe-424d-a21c-17b6eed13b0b
Newport, Melanie J.
62b9be02-6106-4dab-b82e-9fd697d45dcf
Davey, Gail
0ecc5cff-ed5a-4184-b555-bdd97ff91860
Molla, Yordanos
5d9a30e1-c3d2-45d8-9bf8-44c3b326a644
Le Blond, Jennifer
8e5b009e-2e8e-413f-a8d6-e2c664529c0f
Wardrop, Nicola A.
8f3a8171-0727-4375-bc68-10e7d616e176
Baxter, Peter
0e58b63b-ba61-44de-8ee3-1714d86a8134
Atkinson, Peter M.
96e96579-56fe-424d-a21c-17b6eed13b0b
Newport, Melanie J.
62b9be02-6106-4dab-b82e-9fd697d45dcf
Davey, Gail
0ecc5cff-ed5a-4184-b555-bdd97ff91860

Molla, Yordanos, Le Blond, Jennifer, Wardrop, Nicola A., Baxter, Peter, Atkinson, Peter M., Newport, Melanie J. and Davey, Gail (2013) Individual correlates of Podoconiosis in areas of varying endemicity: a case-control study. PLoS Neglected Tropical Diseases, 7 (12), e2554-[11pp]. (doi:10.1371/journal.pntd.0002554).

Record type: Article

Abstract

Background
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.

Text
MollaEtAl_PLOSNTD_2013.pdf - Version of Record
Available under License Other.
Download (975kB)

More information

Published date: December 2013
Organisations: PHEW – P (Population Health), Population, Health & Wellbeing (PHeW)

Identifiers

Local EPrints ID: 360542
URI: https://eprints.soton.ac.uk/id/eprint/360542
ISSN: 1935-2735
PURE UUID: e0d47efc-94cb-477e-8107-2f573dbb3440
ORCID for Peter M. Atkinson: ORCID iD orcid.org/0000-0002-5489-6880

Catalogue record

Date deposited: 17 Dec 2013 10:09
Last modified: 20 Jul 2019 01:20

Export record

Altmetrics

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of https://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×