Burden of podoconiosis in poor rural communities in Guliso woreda, western Ethiopia

Background. Podoconiosis is an environmental lymphoedema affecting people living and working barefoot on irritant red clay soil. Podoconiosis is relatively well described in southern Ethiopia, but remains neglected in other parts of the Ethiopian highlands. This study aimed to assess the burden of podoconiosis in rural communities in western Ethiopia. Methodology/Principal Findings. A cross-sectional study was conducted in Gulliso woreda (district), west Ethiopia. A household survey in the 26 rural kebeles (villages) of this district was conducted to identify podoconiosis patients and to measure disease prevalence. A more detailed study was done in six randomly selected kebeles to describe clinical features of the disease, patients’ experiences of foot hygiene, and shoe wearing practice. 1,935 cases of podoconiosis were registered, giving a prevalence of 2.8%. The prevalence was higher in those aged 15 – 64 years (5.2%) and in females than males (prevalence ratio 2.6:1). 90.3% of patients were in the 15 – 64 year age group. In the detailed study, 335 cases were interviewed and their feet assessed. The majority of patients were farmers, uneducated, and poor. Two-third of patients developed the disease before the age of thirty. Almost all patients (97.0%) had experienced adenolymphangitis (ALA - red, hot legs, swollen and painful groin) at least once during the previous year. Patients experienced an average of 5.5 ALA episodes annually, each of average 4.4 days, thus 24 working days were lost annually. The incidence of ALA in podoconiosis patients was higher than that reported for filariasis in other countries. Shoe wearing was limited mainly due to financial problems. Conclusions. We have documented high podoconiosis prevalence, frequent adenolymphangitis and high disease-related morbidity in west Ethiopia. Interventions must be developed to prevent, treat and control podoconiosis, one of the core neglected tropical diseases in Ethiopia

Iodine status in pregnant women and school children of the Aira district in Ethiopia

Iodine deficiency is a public health problem in Ethiopia. This study was conducted to investigate the iodine status of pregnant women and school children of Aira district, west Ethiopia. A school-based survey of children and a clinic-based assessment that focused on pregnant women were conducted from May to June 2014. Spot urine and salt samples were collected and their iodine concentrations determined by an ammonium persulfate test and titration, respectively. Qualitative information was obtained by focus group discussions and individual interviews. The median urinary iodine excretion found in school children (n = 73) and pregnant women (n = 40) were 70.5 μg/l (95% CI, 48.1 μg/l–83.8 μg/l) and 88.6 μg/l (95% CI, 66.9 μg/l–113.5 μg/l), respectively. About 72.6% of the school children and 80% of the pregnant women had insufficient iodine intake. 67% of household salt samples (n = 46) contained iodine ˂15 ppm. In addition to its health consequences, iodine deficiency has negative social impacts. A deformed physical appearance (with clinical signs of goitre) entails psychological tensions, and is also considered to reduce chances for marriage. Iodine levels both in urine and salt samples indicated that the majority of school children and pregnant women from this study were at risk of iodine deficiency disorders. Thus, raising awareness about the nutritional importance of iodized salt and its proper packaging with sealed containers which reduce iodine loss should be promoted

The relationship between paediatric calcaneal quantitative ultrasound measurements and dual energy X-ray absorptiometry (DXA) and DXA with laser (DXL) as well as body composition

Background: Quantitative ultrasound (QUS) is a quick, non-invasive and inexpensive method to measure bone strength. Moreover, the device is portable, which makes it easy to be used in the field. In contrast to other bone measuring techniques, QUS does not use any ionised radiation. However, the validity of QUS in the measurement of bone health and the relationship between QUS output and body composition have not been assessed in very young children. Objective: To investigate the relationship between paediatric calcaneal QUS and both dual-energy X-ray absorptiometry (DXA) and calcaneal DXA with laser (DXL) and body composition parameters. Subjects: A total of 37 Belgian children (10 boys and 27 girls; 4 to 8 years old) underwent a calcaneal QUS as well as a DXA scan. A total of 24 Swedish children (15 boys and 9 girls; 3 to 5 years old) underwent a calcaneal QUS as well as a heel DXL scan. The height and weight of all children were measured. Results: The QUS stiffness index (SI) was significantly negatively correlated with bone mineral density (BMD) of the total body (r = -0.370, P = 0.02). No significant correlations were found between the SI and DXL results. In the total sample, the SI showed a significant positive correlation with body mass index (BMI) (r = 0.298, P = 0.02), even after correction for age, gender and centre. In the Belgian sample, the SI was also significantly positively correlated with total body fat mass content (r = 0.416, P = 0.01) and body fat percentage (r = 0.566, P < 0.01) obtained by whole-body DXA. Conclusion: The SI measured by QUS does not correlate significantly with BMD values measured by DXA or DXL in 3- to 8-year-old children. However, there is a significant positive correlation between SI and BMI and body fat %. International Journal of Obesity (2011) 35, S125-S130; doi:10.1038/ijo.2011.4