Community based cross sectional study of podoconiosis and associated factors in Dano district, Central Ethiopia

Background Podoconiosis, affects lower limb, is an entirely preventable non-communicable tropical disease common in low income countries. Globally it is estimated that there are 4 million peoples with podoconiosis and nationally it is estimated that there are 1.56 million cases of podoconiosis. Even though nationwide mapping has been conducted including the current district under investigation, there are no studies conducted to identify factors associated with podoconiosis in the district. Hence, this study was aimed to determine the prevalence of podoconiosis and associated factors in the west Shewa of Dano district community. Method A community based cross sectional study was conducted from March 1 to 26, 2018. Seven kebeles out of the total of twenty-three kebeles found in the district were selected randomly. The total sample size was allocated by probability proportional to size to each kebele based on the number of households they had. Then, systematic random sampling was employed to select 652 study participants from the seven kebeles. Data was collected using interviewer administered structured questionnaire and observation. In addition, a blood sample was collected from the study subjects who had leg swelling for ruling out lymphedema due to lymphatic filarasis by using Immunochromatographic test card. Podoconiosis case was defined as bilateral but asymmetric swelling which develop first in the foot often confined to the lower leg and negative result for immune-chromatographic test (ICT card). The prevalence of podoconiosis was determined and multiple logistic regression model was fitted using SPSS version 23 to identify factors associated with podoconiosis. Result The prevalence of podoconiosis in Dano district was found to be 6.3% (95%CI: 5.8, 6.8). Age at first shoe wearing (AOR = 1.08,95% CI = 1.06-1.11), washing practice of feet by water only (AOR = 3.68, 95% CI = 1.47-9.24) and not wearing shoe daily (AOR = 9.32, 95% CI = 4.27-20.4) were found to be significantly associated with increased odds of podoconiosis. Conclusion This study revealed that there was significant burden of podoconiosis in the study area. Age at first shoe wearing, washing practice and frequency of shoe wearing were associated with the development of podoconiosis disease. Modalities to enhance the shoe wearing behaviour of the communities should be planned by high level decision makers working in the area of Health. Moreover, collaboration between local government and non-government stakeholders, and integration with existing programs addressing foot hygiene which involves washing feet with soap and water needs to be addressed. Author summary Podoconiosis (endemic non-filarial elephantiasis) is one of a disabling and stigmatizing neglected tropical disease (NTD) which affects the lower limb found mostly in low income countries. Even though there were mostly prevalence studies and disease mapping, there was no report, especially on factors associated with the disease, from the study area. Hence, community based cross sectional study was conducted to determine its prevalence and factors associated with it in the west Shewa Zone of Dano district community. Data were collected from a total of 652 randomly selected peoples using interviewer administered structured questionnaire and observation. In addition, a blood sample was collected from the study subjects who had leg swelling for ruling out lymphedema due to lymphatic filarasis by using Immunochromatographic test card. Podoconiosis case was defined as bilateral but asymmetric swelling which develop first in the foot often confined to the lower leg and negative result for immune-chromatographic test (ICT card). Accordingly, the prevalence of podoconiosis in the district was found to be 6.3%. Age at first shoe wearing, washing practice of feet by water only and not wearing shoe daily were found to be the risk factors for the development of podoconiosis. Hence, this study revealed that there was significant burden of the disease in the study area. Thus, collaboration between local government and non-government stakeholders, and integration with existing programs addressing foot hygiene which involves washing feet with soap and water needs to be addressed.