Abstract
BackgroundPodoconiosis is one of the most neglected tropical diseases, which untreated, causes considerable physical disability and stigma for affected individuals. Little is known about the quality of life (QoL) of patients with podoconiosis. This study aimed to assess the QoL of patients with podoconiosis in comparison with healthy controls in Ethiopia.MethodsA comparative cross-sectional study was conducted in May 2012, among 346 clinically confirmed adult patients with podoconiosis, and 349 healthy adult neighbourhood controls in Dembecha woreda (district) in northern Ethiopia. QoL was assessed using the validated Amharic version of the World Health Organisation Quality of Life questionnaire (WHOQoL-BREF) scale; in addition, mental health and stigma were assessed by the Kessler-10 scale and podoconiosis stigma scale respectively. Logistic regression analysis was done to identify factors associated with QoL.ResultsPatients with podoconiosis had significantly lower mean overall QoL than the controls (52.05 versus 64.39), and this was also true in all four sub domains (physical, psychological, social and environmental). Controls were 7 times more likely to have high (above median) QoL (Odds Ratio = 6.74, 95% Confidence Interval 4.62 to 9.84) than cases. Factors associated with lower QoL were: experiencing high levels of stigma, living in an urban area, being illiterate, having additional co-morbidities, and being unmarried. Mental illness was associated with lower scores in psychological and physical domains.ConclusionsPrograms targeting podoconiosis interventions should include QoL as an indicator for monitoring progress. Interventions targeting improvement of QoL among patients with podoconiosis should address depression, stigma and other co-morbidities.
Highlights
Podoconiosis is one of the most neglected tropical diseases, which untreated, causes considerable physical disability and stigma for affected individuals
Podoconiosis is a form of elephantiasis that predominantly affects barefoot subsistence farmers in areas with red volcanic soil [1]
It has been identified as an important neglected tropical disease (NTD) in East Africa, South America and Asia [2,3,4,5,6,7], and is estimated to affect 1 million people in Ethiopia alone [8]. This neglected tropical disease is characterised by bilateral swelling of the lower legs with mossy and nodular changes to the skin, and causes considerable disability [1]
Summary
Podoconiosis is one of the most neglected tropical diseases, which untreated, causes considerable physical disability and stigma for affected individuals. Podoconiosis is a form of elephantiasis that predominantly affects barefoot subsistence farmers in areas with red volcanic soil [1] It has been identified as an important neglected tropical disease (NTD) in East Africa, South America and Asia [2,3,4,5,6,7], and is estimated to affect 1 million people in Ethiopia alone [8]. The disability and deformity caused by podoconiosis have been shown to have economic and social consequences [11,12] These include isolation, and exclusion from community events [13], and difficulties finding employment, gaining education and getting married [12]. Associated with this, it has been shown that podoconiosis attracts a great deal of stigma, with many negative attitudes and beliefs found about podoconiosis in affected communities, as well as among patients themselves [7,14]
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