Case Report and Literature Review: Podoconiosis in Southwestern Uganda
Philip Dwek
Department of Medicine, Western University, London, Ontario, Canada and Bridge to Health Medical and Dental, Canada.
Ling Yuan Kong
Bridge to Health Medical and Dental, Canada and Department of Medicine, McGill University, Montreal, Quebec, Canada.
Meghan Wafer
Department of Medicine, University College Cork, National University of Ireland, Cork, Ireland.
William Cherniak
Bridge to Health Medical and Dental, Canada and Department of Family and Community Medicine, University of Toronto, Toronto, Canada.
Romina Pace
Bridge to Health Medical and Dental, Canada and Department of Medicine, McGill University, Montreal, Quebec, Canada.
Isabelle Malhamé
Bridge to Health Medical and Dental, Canada and Department of Medicine, McGill University, Montreal, Quebec, Canada.
Dean Simonsky
Bridge to Health Medical and Dental, Canada and Department of Chemistry and Biology, Ryerson University, Toronto, Canada.
Geoffrey Anguyo
Bridge to Health Medical and Dental, Canada and Kigezi Healthcare Foundation (KIHEFO), Kabale, Uganda.
Eben Stern
Bridge to Health Medical and Dental, Canada.
Michael Silverman *
Bridge to Health Medical and Dental, Canada and Division of Infectious Diseases, Western University, London, Ontario, Canada.
*Author to whom correspondence should be addressed.
Abstract
Aims: This report presents one confirmed and two suspected cases of podoconiosis in the Kabale region of southwestern Uganda. Podoconiosis has not previously been described in Uganda outside of the eastern region bordering Kenya. The aim of this case report is to increase awareness of the condition in order to enhance prevention and treatment efforts.
Presentation of Cases: Podoconiosis is associated with chronic barefoot exposure to red volcanic soil, with greater prevalence in high-altitude, impoverished areas of the tropics. This report describes one confirmed case and two suspected cases. Case 1 was confirmed by a negative filarial antigen detection test. Cases 2 and 3 had negative filarial smears, but antigen detection kits were not available onsite at the time. However, the altitude at which all three patients live (>1500 masl) makes filarial disease unlikely.
Discussion: Podoconiosis has not been previously reported in the region, and thus may be under-diagnosed due to a low index of suspicion among clinicians. Using adequate footwear is an important component of prevention. However, limited financial resources present a significant barrier to the use of footwear. Understanding community attitudes towards causes and risk factors is also integral to effective prevention.
Conclusion: Podoconiosis has a high potential for elimination, as it is preventable and treatable in the early stages with consistent use of footwear and regular foot-washing. In addition, increased awareness among physicians and clinicians of the presence of the disease in this area can lead to early detection and treatment.
Keywords: Podoconiosis, Uganda, mossy foot, case report.