Rwanda: Up to 7,000 Rwandans Affected By Non-Infectious Elephantiasis – WHO

An estimated 7,000 people in Rwanda are affected by podoconiosis, a non-infectious form of elephantiasis caused by long-term contact with irritant red clay soil of volcanic origins, according to the World Health Organisation (WHO).

The neglected tropical disease is responsible for an estimated four million cases of leg swelling (lymphedema) in highland tropical and sub-tropical areas of 17 countries in Africa, Central and South America, and South and South-East Asia.

WHO noted that out of the 17 countries in which there is evidence of Podoconiosis, 12 are in Africa, three are in Latin America, and two are in Asia.

“Tropical African countries bear the highest disease burden with about 1.5 million people living with podoconiosis in Ethiopia, a further 40,000 in Cameroon, 9,000 in Kenya, and 7,000 in Rwanda,” WHO’s report read.

The disease mostly affects poor, remote, subsistence farming communities.

It causes avoidable disability through swollen, deformed feet and lower legs and painful acute attacks that render patients bedbound for 3-5 days each episode.

Podoconiosis is both preventable and treatable. “Prevention is through avoiding contact with irritant soil by wearing footwear, covering house floors, and paving roads,” the WHO said.

“Treatment using a holistic lymphedema management package has been demonstrated to decrease swelling, disability, and incidence of acute attacks, improve quality of life, and can be readily mainstreamed into government community health services,” it added.

According to the WHO, the average age at first noticing leg swelling is 25 years, and the disease is common up to the sixth decade.

The disease is more common in women; a recent meta-analysis concluded that the likelihood of Podoconiosis among women was 1.15 times greater than among men.

Early symptoms of the disease include a burning sensation and itching on the back of the feet. Skin thickening is accompanied by some growths around the sides of the feet and the heel.

“Reversible foot and lower leg oedema (swelling) later becomes fixed and gradually progresses up the leg. Swelling is bilateral but often asymmetrical and the swelling is mostly limited to below the knees. Nodules and maceration between toes are common,” the WHO says.

Treatment and care