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about podoconiosis

Podoconiosis is a type of elephantiasis (leg swelling) found in subsistence farming communities in the tropics. It is an unusual disease, triggered not by any bacterium, virus or parasite, but by an abnormal reaction to irritant mineral particles found in soils of volcanic origins.

Many years of walking, ploughing or going barefoot on these clay soils appears to trigger inflammatory changes within the lymph system in the legs, then foot swelling, and after years of exposure to the mineral particles, elephantiasis.

It was the work of Dr Ernest Price, in the 1970s, that established the link between irritant soils and podoconiosis (pdf), but research is still necessary to establish precisely what the mineral trigger is.

Not everyone who lives and works on irritant soils without shoes becomes affected. Studies have shown strong ‘heritability’ of podo susceptibility, and current research is homing in on where the susceptibility genes might lie on the genome.

economic and social consequences

In a 2005 economic study, podoconiosis cost Ethiopia an estimated $208 million per year in lost productivity and medical costs. This level of impact multiplies across the number of endemic countries worldwide. It also has profound social impact – affected individuals are — for a variety of reasons — typically  barred from attending school, ostracised from social and religious events, and have difficulty finding marriage partners, marginalizing them with little prospect for a meaningful life as a contributing member of their communities.


Field experience and a pilot study suggest the effectiveness of simple, inexpensive lymphoedema management (foot hygiene [washing with water and antiseptic], emollient, bandaging, exercise/massage, and socks & shoes) in reducing swelling, improving clinical appearance and quality of life for podoconiosis patients. A formal trial of this treatment is planned.

Before treatmentAfter 3mo treatment


Dr Ernest Price, a British leprologist, suggested that podoconiosis was previously common in North Africa (Algeria, Tunisia, Morocco and the Canary Islands) and parts of Europe, but is no longer found in these areas since use of footwear has become the norm.

In highland volcanic areas (>1500m/5000ft), everyday foot washing and use of shoes or boots to protect feet against irritant soil is encouraged to help prevent podoconiosis. Research studies are planned to measure the effectiveness of various means of disease prevention.

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