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. 2018 Jul 2;12(7):e0006491.
doi: 10.1371/journal.pntd.0006491. eCollection 2018 Jul.

Integrated morbidity mapping of lymphatic filariasis and podoconiosis cases in 20 co-endemic districts of Ethiopia

Biruk Kebede  1 , Sarah Martindale  2 , Belete Mengistu  3 , Biruck Kebede  3 , Asrat Mengiste  1 , Fikre H/Kiros  1 , Abraham Tamiru  1 , Gail Davey  4 , Louise A Kelly-Hope  2 , Charles D Mackenzie  2   5
Affiliations

Integrated morbidity mapping of lymphatic filariasis and podoconiosis cases in 20 co-endemic districts of Ethiopia

Biruk Kebede et al. PLoS Negl Trop Dis. .

Abstract

Background: Lymphatic filariasis (LF) and podoconiosis are neglected tropical diseases (NTDs) that pose a significant physical, social and economic burden to endemic communities. Patients affected by the clinical conditions of LF (lymphoedema and hydrocoele) and podoconiosis (lymphoedema) need access to morbidity management and disability prevention (MMDP) services. Clear estimates of the number and location of these patients are essential to the efficient and equitable implementation of MMDP services for both diseases.

Methodology/principle findings: A community-based cross-sectional study was conducted in Ethiopia using the Health Extension Worker (HEW) network to identify all cases of lymphoedema and hydrocoele in 20 woredas (districts) co-endemic for LF and podoconiosis. A total of 612 trained HEWs and 40 supervisors from 20 districts identified 26,123 cases of clinical morbidity. Of these, 24,908 (95.3%) reported cases had leg lymphoedema only, 751 (2.9%) had hydrocoele, 387 (1.5%) had both leg lymphoedema and hydrocoele, and 77 (0.3%) cases had breast lymphoedema. Of those reporting leg lymphoedema, 89.3% reported bilateral lymphoedema. Older age groups were more likely to have a severe stage of disease, have bilateral lymphoedema and to have experienced an acute attack in the last six months.

Conclusions/significance: This study represents the first community-wide, integrated clinical case mapping of both LF and podoconiosis in Ethiopia. It highlights the high number of cases, particularly of leg lymphoedema that could be attributed to either of these diseases. This key clinical information will assist and guide the allocation of resources to where they are needed most.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Study regions in Ethiopia, and the number and prevalence per 10,000 of lymphoedema and hydrocoele cases by district.
A. Lymphoedema–all cases. B. Lymphoedema–all prevalence. C. Lymphoedema–bilateral cases. D. Lymphoedema–bilateral prevalence. E. Lymphoedema–unilateral cases. F. Lymphoedema–unilateral prevalence. G. Hydrocoele–all cases. H. Hydrocoele–all prevalence. Note. The names of each district and their endemicity classification are shown in reference S1 Fig.
Fig 2
Fig 2. Number of leg lymphoedema, breast lymphoedema and hydrocoele cases by sex and age.
A. Leg lymphoedema. B. Breast lymphoedema and hydrocele.
Fig 3
Fig 3. Proportion of cases experiencing acute attacks by age group and severity of lymphoedema stratified by sex.
A. Age group. B. Severity of lymphoedema.
See this image and copyright information in PMC

References

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