Podoconiosis, a neglected lymphatic tropical disease

Podoconiosis causes a painful massive swelling of the lower limbs, bilaterally and asymmetrically. It is caused by exposure to particles common in soils of volcanic origin and is second only to lymphatic filariasis as the leading cause of tropical lymphoedema. An estimated 4 million people live with podoconiosis globally in 32 potentially endemic countries. Podoconiosis is associated with positive family history of podoconiosis, bare foot, gender, poor housing condition, foot hygiene, income and educational status of the affected patients. There are also cultural barriers involved in maintaining a high epidemiology of the disease. Podoconiosis was never been prioritized either in intervention or research programmes. This may be due to the lack of resources for new health initiatives, which is a common problem in the low-income tropical countries in which this disease is present. Only Ethiopia, Cameroon, and Rwanda report podoconiosis within their routine health management information systems.We believe that comprehensive podoconiosis control strategies such as promotion of footwear and personal hygiene are urgently needed in endemic countries in the African Region. Mapping, active surveillance and a systematic approach to the monitoring of disease burden must accompany the implementation of podoconiosis control activities.