Abstract
BackgroundWhile morbidity attributable to podoconiosis is relatively well studied, its pattern of mortality has not been established.MethodsWe compared the age-standardised mortality ratios (SMRs) of two datasets from northern Ethiopia: podoconiosis patients enrolled in a 1-y trial and a Health and Demographic Surveillance System cohort.ResultsThe annual crude mortality rate per 1000 population for podoconiosis patients was 28.7 (95% confidence interval [CI] 17.3 to 44.8; n=663) while that of the general population was 2.8 (95% CI 2.3 to 3.4; n=44 095). The overall SMR for the study period was 6.0 (95% CI 3.6 to 9.4).ConclusionsPodoconiosis patients experience elevated mortality compared with the general population and further research is required to understand the reasons.
Highlights
Many of the neglected tropical diseases (NTDs) listed for elimination, including soil-transmitted helminthiases, schistosomiasis, lymphatic filariasis (LF), onchocerciasis and trachoma, are thought of as disabling rather than the direct causes of excess mortality
Podoconiosis patients experience elevated mortality compared with the general population and further research is required to understand the reasons
Disability-adjusted life years (DALYs) estimates for these diseases are predominantly influenced by years lived with disability rather than years of life lost, this may reflect the absence of data on mortality rather than data on the absence of mortality.[1]
Summary
Many of the neglected tropical diseases (NTDs) listed for elimination, including soil-transmitted helminthiases, schistosomiasis, lymphatic filariasis (LF), onchocerciasis and trachoma, are thought of as disabling rather than the direct causes of excess mortality. Podoconiosis, a non-infectious, geochemical NTD characterised by lymphoedema, is associated with severe social, economic, physical and mental health consequences.[2] Acute dermatolymphangioadenitis (ADLA) attacks, similar to those in LF patients, occur at least monthly among untreated patients.[3] Stigma results in the inability to marry, divorce among those already married, exclusion from school and ostracism in the community. Disability causes a productivity loss of 45% of working days per year on average, and depression is common.[2] No information on mortality has yet been reported, anecdotal evidence suggests increased mortality related to acute attacks. While morbidity attributable to podoconiosis is relatively well studied, its pattern of mortality has not been established
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