부산대학교 도서관

Podoconiosis is a type of tropical lymphedema that causes massive swelling of the lower limbs. The disease is associated with both economic insecurity, due to long-term morbidity-related loss of productivity, and intense social stigma. The geographical distribution and burden of podoconiosis in Africa are uncertain. We applied statistical modelling to the most comprehensive database compiled to date to predict the environmental suitability of podoconiosis in the African continent. By combining climate and environmental data and overlaying population figures, we predicted the environmental suitability and human population at risk of podoconiosis in Africa. Environmental suitability for podoconiosis was predicted in 29 African countries. In the year 2020, the total population in areas suitable for podoconiosis is estimated at 114.5 million people, (95% uncertainty interval: 109.4–123.9) with 16.9 million in areas suitable for both lymphatic filariasis and podoconiosis. Of the total 5,712 implementation units (typically second administrative-level units, such as districts) defined by the World Health Organization in Africa, 1,655 (29.0%) were found to be environmentally suitable for podoconiosis. The majority of implementation units with high environmental suitability are located in Angola (80, 4.8%), Cameroon (170, 10.3%), the DRC (244, 14.7%), Ethiopia (495, 29.9%), Kenya (217, 13.1%), Uganda (116, 7.0%) and Tanzania (112, 6.8%). Of the 1,655 environmentally suitable implementation units, 960 (58.0%) require more detailed community-level mapping. Our estimates provide key evidence of the population at risk and geographical extent of podoconiosis in Africa, which will help decision-makers to better plan more integrated intervention programmes. Author summary: Podoconiosis is one of the major causes of tropical lymphedema and results in massive swelling of the lower limbs. It is caused by exposure to mineral particle-induced inflammation among genetically susceptible individuals. People affected by the disease often suffer both physical and psychological comorbidities, which can include painful swelling, distress, depression, stigma and discrimination. In spite of its presence among some African countries, its geographical distribution and burden in Africa are uncertain. We applied statistical modelling to the most comprehensive database compiled to date to predict the environmental suitability of podoconiosis in the African continent. By combining climate and environmental data (elevation, annual precipitation, land surface temperature, vegetation index, and soil characteristics such as clay and silt fraction) and overlaying population figures, we predicted both the environmental suitability as well as the human population at risk for podoconiosis in Africa. Environmental suitability for podoconiosis was predicted in 29 African countries. Our estimates provide key evidence that will help decision-makers to better plan more integrated intervention programmes. [ABSTRACT FROM AUTHOR]