Brighton and Sussex Medical School, Falmer, Brighton, United Kingdom.
PLoS One. 2013 Jul 9;8(7):e68330. doi: 10.1371/journal.pone.0068330. Print 2013.
An up-to-date and reliable map of podoconiosis is needed to design geographically targeted and cost-effective intervention in Ethiopia. Identifying the ecological correlates of the distribution of podoconiosis is the first step for distribution and risk maps. The objective of this study was to investigate the spatial distribution and ecological correlates of podoconiosis using historical and contemporary survey data.
Data on the observed prevalence of podoconiosis were abstracted from published and unpublished literature into a standardized database, according to strict inclusion and exclusion criteria. In total, 10 studies conducted between 1969 and 2012 were included, and data were available for 401,674 individuals older than 15 years of age from 229 locations. A range of high resolution environmental factors were investigated to determine their association with podoconiosis prevalence, using logistic regression.
The prevalence of podoconiosis in Ethiopia was estimated at 3.4% (95% CI 3.3%-3.4%) with marked regional variation. We identified significant associations between mean annual Land Surface Temperature (LST), mean annual precipitation, topography of the land and fine soil texture and high prevalence of podoconiosis. The derived maps indicate both widespread occurrence of podoconiosis and a marked variability in prevalence of podoconiosis, with prevalence typically highest at altitudes >1500 m above sea level (masl), with >1500 mm annual rainfall and mean annual LST of 19-21°C. No (or very little) podoconiosis occurred at altitudes <1225 masl, with annual rainfall <900 mm, and mean annual LST of >24°C.
Podoconiosis remains a public health problem in Ethiopia over considerable areas of the country, but exhibits marked geographical variation associated in part with key environmental factors. This is work in progress and the results presented here will be refined in future work.
为了在埃塞俄比亚设计具有地域针对性且具有成本效益的干预措施，需要有最新和可靠的 Podoconiosis 地图。确定 Podoconiosis 分布的生态相关因素是制作分布和风险地图的第一步。本研究的目的是使用历史和当代调查数据来研究 Podoconiosis 的空间分布和生态相关性。
根据严格的纳入和排除标准，将发表和未发表文献中观察到的 Podoconiosis 患病率数据摘录到标准化数据库中。总共纳入了 1969 年至 2012 年期间进行的 10 项研究，共有来自 229 个地点的 401,674 名 15 岁以上的个体的数据可用。为了确定与 Podoconiosis 患病率相关的各种高分辨率环境因素，我们使用逻辑回归进行了研究。
埃塞俄比亚的 Podoconiosis 患病率估计为 3.4%（95%CI 3.3%-3.4%），具有明显的区域差异。我们发现，平均年陆地表面温度（LST）、平均年降水量、地形和细土质地与 Podoconiosis 高患病率之间存在显著关联。所得地图表明 Podoconiosis 的广泛发生以及患病率的明显变化，患病率通常在海拔 >1500 米以上（masl）、年降雨量 >1500 毫米和平均年 LST 为 19-21°C 的地区最高。海拔 <1225 masl、年降雨量 <900 毫米和平均年 LST >24°C 的地区则没有（或很少）发生 Podoconiosis。
在埃塞俄比亚的相当大的地区，Podoconiosis 仍然是一个公共卫生问题，但表现出明显的地理变化，部分与关键环境因素有关。这是一项正在进行的工作，这里呈现的结果将在未来的工作中得到完善。
