Abstract
Podoconiosis is an endemic, non-infectious, geochemical and non-filarial inflammatory cause of tropical elephantiasis. The immunology of podoconiosis is not yet expressly understood. In spite of this, co-infection and co-morbidity with the infectious, soil-transmitted hookworm disease that causes iron deficiency anemia has been found to be predominant among affected individuals living in co-endemic settings, thus creating a more complex immunological interplay that still has not been investigated. Although deworming and iron-rich nutrient supplementation have been suggested in podoconiosis patients living under resource-poor conditions, and it is thought that hookworm infection may help to suppress inflammatory responses, the undisputed link that exists between a non-infectious and an infectious disease may create a scenario whereby during a co-infection, treatment of one exacerbates the other disease condition or is dampened by the debilitation caused by the other. In this paper, we elaborate on the immunopathogenesis of podoconiosis and examine the possible immunological dynamics of hookworm co-infection in the immunopathology of podoconiosis, with a view toward improved management of the disease that will facilitate its feasible elimination.
Highlights
Podoconiosis is an endemic, non-infectious, geochemical and inflammatory disease caused by chronic barefoot contact with mineral particles present in certain volcanic clay soils, resulting in bilateral lymphedema and disfigurement of the lower legs [1]
This may attribute to the higher percentage (33%) of anemia cases found among podoconiosis patients, which reaches well above the 15.25% cases of anemia found in the endemic controls [27]
Co-occurrence with light, moderate or heavy hookworm infection has the potential to attenuate inflammatory responses, it may contribute to fibrogenesis
Summary
Podoconiosis is an endemic, non-infectious, geochemical and inflammatory disease caused by chronic barefoot contact with mineral particles present in certain volcanic clay soils, resulting in bilateral lymphedema and disfigurement of the lower legs [1]. Higher hookworm infection rates have been reported among podoconiosis patients [27], especially during the early clinical stages. According to Taye et al [27], hookworm infections were found in 40.9% of podoconiosis patients but in only 27.5% of the human controls living in the same endemic area. This may attribute to the higher percentage (33%) of anemia cases found among podoconiosis patients, which reaches well above the 15.25% cases of anemia found in the endemic controls [27]. Dis. 2018, 3, 37 the possible involvement of hookworm co-infection in the immunopathogenesis and progression of human podoconiosis
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