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

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Kebede, Biruk, Martindale, Sarah, Mengistu, Belete, Kebede, Biruck, Mengiste, Asrat, H/Kiros, Fikre, Tamiru, Abraham, Davey, Gail, Kelly-Hope, Louise ORCID: https://orcid.org/0000-0002-3330-7629 and Mackenzie, Charles D. (2018) 'Integrated morbidity mapping of lymphatic filariasis and podoconiosis cases in 20 co-endemic districts of Ethiopia'. PLoS Neglected Tropical Diseases, Vol 12, Issue 7, e0006491.

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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.

Item Type: Article
Subjects: WA Public Health > WA 30 Socioeconomic factors in public health (General)
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 880 Filariasis and related conditions (General)
WH Hemic and Lymphatic Systems > Lymphatic System > WH 700 Lymphatic system. Lymphatic diseases (General)
Faculty: Department: Biological Sciences > Department of Tropical Disease Biology
Digital Object Identifer (DOI): https://doi.org/10.1371/journal.pntd.0006491
SWORD Depositor: JISC Pubrouter
Depositing User: Stacy Murtagh
Date Deposited: 18 Jul 2018 14:46
Last Modified: 06 Sep 2019 10:55
URI: https://archive.lstmed.ac.uk/id/eprint/8917

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