Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
What is Podoconiosis? - 1 • Non-infectious elephantiasis (“swelling of limb like an elephant’s”) caused by long term exposure of bare feet to irritant soil. The most neglected tropical disease? What is podoconiosis? (1) Non-filarial elephantiasis • Non-infectious • Caused by long term exposure of bare feet to irritant soil The most neglected tropical disease? What is podoconiosis? (2) ‘Gene + soil exposure = disease’ Susceptible people who go barefoot have high risk Differential diagnosis Filarial lymphedema • Asymmetrical • Also upperleg (and elsewhere) • Lowland Why is it important in Ethiopia? HIV LF Podo 6% 4% 2% 0% Prevalence Wolaita Zone At least one million people affected in Ethiopia 5% prevalence in areas of irritant soil & subsistence farming Profound social stigma Countries where podoconiosis is endemic or has been described. Deribe K, Tomczyk S, Tekola-Ayele F (2013) Ten Years of Podoconiosis Research in Ethiopia. PLoS Negl Trop Dis 7(10): e2301. doi:10.1371/journal.pntd.0002301 http://www.plosntd.org/article/info:doi/10.1371/journal.pntd.0002301 Podoconiosis: an issue across tropical Africa Other countries known to be affected: • • • • • • Uganda Kenya Tanzania Rwanda Congo (east) Cameroon (north-west) What can be done about podoconiosis? Podoconiosis is • Preventable (if shoes are worn consistently) • Treatable (using good foot hygiene, bandages, socks and shoes) People with podoconiosis can return to a full role in society. Prevention To PREVENT podoconiosis • education through schools, kebeles, churches, mosques, events • from young childhood: shoes What is Podoconiosis? - 1 Non-infectious elephantiasis (“swelling of limb like an elephant’s”) caused by long term exposure of bare feet to irritant soil. The most neglected tropical disease? Treatment To TREAT people with podoconiosis • foot hygiene, soap, antiseptic, ointment, pressure bandages, socks and shoes • different clinics different programs Foot Hygiene Wash feet with soap and soak in clean, cool water with antiseptic berekina (bleach), aceto, eucalyptus, neem, gentianviolet,salt which is the best antiseptic/antifungal ????? Skin care Keep skin soft and flexible: Rub small piece of Whitfield ointment or local oil into skin of lower legs after washing and drying. may be clean cooking oil with eucalyptus extract. Medische behandeling • Antibiotica: alleen bij erysipelas • Chirurgie: alleen evt. nodulectomie (dun-gesteelde noduli : afbinden) Elevation & Movement • Ankle circles & calf raises to improve lymphatic circulation • Raise end of bed with a brick • Elevate leg on small stool when sitting Zwachtels/kousen Doel: in sokken/schoenen passen Patientenselectie: • schoon, moeten schoenen (kunnen) dragen • moeten het zelf kunnen/willen doen • wegdrukbaar oedeem? Instructie: • • • • startmeting, maandelijks vervolgen moet strak voelen, geen pijn voor de nacht af, voor de dag om bij problemen (pijn) onmiddellijk af en retour kliniek Zwachtels? Ethiopische zwachtels (firma Asmi): • te veel stretch, maar toch wel resultaat • duur: € 3,32 per 4 (1 persoon) • nog niet in Nekemte? Nederlandse zwachtels: • • • nadeel: persoonlijke import, te weinig voordeel: “gratis” juxta fit/lite: makkelijk?? Simple Treatment is Effective Before After Summary • Podoconiosis is NOT INFECTIOUS – no virus, bacterium or parasite is responsible • Podoconiosis is PREVENTABLE – by avoiding contact with irritant soil, primarily by wearing shoes • Podoconiosis is TREATABLE – using simple measures, for which patients can take responsibility Simple Treatment is Effective Before After