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Precision maps reveal widespread distribution of disabling neglected tropical disease in Rwanda

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Precision maps reveal widespread distribution of disabling neglected tropical disease in Rwanda

The painful and stigmatising neglected tropical disease podoconiosis is widespread across Rwanda, according to the first mapping of the disease. All 30 districts have been found to be endemic for non-filarial elephantiasis, also known as podoconiosis, which affects the feet and lower limbs. 

More than a million people were screened for the disease across 30 districts, and cases of podoconiosis were found in all districts. An overall prevalence was established of 68.5 per 100,000 people, meaning an estimated 6,429 people throughout the country are living with the painful disease that brings widespread stigma.

The study, which mapped the entire country in 1x1 square kilometres, was published today in the journal Lancet Global Health. Mapping podoconiosis at precise local levels provides health providers, donors, programme planners and policymakers with insights into where to direct resources for effective intervention for the control of this disabling disease. 

Lead author Dr Kebede Deribe, Research Fellow at Brighton and Sussex Medical School, said: “Our data provides information on where the disease is prevalent and quantifies the number of cases. Having found podoconiosis across all districts in Rwanda, we need to now focus on ensuring that those suffering from it have access to treatment and preventing the occurrence of new disease.”

Podoconiosis is a non-infectious form of elephantiasis found in the tropical, highland areas of Africa, Central America and Asia, where the volcanic soil causes extreme painful swelling of the feet and lower limbs. It is most prevalent in subsistence farming communities, who spend their time working barefoot in these irritant soils. Years of exposure can cause debilitating disfigurement, affecting a person’s ability to work, and can result in them being ostracised from their families and communities. Yet it can be prevented and treated with simple interventions such as foot washing and wearing shoes. 

A population-based cross-sectional survey was conducted in Rwanda to determine the national prevalence of podoconiosis, screening a total of 1,360,612 individuals. Teams, which included a medical doctor, a nurse and a laboratory technician, visited participants who were interviewed, given a physical examination and two rapid diagnostic tests. Results were collated via smartphone.

Dr Deribe added: “Investing in data is critical – before this survey we did not know the actual burden and distribution of podoconiosis in Rwanda. Now healthcare planners can make evidence-based decisions and data-driven interventions. The findings presented here are intended to inform national level planning, monitoring and implementation of interventions. As the burden of podoconiosis in Rwanda is low compared with other countries, Rwanda could provide a very good example of a quick win over the disease, from which we could learn valuable insights to feed into the global podoconiosis strategy.”

The full article has been published by The Lancet Global Health.

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