title: Epidemiology and individual, household and geographical risk factors of podoconiosis in Ethiopia: results from the first nationwide mapping.
abstract: Although podoconiosis is one of the major causes of tropical lymphoedema and is endemic in Ethiopia its epidemiology and risk factors are poorly understood. Individual-level data for 129,959 individuals from 1,315 communities in 659 woreda (districts) were collected for a nationwide integrated survey of lymphatic filariasis and podoconiosis. Blood samples were tested for circulating Wuchereria bancrofti antigen using immunochromatographic card tests. A clinical algorithm was used to reach a diagnosis of podoconiosis by excluding other potential causes of lymphoedema of the lower limb. Bayesian multilevel models were used to identify individual and environmental risk factors. Overall, 8,110 of 129,959 (6.2%, 95% confidence interval [CI] 6.1-6.4%) surveyed individuals were identified with lymphoedema of the lower limb, of whom 5,253 (4.0%, 95% CI 3.9-4.1%) were confirmed to be podoconiosis cases. In multivariable analysis, being female, older, unmarried, washing the feet less frequently than daily, and being semiskilled or unemployed were significantly associated with increased risk of podoconiosis. Attending formal education and living in a house with a covered floor were associated with decreased risk of podoconiosis. Podoconiosis exhibits marked geographical variation across Ethiopia, with variation in risk associated with variation in rainfall, enhanced vegetation index, and altitude.
authors.forename: Kebede
authors.initials: K
authors.lastname: Deribe
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Brooker
authors.forename: Rachel L
authors.initials: RL
authors.lastname: Pullan
authors.forename: Heven
authors.initials: H
authors.lastname: Sime
authors.forename: Abeba
authors.initials: A
authors.lastname: Gebretsadik
authors.forename: Ashenafi
authors.initials: A
authors.lastname: Assefa
authors.forename: Amha
authors.initials: A
authors.lastname: Kebede
authors.forename: Asrat
authors.initials: A
authors.lastname: Hailu
authors.forename: Maria P
authors.initials: MP
authors.lastname: Rebollo
authors.forename: Oumer
authors.initials: O
authors.lastname: Shafi
authors.forename: Moses J
authors.initials: MJ
authors.lastname: Bockarie
authors.forename: Abraham
authors.initials: A
authors.lastname: Aseffa
authors.forename: Richard
authors.initials: R
authors.lastname: Reithinger
authors.forename: Jorge
authors.initials: J
authors.lastname: Cano
authors.forename: Fikre
authors.initials: F
authors.lastname: Enquselassie
authors.forename: Melanie J
authors.initials: MJ
authors.lastname: Newport
authors.forename: Gail
authors.initials: G
authors.lastname: Davey
mesh_terms: D000328:Adult; D000368:Aged; D004604:Elephantiasis / Q000453:epidemiology*; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D005843:Geography; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult