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Geta ET, Guteta TO, Tiruneh G. Impairment of health-related quality of life and its determinants among patients with podoconiosis in East Wollega Zone, Oromia Regional State, Ethiopia: institutional-based cross-sectional study. BMJ Open 2024; 14:e077268. [PMID: 38553080 PMCID: PMC10982751 DOI: 10.1136/bmjopen-2023-077268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 03/15/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVE This study aimed to assess the impairment of health-related quality of life (HRQoL) and its determinants among patients diagnosed with podoconiosis in East Wollega Zone, Oromia Regional State, Ethiopia. METHODS An institutional-based cross-sectional study design was used in the setting of primary healthcare facilities to assess impaired HRQoL among patients with podoconiosis in the East Wollega Zone from 1 March 2023 to 30 April 2023, using the Dermatologic Life Quality Index (DLQI). Data was collected from 494 patients with podoconiosis, and a multistage sampling technique was employed. The data was entered into EpiData V.4.6 and exported to SPSS V.27 for analysis. A linear regression model with a 95% cofidence interval (CI) was used to estimate level of HRQoL and to identify its determinants estimating beta (β) coefficient declaring the significance level at p<0.05. RESULTS The quality of life among patients was impaired on average by 9.6±6.1 with the lowest DLQI Score in the domain of treatment (0.8±0.97) and the highest in the domain of daily activity (2.3±1.72). The identified significant determinants of impairment of HRQoL associated with DLQI scores were duration of disease (95% CI, β=0.11 (0.08 to 0.15)), acute dermato-lymphangio-adenitis (ADLA) (95% CI, β=0.08 (0.01 to 0.16)), comorbidity (95% CI, β=1.26 (0.37 to 2.16)), consistently wearing shoes (95% CI, β=-0.06 (-0.09 to -0.03)), feeling of stigmatised (95% CI, β=0.21 (0.16 to 0.25)) and psychological distress (95% CI, β=0.17 (0.14 to 0.21)) and being female (95% CI, β=1.16 (0.19 to 2.12)). CONCLUSION Overall, HRQoL among patients with podoconiosis was moderately impaired. The duration of disease, ADLA, comorbidity, stigma, psychological distress and being female in sex significantly impaired HRQoL, whereas consistently wearing shoes significantly improved HRQoL among the patients with podoconiosis. Therefore, healthcare providers and public health experts should work on educating communities and counselling patients to avoid stigma and psychological distress, wearing shoes consistently and treating podoconiosis and other comorbidities among these patients.
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Affiliation(s)
- Edosa Tesfaye Geta
- School of Public Health, Wollega University, Nekemte, Oromia Regional State, Ethiopia
| | | | - Gemechu Tiruneh
- School of Public Health, Wollega University, Nekemte, Oromia Regional State, Ethiopia
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2
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Abiso TL, Abebe Kerbo A, Wolka Woticha E. Epidemiology of podoconiosis in sub-Saharan Africa: A systematic review and meta-analysis. SAGE Open Med 2023; 11:20503121231193602. [PMID: 37719165 PMCID: PMC10504841 DOI: 10.1177/20503121231193602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 07/24/2023] [Indexed: 09/19/2023] Open
Abstract
Objective Podoconiosis, one of the neglected tropical diseases (NTDs), affects barefoot people in impoverished regions and contributes to poverty by having negative impacts on economic output, education, and disability. People who have the disease waste nearly half of all of their productive workdays. There is limited evidence available on prevalence of podoconiosis in sub-Saharan Africa (SSA). Therefore, the aim of this research was to determine the pooled prevalence of podoconiosis in the SSA over the last 10 years. Methods Studies were retrieved from PubMed, Embase, Web of Science, Scopus, Google Scholar, and Google by using a combination of search terms with Boolean operators. All authors independently assessed each study's quality using the modified Newcastle-Ottawa Scale for cross-sectional studies. STATA Version 14 was used to conduct the statistical analysis. The random-effect approach of meta-analysis was used. To test for heterogeneity, I-Squared (I2) statistics were employed and sensitivity analysis with a leave-one-out was done. Result In this systematic review and meta-analysis, a total of 16 publications with 2,195,722 individuals were included. The pooled prevalence of podoconiosis was 2.66 (95% confidence interval (CI): 2.24, 3.10) with heterogeneity index (I2) of 99.9%. Walking barefoot adjusted odd ratio (AOR) 5.35 (95% CI: 1.65, 9.05), p = 0.001, not washing feet with soap and water regularly AOR 2.8 (95% CI: 1.16, 4.44, p = 0.001), and an increased age AOR 2.23 (95% CI: 1.25, 5.58) were factors significantly associated with the prevalence of podoconiosis. Conclusion This study revealed that pooled prevalence of podoconiosis was considerable in SSA. Age, being barefoot, and failing to wash one's feet with soap and water have been identified to be factors that were significantly associated with the prevalence of podoconiosis. Therefore, creating awareness on shoe wearing and providing shoes in communication with supporting organizations in podoconiosis prevalent areas, and early diagnosis based on family history are needed for the prevention of podoconiosis.
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Affiliation(s)
- Temesgen Lera Abiso
- School of Public Health, College of Health sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Amene Abebe Kerbo
- School of Public Health, College of Health sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Eskinder Wolka Woticha
- School of Public Health, College of Health sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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3
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Neidhöfer C, Nkwetta DL, Fuen BR, Yenban NF, Mbiatong N, Nchanji GT, Korir P, Wetzig N, Sieber M, Thiele R, Parcina M, Klarmann-Schulz U, Hoerauf A, Wanji S, Ritter M. Tropical leg lymphedema caused by podoconiosis is associated with increased colonisation by anaerobic bacteria. Sci Rep 2023; 13:13785. [PMID: 37612446 PMCID: PMC10447442 DOI: 10.1038/s41598-023-40765-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 08/16/2023] [Indexed: 08/25/2023] Open
Abstract
The non-filarial and non-communicable disease podoconiosis affects around 4 million people and is characterized by severe leg lymphedema accompanied with painful intermittent acute inflammatory episodes, called acute dermatolymphangioadenitis (ADLA) attacks. Risk factors have been associated with the disease but the mechanisms of pathophysiology remain uncertain. Lymphedema can lead to skin lesions, which can serve as entry points for bacteria that may cause ADLA attacks leading to progression of the lymphedema. However, the microbiome of the skin of affected legs from podoconiosis individuals remains unclear. Thus, we analysed the skin microbiome of podoconiosis legs using next generation sequencing. We revealed a positive correlation between increasing lymphedema severity and non-commensal anaerobic bacteria, especially Anaerococcus provencensis, as well as a negative correlation with the presence of Corynebacterium, a constituent of normal skin flora. Disease symptoms were generally linked to higher microbial diversity and richness, which deviated from the normal composition of the skin. These findings show an association of distinct bacterial taxa with lymphedema stages, highlighting the important role of bacteria for the pathogenesis of podoconiosis and might enable a selection of better treatment regimens to manage ADLA attacks and disease progression.
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Affiliation(s)
- Claudio Neidhöfer
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn (UKB), Bonn, Germany
| | - Derick Lekealem Nkwetta
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Bangsi Rose Fuen
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Njodzeka Flora Yenban
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Nancielle Mbiatong
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Gordon Takop Nchanji
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Patricia Korir
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn (UKB), Bonn, Germany
| | - Nina Wetzig
- Institute for Functional Gene Analytics, Bonn-Rhein-Sieg University of Applied Sciences, Sankt Augustin, Germany
| | - Martin Sieber
- Institute for Functional Gene Analytics, Bonn-Rhein-Sieg University of Applied Sciences, Sankt Augustin, Germany
| | - Ralf Thiele
- Institute for Functional Gene Analytics, Bonn-Rhein-Sieg University of Applied Sciences, Sankt Augustin, Germany
| | - Marijo Parcina
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn (UKB), Bonn, Germany
| | - Ute Klarmann-Schulz
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn (UKB), Bonn, Germany
- German Center for Infection Research (DZIF), Neglected Tropical Disease, Partner Site, Bonn-Cologne, Bonn, Germany
| | - Achim Hoerauf
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn (UKB), Bonn, Germany
- German Center for Infection Research (DZIF), Neglected Tropical Disease, Partner Site, Bonn-Cologne, Bonn, Germany
- German-West African Centre for Global Health and Pandemic Prevention (G-WAC), Partner Site, Bonn, Bonn, Germany
| | - Samuel Wanji
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Manuel Ritter
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn (UKB), Bonn, Germany.
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Deribe K, Sultani HM, Okoyo C, Omondi WP, Ngere I, Newport MJ, Cano J. Geostatistical modelling of the distribution, risk and burden of podoconiosis in Kenya. Trans R Soc Trop Med Hyg 2023; 117:72-82. [PMID: 36130407 PMCID: PMC9890307 DOI: 10.1093/trstmh/trac092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/27/2022] [Accepted: 09/02/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Understanding and accurately predicting the environmental limits, population at risk and burden of podoconiosis are critical for delivering targeted and equitable prevention and treatment services, planning control and elimination programs and implementing tailored case finding and surveillance activities. METHODS This is secondary analysis of a nationwide podoconiosis mapping survey in Kenya. We combined national representative prevalence survey data of podoconiosis with climate and environmental data, overlayed with population figures in a geostatistical modelling framework, to predict the environmental suitability, population living in at-risk areas and number of cases of podoconiosis in Kenya. RESULTS In 2020, the number of people living with podoconiosis in Kenya was estimated to be 9344 (95% uncertainty interval 4222 to 17 962). The distribution of podoconiosis varies by geography and three regions (Eastern, Nyanza and Western) represent >90% of the absolute number of cases. High environmental suitability for podoconiosis was predicted in four regions of Kenya (Coastal, Eastern, Nyanza and Western). In total, 2.2 million people live in at-risk areas and 4.2% of the total landmass of Kenya is environmentally predisposed for podoconiosis. CONCLUSIONS The burden of podoconiosis is relatively low in Kenya and is mostly restricted to certain small geographical areas. Our results will help guide targeted prevention and treatment approaches through local planning, spatial targeting and tailored surveillance activities.
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Affiliation(s)
- Kebede Deribe
- Children's Investment Fund Foundation, Addis Ababa, Ethiopia.,Brighton and Sussex Centre for Global Health Research, Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, UK.,School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Collins Okoyo
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Wyckliff P Omondi
- Division of Vector Borne and Neglected Tropical Diseases, Ministry of Health, Nairobi, Kenya
| | - Isaac Ngere
- Global Health Program, Washington State University, Nairobi, Kenya
| | - Melanie J Newport
- Brighton and Sussex Centre for Global Health Research, Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, UK
| | - Jorge Cano
- Expanded Special Project for Elimination of Neglected Tropical Diseases, World Health Organization Regional Office for Africa, Brazzaville, Republic of the Congo
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Artificial intelligence and lymphedema: State of the art. J Clin Transl Res 2022; 8:234-242. [PMID: 35813896 PMCID: PMC9260343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/30/2022] [Accepted: 05/01/2022] [Indexed: 11/01/2022] Open
Abstract
Background Lymphedema practice is facing many challenges. Some of these challenges include eradication of tropical lymphedema, preclinical diagnosis of cancer-related lymphedema, and delivery of appropriate individualized care. The past two decades have witnessed an increasing implementation of artificial intelligence (AI) in health-care services. The nature of the challenges facing the lymphedema practice is suitable for AI applications. Aim The aim of this study was to explore the current AI applications in lymphedema prevention, diagnosis, and management and investigate the potential future applications. Methods and Results Four databases were searched: PubMed, Scopus, Web of Science, and EMBASE. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analysis as our basis of organization. Our analysis showed that several domains of AI, including machine learning (ML), fuzzy models, deep learning, and robotics, were successfully implemented in lymphedema practice. ML can guide the eradication campaigns of tropical lymphedema by estimating disease prevalence and mapping the risk areas. Robotic-assisted surgery for gynecological cancer was associated with a lower risk for the lower limb lymphedema. Several feasible models were described for the early detection and diagnosis of lymphedema. The proposed models are more accurate, sensitive, and specific than current methods in practice. ML was also used to guide and monitor patients during the rehabilitation exercises. Conclusion AI offers a variety of solutions to the most challenging problems in lymphedema practice. Further, implementation into the practice can revolutionize many aspects of lymphedema prevention, diagnosis, and management. Relevance to Patients Lymphedema is a chronic debilitating disease that is affecting millions of patients. Developing new modalities for prevention, early diagnosis, and treatment are critical to improve the outcomes. AI offers a variety of solutions for some of the complexities of lymphedema management. In this systematic review, we summarize and discuss the latest AI advances in lymphedema practice.
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Wanji S, Deribe K, Minich J, Debrah AY, Kalinga A, Kroidl I, Luguet A, Hoerauf A, Ritter M. Podoconiosis - From known to unknown: Obstacles to tackle. Acta Trop 2021; 219:105918. [PMID: 33839086 DOI: 10.1016/j.actatropica.2021.105918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 03/24/2021] [Accepted: 04/01/2021] [Indexed: 12/17/2022]
Abstract
Podoconiosis is a non-filarial and non-communicable disease leading to lymphedema of the lower limbs. Worldwide, 4 million individuals live with podoconiosis, which is accompanied by disability and painful intermittent acute inflammatory episodes that attribute to significant disability adjusted life years (DALYs). Different risk factors like contact with volcanic red clay soil, high altitude (above 1000 m), high seasonal rainfall (above 1000 mm/year) and occupation (e.g., subsistence farmer) are associated with the risk of podoconiosis. Although podoconiosis was described to be endemic in 32 countries in Africa, parts of Latin America and South East Asia, knowledge about related genetics, pathophysiology, immunology and especially the causing molecule(s) in the soil remain uncertain. Thus, podoconiosis can be considered as one of the most neglected diseases. This review provides an overview about this non-filarial related geochemical disease and aim to present perspectives and future directions that might be important for better understanding of the disease, prospect for point-of-care diagnosis, achieving protection and developing novel treatment strategies.
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Deribe K, Mackenzie CD, Newport MJ, Argaw D, Molyneux DH, Davey G. Podoconiosis: key priorities for research and implementation. Trans R Soc Trop Med Hyg 2021; 114:889-895. [PMID: 33169167 PMCID: PMC7738650 DOI: 10.1093/trstmh/traa094] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/31/2020] [Accepted: 08/27/2020] [Indexed: 12/14/2022] Open
Abstract
Podoconiosis is a non-infectious tropical lymphoedema causing swelling of the lower legs. Podoconiosis is associated with stigma, depression and reduced productivity, resulting in significant socio-economic impacts for affected individuals, families and communities. It is caused by barefoot exposure to soils and affects disadvantaged populations. Evidence from the past 5 y suggests that podoconiosis is amenable to public health interventions, e.g. footwear and hygiene-based morbidity management, which reduce acute clinical episodes. Although much has been learned in recent years, advances in care for these patients and worldwide control requires further reliable and relevant research. To develop a comprehensive global control strategy, the following key research priorities are important: better understanding of the global burden of podoconiosis through extended worldwide mapping, development of new point-of-care diagnostic methods and approaches to define the presence of the environmental characteristics that contribute to the development of the condition, improving treatment through an increased understanding of the pathogenesis of dermal changes over time, improved understanding of optimal ways of providing patient care at the national level, including research to optimize behavioural change strategies, determine the optimum package of care and integrate approaches to deliver robust surveillance, monitoring and evaluation of control programmes.
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Affiliation(s)
- Kebede Deribe
- Brighton and Sussex Centre for Global Health Research, Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton BN1 9PX, UK.,School of Public Health, College of Health Sciences, Addis Ababa University, PO Box 9086, Addis Ababa, Ethiopia
| | | | - Melanie J Newport
- Brighton and Sussex Centre for Global Health Research, Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton BN1 9PX, UK
| | - Daniel Argaw
- World Health Organization, Control of Neglected Tropical Diseases, Geneva 1211, Switzerland
| | | | - Gail Davey
- Brighton and Sussex Centre for Global Health Research, Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton BN1 9PX, UK.,School of Public Health, College of Health Sciences, Addis Ababa University, PO Box 9086, Addis Ababa, Ethiopia
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Ndzeshang BL, Mbiakop RT, Nchanji GT, Kien CA, Amambo GN, Abong RA, Yuyun T, Beng AA, Bonekeh J, Ritter M, Esum ME, Cho JF, Njouendou AJ, Ndifor IN, Deribe K, Fombad FF, Enyong P, Klarmann-Schulz U, Hoerauf A, Wanji S. Clinical, haematological and biochemical profiling of podoconiosis lymphoedema patients prior to their involvement in a clinical trial in the Northwest Region of Cameroon. Trans R Soc Trop Med Hyg 2021; 114:954-961. [PMID: 33258944 PMCID: PMC7738657 DOI: 10.1093/trstmh/traa146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 11/03/2020] [Accepted: 11/09/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Prior to carrying out clinical trials, it is important to assess the health status of the study participants to be able to interpret subsequent changes that may be related to the effects of the treatments during the follow-up of patients. This study presents the clinical, haematological and biochemical profiles of podoconiosis patients prior to their involvement in the PodoLEDoxy clinical trial. METHODS All lower limb lymphoedema patients visiting the centre were screened and a podoconiosis diagnosis was based on clinical manifestation and detailed medical history. Patients who satisfied the eligibility criteria were enrolled in the study and their demographic data, vital signs and medical history were collected followed by biochemical and haematological examinations. RESULTS Of the 222 participants enrolled in the study, 55.4% and 41.4% had either stage 3 or 2 podoconiosis as their highest stages, respectively. On physical examination, gastritis (46%) and poor vision (2.7%) were the most prevalent health issues identified. The majority of haematological and biochemical values were within the normal range except for mean platelet volume (47.7%), plateletcrit (58.1%), platelet distribution width (66.2%), mean corpuscular volume (67.6%) and red cell distribution width-standard deviation (79.3%), where >40% of the study participants had values out of the normal. CONCLUSION The clinical, haematological and biochemical profiles of the study participants were largely within the normal range except for certain haematological parameters that might be worth investigating.
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Affiliation(s)
- Bertrand Lontum Ndzeshang
- Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea, Cameroon.,Research Foundation in Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon
| | - Randy Tchachoua Mbiakop
- Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea, Cameroon.,Research Foundation in Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon
| | - Gordon Takop Nchanji
- Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea, Cameroon.,Research Foundation in Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon
| | - Chi Anizette Kien
- Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea, Cameroon.,Research Foundation in Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon
| | - Glory Ngongeh Amambo
- Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea, Cameroon.,Research Foundation in Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon
| | - Raphael Awah Abong
- Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea, Cameroon.,Research Foundation in Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon
| | - Timothy Yuyun
- Regional Hospital Bamenda, P.O. Box 818, Bamenda Cameroon
| | - Amuam Andrew Beng
- Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea, Cameroon.,Research Foundation in Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon
| | - John Bonekeh
- Research Foundation in Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon
| | - Manuel Ritter
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn (UKB), Bonn, Germany
| | - Mathias Eyong Esum
- Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea, Cameroon.,Research Foundation in Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon
| | - Jerome Fru Cho
- Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea, Cameroon.,Research Foundation in Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon
| | - Abdel Jelil Njouendou
- Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea, Cameroon.,Research Foundation in Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon
| | | | - Kebede Deribe
- Global Health and Infection Department, Brighton and Sussex Medical School, Brighton, BN1 9PX, UK.,School of Public Health, Addis Ababa University, Ethiopia
| | - Fanny Fri Fombad
- Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea, Cameroon.,Research Foundation in Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon
| | - Peter Enyong
- Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea, Cameroon.,Research Foundation in Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon
| | - Ute Klarmann-Schulz
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn (UKB), Bonn, Germany.,German Center for Infection Research (DZIF), partner-site Bonn-Cologne, Germany
| | - Achim Hoerauf
- Institute for Medical Microbiology, Immunology and Parasitology (IMMIP), University Hospital Bonn (UKB), Bonn, Germany.,German Center for Infection Research (DZIF), partner-site Bonn-Cologne, Germany
| | - Samuel Wanji
- Department of Microbiology and Parasitology, University of Buea, P.O. Box 63, Buea, Cameroon.,Research Foundation in Tropical Diseases and Environment, P.O. Box 474, Buea, Cameroon
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9
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Berhe B, Legese H, Mardu F, Tesfay K, Adhanom G, Kahsay T, Belay G, Negash H. Epidemiology and sex differences of podoconiosis in Ethiopia: A systemic review and meta-analysis. Heliyon 2021; 7:e05446. [PMID: 33981868 PMCID: PMC8082554 DOI: 10.1016/j.heliyon.2020.e05446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/10/2020] [Accepted: 11/03/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Podoconiosis is a poorly understood neglected tropical disease which results in a high socio-economic burden. In Ethiopia, despite the high prevalence, morbidity, and socio-economic impacts, little information is available about the disease. Thus, this review aimed to assess the effect of sex differences and pooled prevalence of podoconiosis in Ethiopia. STUDY SETTING Ethiopia is a country located in East Africa. METHODS Published literature on the prevalence of podoconiosis in Ethiopia was searched through MEDLINE/PubMed, Cochrane Library, Goggle scholar, and Global Health. Studies conducted in humans, open access, and met 50% threshold on the quality assessment checklist score adopted from Joanna Briggs Institute were eligible for inclusion. Data were extracted using first author, year of publication, participants' population, setting (urban/rural), study design, podoconiosis infection among males, the total number of males, podoconiosis infection among females, the total number of females, and context using Microsoft™ Excel. R statistical software version 3.6.1 was utilized to carry out the meta-analysis. The protocol of this review is registered in the PROSPERO international prospective register of systematic reviews and assigned a registration number of CRD 42020154697. RESULTS We performed heterogeneity, sensitivity, and publication bias analysis for the included articles. We identified 229 records, of which 11 studies met the inclusion criteria. The pooled prevalence of podoconiosis in Ethiopia was 6% [95% CI: 5%; 6%]. Subgroup analysis by setting indicated slightly higher prevalence in rural settings. The odds of podoconiosis infection among female is 1.15 times that of males" The effect of sex on podoconiosis was sub-grouped by study setting and the odds of females were 1.29 times at increased risk of acquiring podoconiosis than males (p < 0.01) in rural settings. CONCLUSIONS The prevalence of podoconiosis in Ethiopia is high. This review suggested that females are at higher risk of developing podoconiosis than males, particularly in rural communities which has health promotion and awareness implications regarding protective wear.
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Affiliation(s)
- Brhane Berhe
- Unit of Medical Parasitology, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Adigrat University, P.O. Box: 50, Adigrat, Ethiopia
| | - Haftom Legese
- Unit of Medical Microbiology, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Adigrat University, P.O. Box: 50, Adigrat, Ethiopia
| | - Fitsum Mardu
- Unit of Medical Parasitology, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Adigrat University, P.O. Box: 50, Adigrat, Ethiopia
| | - Kebede Tesfay
- Unit of Medical Parasitology, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Adigrat University, P.O. Box: 50, Adigrat, Ethiopia
| | - Gebre Adhanom
- Unit of Medical Microbiology, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Adigrat University, P.O. Box: 50, Adigrat, Ethiopia
| | - Tsega Kahsay
- Unit of Medical Microbiology, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Adigrat University, P.O. Box: 50, Adigrat, Ethiopia
| | - Getachew Belay
- Unit of Clinical Chemistry, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Adigrat University, P.O. Box: 50, Adigrat, Ethiopia
| | - Hadush Negash
- Unit of Medical Microbiology, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Adigrat University, P.O. Box: 50, Adigrat, Ethiopia
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10
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Alcoba G, Ochoa C, Babo Martins S, Ruiz de Castañeda R, Bolon I, Wanda F, Comte E, Subedi M, Shah B, Ghimire A, Gignoux E, Luquero F, Nkwescheu AS, Sharma SK, Chappuis F, Ray N. Novel transdisciplinary methodology for cross-sectional analysis of snakebite epidemiology at national scale. PLoS Negl Trop Dis 2021; 15:e0009023. [PMID: 33577579 PMCID: PMC7906452 DOI: 10.1371/journal.pntd.0009023] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 02/25/2021] [Accepted: 12/01/2020] [Indexed: 12/12/2022] Open
Abstract
Background Worldwide, it is estimated that snakes bite 4.5–5.4 million people annually, 2.7 million of which are envenomed, and 81,000–138,000 die. The World Health Organization reported these estimates and recognized the scarcity of large-scale, community-based, epidemiological data. In this context, we developed the “Snake-Byte” project that aims at (i) quantifying and mapping the impact of snakebite on human and animal health, and on livelihoods, (ii) developing predictive models for medical, ecological and economic indicators, and (iii) analyzing geographic accessibility to healthcare. This paper exclusively describes the methodology we developed to collect large-scale primary data on snakebite in humans and animals in two hyper-endemic countries, Cameroon and Nepal. Methodology/Principal findings We compared available methods on snakebite epidemiology and on multi-cluster survey development. Then, in line with those findings, we developed an original study methodology based on a multi-cluster random survey, enhanced by geospatial, One Health, and health economics components. Using a minimum hypothesized snakebite national incidence of 100/100,000/year and optimizing design effect, confidence level, and non-response margin, we calculated a sample of 61,000 people per country. This represented 11,700 households in Cameroon and 13,800 in Nepal. The random selection with probability proportional to size generated 250 clusters from all Cameroonian regions and all Nepalese Terai districts. Our household selection methodology combined spatial randomization and selection via high-resolution satellite images. After ethical approval in Switerland (CCER), Nepal (BPKIHS), and Cameroon (CNERSH), and informed written consent, our e-questionnaires included geolocated baseline demographic and socio-economic characteristics, snakebite clinical features and outcomes, healthcare expenditure, animal ownership, animal outcomes, snake identification, and service accessibility. Conclusions/Significance This novel transdisciplinary survey methodology was subsequently used to collect countrywide snakebite envenoming data in Nepal and Cameroon. District-level incidence data should help health authorities to channel antivenom and healthcare allocation. This methodology, or parts thereof, could be easily adapted to other countries and to other Neglected Tropical Diseases. Snakebite envenoming was recently classified as a priority neglected tropical disease by the World Health Organization. Up to five million people are bitten, more than a million envenomed, and around 100,000 victims die, mainly in rural and remote areas of low- and middle-income countries. Snakebite envenoming not only affects victims acutely, but it can also cause long-term disability, disfiguring scars, and heavy economic burden due to treatment costs and inability to work. Previous studies have analyzed snakebite clinical, epidemiological, or socio-economic impacts independently, and little has been done to assess the impact of snakebite in animals and on the livelihoods of the communities that depend upon them. We present an innovative, holistic, national-scale methodology that includes epidemiology, One Health, economic, and geographic information science approaches into one multi-cluster household survey. We randomly selected 250 sub-district areas from all Cameroonian regions and all Nepali Terai districts, which represented more than 61,000 participants in each country. This methodology could be adapted and implemented in other countries affected by snakebite.
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Affiliation(s)
- Gabriel Alcoba
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals (HUG), Geneva, Switzerland
- Institute of Global Health (IGH), Department of Community Health and Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Médecins Sans Frontières (MSF), Geneva, Switzerland
- * E-mail:
| | - Carlos Ochoa
- Institute of Global Health (IGH), Department of Community Health and Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Institute for Environmental Sciences (ISE), University of Geneva, Geneva, Switzerland
| | - Sara Babo Martins
- Institute of Global Health (IGH), Department of Community Health and Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Rafael Ruiz de Castañeda
- Institute of Global Health (IGH), Department of Community Health and Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Isabelle Bolon
- Institute of Global Health (IGH), Department of Community Health and Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Franck Wanda
- Centre International de Recherche, d’Enseignement et de Soins en Milieu Tropical (CIRES), Akonolinga, Cameroon
| | - Eric Comte
- Centre International de Recherche, d’Enseignement et de Soins en Milieu Tropical (CIRES), Akonolinga, Cameroon
| | - Manish Subedi
- B.P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - Bhupendra Shah
- B.P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - Anup Ghimire
- B.P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - Etienne Gignoux
- Epicentre, Médecins Sans Frontières, Geneva, Switzerland/ Paris, France
| | - Francisco Luquero
- Epicentre, Médecins Sans Frontières, Geneva, Switzerland/ Paris, France
| | - Armand Seraphin Nkwescheu
- Cameroon Society of Epidemiology (CaSE), and Faculty of Medicine and Biomedical Science, University of Yaoundé 1, Yaoundé, Cameroon
| | | | - François Chappuis
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals (HUG), Geneva, Switzerland
- Department of Community Health and Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Nicolas Ray
- Institute of Global Health (IGH), Department of Community Health and Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Institute for Environmental Sciences (ISE), University of Geneva, Geneva, Switzerland
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11
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Gislam H, Burnside NG, Brolly M, Deribe K, Davey G, Wanji S, Suh CE, Kemp SJ, Watts MJ, Le Blond JS. Linking soils and human health: geospatial analysis of ground-sampled soil data in relation to community-level podoconiosis data in North West Cameroon. Trans R Soc Trop Med Hyg 2020; 114:937-946. [PMID: 33216129 PMCID: PMC7738663 DOI: 10.1093/trstmh/traa138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/26/2020] [Accepted: 11/02/2020] [Indexed: 12/02/2022] Open
Abstract
Background Podoconiosis is a form of leg swelling, which arises when individuals are exposed over time to red clay soil formed from alkaline volcanic rock. The exact causal agent of the disease is unknown. This study investigates associations between podoconiosis disease data and ground-sampled soil data from North West Cameroon. Methods The mineralogy and elemental concentrations were measured in the soil samples and the data were spatially interpolated. Mean soil values were calculated from a 3 km buffer region around the prevalence data points to perform statistical analysis. Analysis included Spearman's rho correlation, binary logistic regression and principal component analysis (PCA). Results Six elements, barium, beryllium, potassium, rubidium, strontium and thallium, as well as two minerals, potassium feldspar and quartz, were identified as statistically related to podoconiosis. PCA did not show distinct separation between the spatial locations with or without recorded cases of podoconiosis, indicating that other factors such as shoe-wearing behaviour and genetics may significantly influence podoconiosis occurrence and prevalence in North West Cameroon. Conclusion Several soil variables were statistically significantly related to podoconiosis. To further the current study, future investigations will look at the inflammatory pathway response of cells after exposure to these variables.
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Affiliation(s)
- H Gislam
- School of Environment & Technology, University of Brighton, Brighton, UK
| | - N G Burnside
- School of Environment & Technology, University of Brighton, Brighton, UK
| | - M Brolly
- School of Environment & Technology, University of Brighton, Brighton, UK
| | - K Deribe
- Centre for Global Health Research, Brighton and Sussex Medical School, Brighton, UK.,Centre for Environmental and Developmental Studies and School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - G Davey
- Centre for Global Health Research, Brighton and Sussex Medical School, Brighton, UK.,Centre for Environmental and Developmental Studies and School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - S Wanji
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - C E Suh
- Department of Geology, Environmental Science and Mining, University of Bamenda, Bamenda, Cameroon
| | - S J Kemp
- British Geological Survey, Environmental Science Centre, Keyworth, Nottingham, NG12 5GG, UK
| | - M J Watts
- British Geological Survey, Environmental Science Centre, Keyworth, Nottingham, NG12 5GG, UK
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12
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Bikorimana JP, Bayisenge U, Huston T, Ruberanziza E, Mbonigaba JB, Dukuzimana MJ, Davey G. Individual and familial characteristics of patients with podoconiosis attending a clinic in Musanze District, Rwanda: A retrospective study. Trans R Soc Trop Med Hyg 2020; 114:947-953. [PMID: 33169149 PMCID: PMC7738661 DOI: 10.1093/trstmh/traa068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/07/2020] [Accepted: 07/27/2020] [Indexed: 01/01/2023] Open
Abstract
Background Podoconiosis is a progressive swelling of the legs affecting genetically susceptible people who live in areas with irritant red clay soils and walk barefoot. The disease is a public health concern in many countries, including Rwanda. Methods This retrospective study described individual and familial characteristics of patients with podoconiosis attending the Heart and Sole Africa (HASA) clinics in Rwanda. Data on patient characteristics and family history were retrieved from electronic medical records (January 2013 – August 2019). A multiple regression analysis was used to explore factors influencing age of onset of podoconiosis. Results Among 467 patients with podoconiosis, the mean (standard deviation) age of onset was 34.4 (19.6) years, 139 (29.8%) patients developed podoconiosis at <20 years of age, 417 (89%) came from Musanze or neighboring Burera Districts, and 238 (51.0%) had a family history of podoconiosis. Increasing patient age was associated with older age at onset of disease (p<0.001), while an increased number of relatives with podoconiosis (p<0.002) was significantly associated with earlier disease onset. Conclusion Most patients with podoconiosis were women, and more than half had a family history of podoconiosis. An increased number of relatives with podoconiosis was associated with a significantly younger age at disease onset.
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Affiliation(s)
| | - Ursin Bayisenge
- Centre for One Health, University of Global Health Equity, Kigali, PO Box 6955, Rwanda
| | - Tonya Huston
- Heart and Sole Africa, Musanze, Musanze District, PO Box 30, Rwanda
| | - Eugene Ruberanziza
- Rwanda Biomedical Centre, Institute of HIV/AIDS, Diseases Prevention and Control, Kigali, 7162, Rwanda
| | - Jean Bosco Mbonigaba
- Ministry of Health, Rwanda Biomedical Centre, Neglected Tropical Diseases and Other Parasitic Diseases Unit, Kigali, 7162, Rwanda
| | | | - Gail Davey
- Centre for Global Health Research, Brighton & Sussex Medical School, University of Sussex, Falmer, Brighton, BN1 9PX, UK
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13
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Deribe K, Simpson H, Pullan RL, Bosco MJ, Wanji S, Weaver ND, Murray CJL, Newport MJ, Hay SI, Davey G, Cano J. Predicting the environmental suitability and population at risk of podoconiosis in Africa. PLoS Negl Trop Dis 2020; 14:e0008616. [PMID: 32853202 PMCID: PMC7480865 DOI: 10.1371/journal.pntd.0008616] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 09/09/2020] [Accepted: 07/20/2020] [Indexed: 01/17/2023] Open
Abstract
Podoconiosis is a type of tropical lymphedema that causes massive swelling of the lower limbs. The disease is associated with both economic insecurity, due to long-term morbidity-related loss of productivity, and intense social stigma. The geographical distribution and burden of podoconiosis in Africa are uncertain. We applied statistical modelling to the most comprehensive database compiled to date to predict the environmental suitability of podoconiosis in the African continent. By combining climate and environmental data and overlaying population figures, we predicted the environmental suitability and human population at risk of podoconiosis in Africa. Environmental suitability for podoconiosis was predicted in 29 African countries. In the year 2020, the total population in areas suitable for podoconiosis is estimated at 114.5 million people, (95% uncertainty interval: 109.4-123.9) with 16.9 million in areas suitable for both lymphatic filariasis and podoconiosis. Of the total 5,712 implementation units (typically second administrative-level units, such as districts) defined by the World Health Organization in Africa, 1,655 (29.0%) were found to be environmentally suitable for podoconiosis. The majority of implementation units with high environmental suitability are located in Angola (80, 4.8%), Cameroon (170, 10.3%), the DRC (244, 14.7%), Ethiopia (495, 29.9%), Kenya (217, 13.1%), Uganda (116, 7.0%) and Tanzania (112, 6.8%). Of the 1,655 environmentally suitable implementation units, 960 (58.0%) require more detailed community-level mapping. Our estimates provide key evidence of the population at risk and geographical extent of podoconiosis in Africa, which will help decision-makers to better plan more integrated intervention programmes.
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Affiliation(s)
- Kebede Deribe
- Department of Global Heath and Infection, Brighton and Sussex Medical School, Falmer, Brighton, BN1 9PX, United Kingdom
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- * E-mail:
| | - Hope Simpson
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Rachel L. Pullan
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Mbonigaba Jean Bosco
- Malaria and Other Parasitic Disease Division, Rwanda Biomedical Center–Ministry of Health, Kigali, Rwanda
| | - Samuel Wanji
- Parasites and Vector Biology Research Unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Research Foundation in Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon
| | - Nicole Davis Weaver
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America
| | - Christopher J. L. Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America
- Department of Health Metrics Sciences, University of Washington, Seattle, Washington, United States of America
| | - Melanie J. Newport
- Department of Global Heath and Infection, Brighton and Sussex Medical School, Falmer, Brighton, BN1 9PX, United Kingdom
| | - Simon I. Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America
- Department of Health Metrics Sciences, University of Washington, Seattle, Washington, United States of America
| | - Gail Davey
- Department of Global Heath and Infection, Brighton and Sussex Medical School, Falmer, Brighton, BN1 9PX, United Kingdom
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Jorge Cano
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
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14
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Uusitalo R, Siljander M, Dub T, Sane J, Sormunen JJ, Pellikka P, Vapalahti O. Modelling habitat suitability for occurrence of human tick-borne encephalitis (TBE) cases in Finland. Ticks Tick Borne Dis 2020; 11:101457. [PMID: 32723626 DOI: 10.1016/j.ttbdis.2020.101457] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 12/11/2022]
Abstract
The numbers of reported human tick-borne encephalitis (TBE) cases in Europe have increased in several endemic regions (including Finland) in recent decades, indicative of an increasing threat to public health. As such, it is important to identify the regions at risk and the most influential factors associated with TBE distributions, particularly in understudied regions. This study aimed to identify the risk areas of TBE transmission in two different datasets based on human TBE disease cases from 2007 to 2011 (n = 86) and 2012-2017 (n = 244). We also examined which factors best explain the presence of human TBE cases. We used ensemble modelling to determine the relationship of TBE occurrence with environmental, ecological, and anthropogenic factors in Finland. Geospatial data including these variables were acquired from several open data sources and satellite and aerial imagery and, were processed in GIS software. Biomod2, an ensemble platform designed for species distribution modelling, was used to generate ensemble models in R. The proportion of built-up areas, field, forest, and snow-covered land in November, people working in the primary sector, human population density, mean precipitation in April and July, and densities of European hares, white-tailed deer, and raccoon dogs best estimated distribution of human TBE disease cases in the two datasets. Random forest and generalized boosted regression models performed with a very good to excellent predictive power (ROC = 0.89-0.96) in both time periods. Based on the predictive maps, high-risk areas for TBE transmission were located in the coastal regions in Southern and Western Finland (including the Åland Islands), several municipalities in Central and Eastern Finland, and coastal municipalities in Southern Lapland. To explore potential changes in TBE distributions in future climate, we used bioclimatic factors with current and future climate forecast data to reveal possible future hotspot areas. Based on the future forecasts, a slightly wider geographical extent of TBE risk was introduced in the Åland Islands and Southern, Western and Northern Finland, even though the risk itself was not increased. Our results are the first steps towards TBE-risk area mapping in current and future climate in Finland.
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Affiliation(s)
- Ruut Uusitalo
- Department of Geosciences and Geography, P.O. Box 64, FI-00014, University of Helsinki, Finland; Department of Virology, Haartmaninkatu 3, P.O. Box 21, FI-00014, University of Helsinki, Finland; Department of Veterinary Biosciences, Agnes Sjöberginkatu 2, P.O. Box 66, FI-00014, University of Helsinki, Finland.
| | - Mika Siljander
- Department of Geosciences and Geography, P.O. Box 64, FI-00014, University of Helsinki, Finland.
| | - Timothée Dub
- National Institute for Health and Welfare, Helsinki, Finland; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
| | - Jussi Sane
- National Institute for Health and Welfare, Helsinki, Finland.
| | | | - Petri Pellikka
- Department of Geosciences and Geography, P.O. Box 64, FI-00014, University of Helsinki, Finland; Helsinki Institute of Sustainability Science, University of Helsinki, Finland; Institute for Atmospheric and Earth System Research, University of Helsinki, Finland.
| | - Olli Vapalahti
- Department of Virology, Haartmaninkatu 3, P.O. Box 21, FI-00014, University of Helsinki, Finland; Department of Veterinary Biosciences, Agnes Sjöberginkatu 2, P.O. Box 66, FI-00014, University of Helsinki, Finland; Virology and Immunology, HUSLAB, Helsinki University Hospital, Finland.
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15
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Chandler DJ, Grijsen ML, Fuller LC. With Bare Feet in the Soil: Podoconiosis, a Neglected Cause of Tropical Lymphoedema. Dermatology 2020; 237:236-247. [PMID: 32101870 DOI: 10.1159/000506045] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 01/19/2020] [Indexed: 11/19/2022] Open
Abstract
Podoconiosis is a form of lymphoedema that occurs in tropical highland areas in genetically susceptible individuals who are exposed to irritant volcanic soils. The disease is preventable through consistent use of footwear and attention to foot hygiene; however, in endemic areas there is a strong barefoot tradition, and many cannot afford shoes. Patients with podoconiosis face significant physical disability, psychological comorbidity, reduced quality of life and experience frequent episodes of systemic illness due to acute dermatolymphangioadenitis. This review provides an overview of this important and neglected tropical skin disease and summarizes the latest research findings.
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Affiliation(s)
- David J Chandler
- Dermatology Department, Brighton General Hospital, Brighton and Sussex University Hospital NHS Trust, Brighton, United Kingdom,
| | - Marlous L Grijsen
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom.,Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia
| | - Lucinda C Fuller
- Department of Dermatology, Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom.,International Foundation for Dermatology, London, United Kingdom
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16
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Deribe K, Fronterre C, Dejene T, Biadgilign S, Deribew A, Abdullah M, Cano J. Measuring the spatial heterogeneity on the reduction of vaginal fistula burden in Ethiopia between 2005 and 2016. Sci Rep 2020; 10:972. [PMID: 31969662 PMCID: PMC6976656 DOI: 10.1038/s41598-020-58036-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 01/09/2020] [Indexed: 12/18/2022] Open
Abstract
Vaginal fistula is a shattering maternal complication characterized by an anomalous opening between the bladder and/or rectum and vagina resulting in continuous leakage of urine or stool. Although prevalent in Ethiopia, its magnitude and distribution is not well studied. We used statistical mapping models using 2005 and 2016 Ethiopia Demographic Health Surveys data combined with a suite of potential risk factors to estimate the burden of vaginal fistula among women of childbearing age. The estimated number of women of childbearing age with lifetime and untreated vaginal fistula in 2016 were 72,533 (95% CI 38,235-124,103) and 31,961 (95% CI 11,596-70,309) respectively. These figures show reduction from the 2005 estimates: 98,098 (95% CI 49,819-170,737) lifetime and 59,114 (95% CI 26,580-118,158) untreated cases of vaginal fistula. The number of districts having more than 200 untreated cases declined drastically from 54 in 2005 to 6 in 2016. Our results show a significant subnational variation in the burden of vaginal fistula. Overall, between 2005 and 2016 there was substantial reduction in the prevalence of vaginal fistula in Ethiopia. Our results help guide local level tracking, planning, spatial targeting of resources and implementation of interventions against vaginal fistula.
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Affiliation(s)
- Kebede Deribe
- Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, BN1 9PX, UK. .,School of Public Health, Collage of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Claudio Fronterre
- Lancaster Medical School, Faculty of Health and Medicine Lancaster University, LA1 4YB, Lancaster, UK
| | - Tariku Dejene
- Center for Population Studies, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Amare Deribew
- St. Paul Millennium Medical College, Addis Ababa, Ethiopia.,Nutrition International (former Micronutrient Initiative), Addis Ababa, Ethiopia
| | - Muna Abdullah
- United Nations Population Fund (UNFPA), East and Southern Africa Regional Office, 9 Simba Road, Sunninghill, Johannesburg, 2157, South Africa
| | - Jorge Cano
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
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17
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Depressive Symptoms Amongst People with Podoconiosis and Lower Limb Lymphoedema of Other Cause in Cameroon: A Cross-Sectional Study. Trop Med Infect Dis 2019; 4:tropicalmed4030102. [PMID: 31323942 PMCID: PMC6789774 DOI: 10.3390/tropicalmed4030102] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 06/28/2019] [Accepted: 06/29/2019] [Indexed: 12/12/2022] Open
Abstract
Evidence is emerging that shows elevated mental distress and disorder amongst people with several neglected tropical diseases (NTDs). This study aimed to establish the prevalence of depressive symptoms amongst people with podoconiosis and lower limb lymphoedema of other cause in Cameroon. The study was part of a larger research piece that mapped the geographical distribution of podoconiosis in Cameroon. The Patient Health Questionnaire (PHQ-9; mean) was employed to determine the prevalence of depressive symptoms amongst people with lower limb lymphoedema. Linear regression was used to assess the association between socio-demographic characteristics of participants and depressive symptoms. Internal consistency of the PHQ-9 was estimated through Cronbach’s alpha (α = 0.651). The mean PHQ-9 score among people with lower limb lymphoedema was 3.48 (SD ± 3.25). Using a PHQ-9 score of 5 or above as the cut-off score, 32 participants (38.6%) displayed at least mild depressive symptoms. Unemployment was the only factor that was significantly associated with more depressive symptoms overall. This study shows that depressive symptoms are common amongst people with lower limb lymphoedema in Cameroon. The findings provide support for the integration of psychosocial interventions into packages of care for the management of lower limb lymphoedema.
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