Transcript What is Podoconiosis?

What is Podoconiosis? - 1
• Non-infectious
elephantiasis
(“swelling of limb
like an elephant’s”)
caused by long term
exposure of bare
feet to irritant soil.
The most neglected
tropical disease?
What is podoconiosis? (1)
Non-filarial elephantiasis
• Non-infectious
• Caused by long term exposure of
bare feet to irritant soil
The most neglected
tropical disease?
What is podoconiosis? (2)
‘Gene + soil exposure =
disease’
Susceptible people who
go barefoot have high
risk
Differential diagnosis
Filarial lymphedema
• Asymmetrical
• Also upperleg (and
elsewhere)
• Lowland
Why is it important in Ethiopia?
HIV
LF
Podo
6%
4%
2%
0%
Prevalence Wolaita
Zone
At least one million people
affected in Ethiopia
5% prevalence in areas of irritant
soil & subsistence farming
Profound social stigma
Countries where podoconiosis is endemic or has been described.
Deribe K, Tomczyk S, Tekola-Ayele F (2013) Ten Years of Podoconiosis Research in Ethiopia. PLoS Negl Trop Dis 7(10): e2301.
doi:10.1371/journal.pntd.0002301
http://www.plosntd.org/article/info:doi/10.1371/journal.pntd.0002301
Podoconiosis: an issue across tropical
Africa
Other countries known to be
affected:
•
•
•
•
•
•
Uganda
Kenya
Tanzania
Rwanda
Congo (east)
Cameroon (north-west)
What can be done about podoconiosis?
Podoconiosis is
• Preventable (if shoes are worn consistently)
• Treatable (using good foot hygiene, bandages, socks
and shoes)
People with podoconiosis can return to a full role in
society.
Prevention
To PREVENT podoconiosis
• education through schools, kebeles, churches,
mosques, events
• from young childhood: shoes
What is Podoconiosis? - 1
Non-infectious elephantiasis
(“swelling of limb like an
elephant’s”) caused by long term
exposure of bare feet to irritant
soil.
The most neglected
tropical disease?
Treatment
To TREAT people with podoconiosis
• foot hygiene, soap, antiseptic, ointment, pressure
bandages, socks and shoes
• different clinics different programs
Foot Hygiene
Wash feet with soap and
soak in clean, cool
water with antiseptic
berekina (bleach), aceto,
eucalyptus, neem,
gentianviolet,salt
which is the best
antiseptic/antifungal
?????
Skin care
Keep skin soft and flexible:
Rub small piece of Whitfield ointment or local oil into
skin of lower legs after washing and drying.
may be clean cooking oil with eucalyptus extract.
Medische behandeling
• Antibiotica: alleen bij erysipelas
• Chirurgie: alleen evt. nodulectomie
(dun-gesteelde noduli : afbinden)
Elevation & Movement
• Ankle circles & calf raises to improve lymphatic
circulation
• Raise end of bed with a brick
• Elevate leg on small stool when sitting
Zwachtels/kousen
Doel: in sokken/schoenen passen
Patientenselectie:
• schoon, moeten schoenen (kunnen) dragen
• moeten het zelf kunnen/willen doen
• wegdrukbaar oedeem?
Instructie:
•
•
•
•
startmeting, maandelijks vervolgen
moet strak voelen, geen pijn
voor de nacht af, voor de dag om
bij problemen (pijn) onmiddellijk af en retour kliniek
Zwachtels?
Ethiopische zwachtels (firma Asmi):
• te veel stretch, maar toch wel resultaat
• duur: € 3,32 per 4 (1 persoon)
• nog niet in Nekemte?
Nederlandse zwachtels:
•
•
•
nadeel: persoonlijke import, te weinig
voordeel: “gratis”
juxta fit/lite: makkelijk??
Simple Treatment is Effective
Before
After
Summary
• Podoconiosis is NOT INFECTIOUS – no virus,
bacterium or parasite is responsible
• Podoconiosis is PREVENTABLE – by avoiding contact
with irritant soil, primarily by wearing shoes
• Podoconiosis is TREATABLE – using simple measures,
for which patients can take responsibility
Simple Treatment is Effective
Before
After