Prevention
Elimination of podoconiosis relies on prevention with widespread shoe implementation, stringent foot hygiene, and floor coverings. Community-based initiatives are crucial to achieving elimination of this disease. In Ethiopia, The Mossy Foot Treatment and Prevention Association (now Mossy Foot International) works to transform patients into community podoconiosis agents who in turn visit patients, teach basic treatment techniques such as foot hygiene, and educate families about the disease. This model has been adapted by several other non-government groups as they have started programs in other regions of Ethiopia. Treatment
The cornerstone of prevention and treatment of podoconiosis is avoidance of exposure to irritant soils. Wearing shoes in the presence of irritant soils is the primary method of exposure reduction. In Rwanda, a country of high disease prevalence, the government has banned walking barefoot in public, in order to prevent podoconiosis and other soil-borne diseases. Increasing the availability of footwear must be coupled with education on the benefits of wearing shoes as cultural influences, such as barefoot traditions, can hinder widespread use of footwear.Once the disease has developed, rigorous foot hygiene including daily washing with soap and water, application of an emollient, and nightly elevation of the affected extremity has been shown to reduce frequency of acute attacks. Nodules will not resolve with these conservative measures, although surgical removal of the nodules can be performed. Epidemiology
Podoconiosis is most frequently seen in the highland areas of Africa, India, and Central America. The highest prevalence is seen in Uganda, Tanzania, Kenya, Rwanda, Burundi, Sudan, and Ethiopia.
After examining the same tissue using electron microscopy, he was able to identify the presence of silicon, aluminum, and other soil metals both in the phagosomes of macrophages and adhered to the surface of lymphocytes. Price demonstrated that the lymphatic vessels of these patients experienced subendothelial edema and eventual collagenization of the lumen leading to complete blockage. He wrote a monograph on podoconiosis which was published after his death in 1990. Current situation
Podoconiosis is now recognised as one of the WHO Neglected Tropical Diseases, its importance as a public health problem is well recognised in Ethiopia. Footwork is a charity which bring together public and private partners to support prevention and treatment of podoconiosis. There is an active research group led by Gail Davey at the Wellcome Trust Brighton and Sussex Centre for Global Health Research which co-ordinates research worldwide. A recent article in The Lancet includes some excellent illustrations. References
External links
World Health Organization section on podoconiosis