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Podoconiosis - Subsistence Farmers
Brighton & Sussex Medical School

Current research: The Elimination of Podoconiosis


The elimination of podoconiosis

The Wellcome Trust Brighton and Sussex Centre for Global Health Research acts as an international, multidisciplinary, research hub for podoconiosis. Our multidisciplinary approach includes research into the epidemiology, immunology, mineralogy, genetics, bioethics, economics, education, clinical management and social impact of podoconiosis.

Podoconiosis - Treatment

Introduction

Podoconiosis, also known as ‘podo’, is a non-filarial form of elephantiasis endemic to the tropical, highland areas of Africa, central America and Asia, affecting an estimated four million people in Africa alone. The disease is caused by a reaction to the volcanic soils unique to these regions and symptoms include swelling and disfigurement of the feet and lower legs.

It is most prevalent in the subsistence farming communities who spend the majority of their time working barefoot in these irritant soils. Years of exposure can result in debilitating mobility issues, affecting a person's earning ability and local stigmatisation of the disease results in them, and even their entire families, being ostracised from their communities.

Professor Gail Davey came across cases of podoconiosis, which had been largely forgotten as a tropical disease in western medicine, in Ethiopia’s southern districts in 2001 while working in the School of Public Health at Addis Ababa University. She began building a PhD Public Health programme, encouraging further research into the disease, with the long-term aim of finding a way to eradicate it globally.

The centre encourages collaboration between researchers in Europe and the United States and those in endemic countries; provides funding opportunities for researchers in low- and middle-income countries; advocates for the prioritisation of the treatment of podoconiosis at regional, national and international levels; and promotes the dissemination of knowledge and retention of experts within endemic countries.


Areas of research

To date, research has mapped the distribution and defined the burden of podoconiosis in Ethiopia in terms of prevalence, economic cost and social and mental health impact. Aetiological research has identified genetic variants conferring susceptibility and plausible mineral triggers of the disease.

Clinical staging, stigma and quality of life tools have been developed, and co-endemicity with other neglected tropical disease documented. Behavioural work has identified common misconceptions about the condition and barriers to healthcare access. A simple treatment package has been tested, and strategies of delivering this package piloted. 

Future strategy

Research priorities over the next four years include global mapping of podoconiosis, investigation of the immunology and pathogenesis of the disease, development of a point-of-care diagnostic test, and investigation of approaches to integrating care into state health systems, together with care of other foot-related diseases.


Awards

Current Awards

a)      Research

2016-2019    Wellcome Trust PHATIC Intermediate Fellowship for Kebede Deribe. ‘The Global Atlas of Podoconiosis’. £660,064.

2016-2017    Association of Physicians of Great Britain & Northern Ireland. A new view for Ophthalmology in Amhara, Ethiopia. £8.490.

2015-2018    University of Sussex International Research Partnerships and Networks Fund. Tackling podoconiosis in central America. £36,613.

2014-2016    H3Africa Enhancing Ethiopian youths’ literacy about the gene x environment contributions to health using the context of podoconiosis. $149,214.

2013-2017    University of Sussex Chancellor’s International Research Scholarship for Henok Negussie. ‘Defining and managing acute adenolymphangitis in podoconiosis lymphoedema in Northern Ethiopia’. £48,600.

2013-2017    MRC/DfID/Wellcome Trust. RCT of podoconiosis treatment in northern Ethiopia. £791,000.

2013-2017 MRC NTD Highlight Project Grant. Discovering podoconiosis susceptibility genes: from molecules to disease control for a 'neglected' NTD £504,188. 

 

b)      Intervention

2016-2018    Izumi Foundation. Gondar Podoconiosis Prevention & Treatment Project. $100,000.

2014-2017    UK BIG Lottery. PREVENTING PODO PROJECT: Expanding Podoconiosis Interventions in Ethiopia. Lottery grant £499,078 of total project £2,214,745.   

2014-2016    Start Something That Matters Foundation, to New Venture Fund to support Footwork: International Podoconiosis Initiative. $500,000