National Podoconiosis Action Network, Addis Ababa, Ethiopia.
Centre for Neglected Tropical Diseases, Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
PLoS Negl Trop Dis. 2018 Jul 2;12(7):e0006491. doi: 10.1371/journal.pntd.0006491. eCollection 2018 Jul.
Lymphatic filariasis (LF) and podoconiosis are neglected tropical diseases (NTDs) that pose a significant physical, social and economic burden to endemic communities. Patients affected by the clinical conditions of LF (lymphoedema and hydrocoele) and podoconiosis (lymphoedema) need access to morbidity management and disability prevention (MMDP) services. Clear estimates of the number and location of these patients are essential to the efficient and equitable implementation of MMDP services for both diseases.
METHODOLOGY/PRINCIPLE FINDINGS: A community-based cross-sectional study was conducted in Ethiopia using the Health Extension Worker (HEW) network to identify all cases of lymphoedema and hydrocoele in 20 woredas (districts) co-endemic for LF and podoconiosis. A total of 612 trained HEWs and 40 supervisors from 20 districts identified 26,123 cases of clinical morbidity. Of these, 24,908 (95.3%) reported cases had leg lymphoedema only, 751 (2.9%) had hydrocoele, 387 (1.5%) had both leg lymphoedema and hydrocoele, and 77 (0.3%) cases had breast lymphoedema. Of those reporting leg lymphoedema, 89.3% reported bilateral lymphoedema. Older age groups were more likely to have a severe stage of disease, have bilateral lymphoedema and to have experienced an acute attack in the last six months.
CONCLUSIONS/SIGNIFICANCE: This study represents the first community-wide, integrated clinical case mapping of both LF and podoconiosis in Ethiopia. It highlights the high number of cases, particularly of leg lymphoedema that could be attributed to either of these diseases. This key clinical information will assist and guide the allocation of resources to where they are needed most.
淋巴丝虫病（LF）和鹅卵石足是被忽视的热带病（NTD），对流行地区社区造成了重大的身体、社会和经济负担。受 LF（淋巴水肿和鞘膜积液）和鹅卵石足（淋巴水肿）临床状况影响的患者需要获得发病率管理和残疾预防（MMDP）服务。准确估计这些患者的数量和位置对于高效、公平地实施这两种疾病的 MMDP 服务至关重要。
方法/原理发现：在埃塞俄比亚，我们利用基层卫生工作者（HEW）网络开展了一项基于社区的横断面研究，以确定在共流行 LF 和鹅卵石足的 20 个区识别所有淋巴水肿和鞘膜积液病例。来自 20 个区的 612 名经过培训的 HEW 和 40 名主管共确定了 26,123 例临床发病病例。其中，24,908 例（95.3%）报告病例仅患有腿部淋巴水肿，751 例（2.9%）患有鞘膜积液，387 例（1.5%）同时患有腿部淋巴水肿和鞘膜积液，77 例（0.3%）患有乳房淋巴水肿。报告腿部淋巴水肿的患者中，89.3%报告为双侧淋巴水肿。年龄较大的患者更有可能处于疾病的严重阶段，患有双侧淋巴水肿，并在过去六个月内经历过急性发作。
结论/意义：这项研究代表了埃塞俄比亚首次对 LF 和鹅卵石足进行的社区范围的综合临床病例映射。它突出了大量的病例，特别是可能归因于这两种疾病的腿部淋巴水肿病例。这些关键的临床信息将有助于并指导资源分配到最需要的地方。
