Padovese Valeska, Marrone Rosalia, Dassoni Federica, Vignally Pascal, Barnabas Gebre A, Morrone Aldo
National Institute for Health, Migration and Poverty (NIHMP), Rome, Italy.
Tigray Regional Health Bureau, Mekele, Ethiopia.
Int J Dermatol. 2016 May;55(5):563-70. doi: 10.1111/ijd.13120. Epub 2015 Oct 30.
In Ethiopia, lymphatic filariasis and podoconiosis are the two neglected tropical diseases planned to be mapped together within the recently launched Ethiopian neglected tropical diseases master plan (2013-2015). However, other disorders cause tropical lymphedema, and this report aims to identify clinical epidemiological aspects of limb swelling in northern Ethiopia and to provide an algorithm orienting the clinical diagnosis.
Medical records of patients with lower limb elephantiasis attending the Italian Dermatological Centre of Mekele, Tigray capital city, over a 4-year period (2005-2009) were retrospectively analyzed. Nine variables were collected from the charts comprising demographic data, job, origin, literacy, clinical, histopathologic, microscopic, and cultural findings.
Over a total of 511 patients, lymphedema resulted from trauma (40.7%), chronic venous insufficiency (12.5%), deep mycoses (10.8%), lymphatic filariasis (9.2%), elephantiasis nostras verrucosa (7.0%), tropical ulcer (6.3%), leprosy (4.9%), recurrent infections (3.1%), podoconiosis (1.8%), tuberculosis (1.0%), malignancy (1.3%), Kaposi's sarcoma (1.0%), leishmaniasis (0.2%), and neurofibromatosis (0.2%).
Advanced-stage elephantiasis, chronic osteomyelitis, and podoconiosis not previously reported in Tigray were observed. Further epidemiological investigation and training programs addressed to healthcare providers at the peripheral level are needed to detect elephantiasis early, prevent disabilities, and improve patients' quality of life.
在埃塞俄比亚，淋巴丝虫病和足分支菌病是计划在最近启动的埃塞俄比亚被忽视热带病总体规划（2013 - 2015年）中共同绘制地图的两种被忽视热带病。然而，其他疾病也会导致热带性淋巴水肿，本报告旨在确定埃塞俄比亚北部肢体肿胀的临床流行病学特征，并提供指导临床诊断的算法。
回顾性分析了在提格雷首府默克莱的意大利皮肤病中心就诊的下肢象皮肿患者在4年期间（2005 - 2009年）的病历。从病历中收集了9个变量，包括人口统计学数据、职业、出身、识字情况、临床、组织病理学、显微镜检查和文化特征。
在总共511名患者中，淋巴水肿的病因包括创伤（40.7%）、慢性静脉功能不全（12.5%）、深部真菌病（10.8%）、淋巴丝虫病（9.2%）、疣状自体象皮病（7.0%）、热带溃疡（6.3%）、麻风病（4.9%）、反复感染（3.1%）、足分支菌病（1.8%）结核病（1.0%）、恶性肿瘤（1.3%）、卡波西肉瘤（1.0%）、利什曼病（0.2%）和神经纤维瘤病（0.2%）。
观察到了提格雷此前未报告的晚期象皮病、慢性骨髓炎和足分支菌病。需要针对基层医疗服务提供者开展进一步的流行病学调查和培训项目，以便早期发现象皮病、预防残疾并改善患者的生活质量。
