Abstract
Podoconiosis is non-filarial elephantiasis of lower legs which predominantly affects barefooted people. In later clinical stages, the disease manifests lymphoedema of the lower legs with mossy and nodular changes to the skin. The disease progressively disables patients when they are continuously exposed to irritant soils. The present study aimed to assess factors associated with lymphoedema management success among podoconiosis patients. A community based cross-sectional study was conducted from February to May, 2014 among podoconiosis patients. A two-stage sampling technique was employed to randomly select a total of 845 study subjects from 4 districts of Wolaita zone. To collect data, interviewer administered questionnaire was used along with observation. Data were entered and analyzed by using SPSS version 20. Bivariate and multivariable logistic regressions were used to select the candidate and the predictor variables respectively. Majority (71.2%) of the study subjects managed their lymphoedema successfully. Three fourth of the study participants were adhered to the stepwise lymphoedema management procedures. Acute dermato lymphangio adenitis (acute attack), was manifested rarely among 61.4% of the subjects after completion of the treatment. Patients' adherence to stepwise treatment procedures, completion of treatment regimen, duration of follow-up, attitude towards lymphoedema management, age and literacy were found to be the main predictors of lymphoedema management success. The present study assessed main factors associated with lymphoedema management success in podoconiosis. Duration of treatment follow-up, adherence to stepwise treatment procedure, completion of treatment, attitude on disease management and community perceptions towards patients were the main factors associated with successful lymphoedema management. Strict supervision and follow-up of patients to reinforce the home-based lymphoedema care is a vital precondition to successfully manage lymphoedema. Furthermore, longitudinal studies have to be conducted to bring a better lymphoedema management scenario with a higher success rate.
Highlights
Podoconiosis, endemic non-filarial elephantiasis, is a chronic lymphatic disease caused by long term exposure to irritant volcanic soil which predominantly affects barefooted people [1]
Though less attention is given to podoconiosis, it is more common than the focused diseases such as HIV/AIDS, tuberculosis and filarial elephantiasis in endemic areas of the country [7, 8]
Measuring treatment outcomes of individuals with podoconiosis is a complex phenomenon due to uncontrolled factors, it was attempted by this study to determine the factors associated with lymphoedema management success among people living with podoconiosis based on the patient's self-report to the key variables used in the present study
Summary
Podoconiosis, endemic non-filarial elephantiasis, is a chronic lymphatic disease caused by long term exposure to irritant volcanic soil which predominantly affects barefooted people [1]. This disease mainly manifests swelling of the lower legs with mossy and nodular changes to the [2]. Though less attention is given to podoconiosis, it is more common than the focused diseases such as HIV/AIDS, tuberculosis and filarial elephantiasis in endemic areas of the country [7, 8] This disease mainly affects people of productive age group. Studies from southern Ethiopia has shown that podoconiosis patients lose forty five percent of their productive work days, costing a single zone more than 16 million USD per year [9]
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