Podoconiosis in East and West Gojam Zones, northern Ethiopia.
Podoconiosis in East and West Gojam Zones, northern Ethiopia.
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DOI：
10.1371/journal.pntd.0001744
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发表时间：
2012
影响因子：
3.8
通讯作者：
Davey G
中科院分区：
文献类型：
--
作者：
Molla YB;Tomczyk S;Amberbir T;Tamiru A;Davey G
足锥虫病是一种被忽视的热带病（NTD），流行于热带非洲、中美洲和南美洲以及印度北部的红粘土覆盖高地。据估计，埃塞俄比亚有多达100万病例。本研究旨在估计足癣病在埃塞俄比亚北部阿姆哈拉地区东部和西部戈贾姆地区的流行情况。在东戈贾姆区Debre Eliyas区和西戈贾姆区Dembecha wooredas区分别进行了横断面家庭调查。此次调查对象是在两个地区随机抽取的20个行政单位（kebeles）的全部17553户。对调查中发现的1,704例足癣患者进行了详细的结构化访谈。15岁及以上人群中足癣的患病率为3.3% （95% CI, 3.2% ~ 3.6%）。87%的病例发生在经济活动年龄组（15-64岁）。平均而言，患者在腿部肿胀开始5年后寻求治疗。大多数患者有第二（42.7%）或第三（36.1%）临床期疾病，97.9%有苔藓病变，53%有开放性伤口。平均而言，患者每年有5次急性腺淋巴管炎（ALA）发作，每年ALA的总时间为90天。第一次穿鞋和袜子的平均年龄分别为22岁和23岁。拥有一双以上鞋子的男性多于女性（61.1% vs. 50.5%; χ2 = 11.6 p = 0.001）。在采访时，23.6%的受访者赤脚，其中约三分之二是女性。这项研究显示足癣病和相关的发病率，如ALA，苔藓病变和开放性伤口在埃塞俄比亚北部的高患病率。足癣病早期临床阶段的病例优势表明逆转肿胀的潜力，并呼吁疾病预防干预。足癣是一种非传染性象皮病，影响长期接触红粘土的赤脚人。它常见于热带非洲、中美洲和印度北部。足癣病表现为双侧膝下肿胀。足癣病可以通过持续洗脚、穿鞋、使用防腐剂和润肤剂来预防和控制。这是迄今为止在埃塞俄比亚进行的最大规模的调查：包括埃塞俄比亚北部东戈贾姆区和西戈贾姆区17,553个家庭，并确定了1,704名患者。我们详细采访了患者的急性发作表现（足部和腿部疼痛的炎症，淋巴结肿大和发烧），临床疾病分期，寻求治疗，洗脚和穿鞋习惯。我们发现足癣的患病率为3.3%。大多数患者是农民，未受过教育，处于经济活跃年龄组。在足癣病的发生率和洗脚方式上没有性别差异。腿部肿胀的发生和第一次穿鞋的年龄相似。我们还发现在急性炎症发作期间延迟寻求治疗和卧床多天。我们得出结论，足癣病在埃塞俄比亚北部造成了巨大的负担。
Podoconiosis is a neglected tropical disease (NTD) that is prevalent in red clay soil-covered highlands of tropical Africa, Central and South America, and northern India. It is estimated that up to one million cases exist in Ethiopia. This study aimed to estimate the prevalence of podoconiosis in East and West Gojam Zones of Amhara Region in northern Ethiopia. A cross-sectional household survey was conducted in Debre Eliyas and Dembecha woredas (districts) in East and West Gojam Zones, respectively. The survey covered all 17,553 households in 20 kebeles (administrative subunits) randomly selected from the two woredas. A detailed structured interview was conducted on 1,704 cases of podoconiosis identified in the survey. The prevalence of podoconiosis in the population aged 15 years and above was found to be 3.3% (95% CI, 3.2% to 3.6%). 87% of cases were in the economically active age group (15–64 years). On average, patients sought treatment five years after the start of the leg swelling. Most subjects had second (42.7%) or third (36.1%) clinical stage disease, 97.9% had mossy lesions, and 53% had open wounds. On average, patients had five episodes of acute adenolymphangitis (ALA) per year and spent a total of 90 days per year with ALA. The median age of first use of shoes and socks were 22 and 23 years, respectively. More men than women owned more than one pair of shoes (61.1% vs. 50.5%; χ2 = 11.6 p = 0.001). At the time of interview, 23.6% of the respondents were barefoot, of whom about two-thirds were women. This study showed high prevalence of podoconiosis and associated morbidities such as ALA, mossy lesions and open wounds in northern Ethiopia. Predominance of cases at early clinical stage of podoconiosis indicates the potential for reversing the swelling and calls for disease prevention interventions. Podoconiosis is non-infectious elephantiasis that affects barefoot people that have prolonged exposure to red clay soil. It is common in tropical Africa, central America and northern India. Podoconiosis presents as bilateral below knee swelling. Podoconiosis can be both prevented and controlled by consistently washing feet, wearing shoes, and using antiseptics and emollients. This survey is the biggest conducted to date in Ethiopia: 17,553 households in East and West Gojam Zones of northern Ethiopia were included, and 1,704 patients were identified. We interviewed patients in detail about manifestations of acute attacks (painful inflammation of the foot and leg with swollen lymph nodes and fever), clinical disease stage, treatment seeking, foot washing and shoe wearing practices. We found the prevalence of podoconiosis to be 3.3%. Most patients were farmers, uneducated and within the economically active age group. There was no gender difference in occurrence of podoconiosis and in foot washing practices. The onset of leg swelling and the age of first shoe wearing were similar. We also found delayed treatment seeking and many days confined to bed during acute inflammatory episodes. We conclude that podoconiosis imposes a huge burden in northern Ethiopia.
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DOI：
10.1016/0035-9203(88)90032-6
发表时间：
1988-11-01
影响因子：
2.2
作者：
DELALLA, F;ZANONI, P;MOLTRASIO, G
通讯作者：
MOLTRASIO, G
影响因子：
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Davey G
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0.6
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影响因子：
2.7
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CORACHAN, M
影响因子：
0.6
作者：
KLOOS, H;KELLO, AB;ADDUS, A
通讯作者：
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