Determinants of Podoconiosis among Adult Population in Dale Sadi District, Kellem Wollega, West Oromia, Ethiopia, 2023: A Community-Based Case-Control Study
Gemechu Kera, Lemi Abebe, Dagnechew Degefu, Michael Asmelash, Gatjiek Wei, Mehari Teka, Mebratu Abera Gurara
Citation: Gemechu Kera, Lemi Abebe, Dagnechew Degefu, Michael Asmelash, Gatjiek Wei, Mehari Teka, Mebratu Abera Gurara, "Determinants of Podoconiosis among Adult Population in Dale Sadi District, Kellem Wollega, West Oromia, Ethiopia, 2023: A Community-Based Case-Control Study", OAS Journal of Medical and Health Sciences, Volume 01, Issue 01.
Copyright: This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Podoconiosis is a non-communicable, geochemical neglected tropical disease causing bilateral lower limb swelling. It is entirely preventable through consistent shoe-wearing and foot hygiene, yet remains endemic in several Ethiopian highlands. This study aimed to identify determinants of podoconiosis among adults in Dale Sadi District, western Ethiopia.
Methods: A community-based unmatched case-control study was conducted from July 1 to August 30, 2023. Cases were clinically confirmed podoconiosis patients aged =15 years registered at three health centres, and controls were podoconiosis-free adults residing in adjacent households. Sample size was 522 (174 cases, 348 controls), calculated using Epi-Info with 80% power and a 2:1 ratio. Data were collected using structured, pretested interviewer-administered questionnaires and an observation checklist. After descriptive analysis, binary logistic regression identified variables associated with podoconiosis at p<0.25 for inclusion in multivariable analysis. Model fit was assessed with the Hosmer-Lemeshow test.
Results: A total of 516 participants (172 cases, 344 controls) were included (response rate 98.8%). In multivariable analysis, significant risk factors were: female sex (AOR = 3.12, 95% CI: 1.72–5.65), starting to wear shoes after age 10 years (AOR = 8.45, 95% CI: 4.32–16.52), barefoot during farming (AOR = 4.21, 95% CI: 2.18–8.13), living in a house with mud/earth floor (AOR = 3.67, 95% CI: 1.68–8.01), washing feet only when already dirty (AOR = 5.89, 95% CI: 3.14–11.04), and family history of podoconiosis (AOR = 2.74, 95% CI: 1.38–5.42). Current foot cleanliness and skin integrity were analysed separately as disease correlates, not as causal factors.
Conclusions: Modifiable behaviours—particularly delayed shoe-wearing, barefoot farming, and inadequate foot hygiene—are strong determinants of podoconiosis in this population. Women bear a disproportionate burden. Interventions should integrate shoe provision, housing improvement, and gender-sensitive health education into the primary health care system. Further longitudinal studies are needed to establish the temporal sequence of hygiene-related factors.
Keywords: Podoconiosis, Case-Control, Shoe-Wearing, Barefoot, Ethiopia, Neglected Tropical Disease.
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