Assessment of Etiology of Elephantiasis and Its Associated Risk Factors in Jeldu District, West Shoa, Ethiopia

Abstract

Elephantiasis is the main cause of tropical lymphoedema in Ethiopia. The aim of the current study was to assess the etiology of elephantiasis and its associated risk factors. Cross-sectional community-based study was carried out from March to May 2020 in seven purposively selected villages of Jeldu district. Identified suspected cases of elephantiasis in those villages were interviewed, clinically observed, and serologically examined using filariasis test strip kits at their respective houses during day time. A midnight blood sample was obtained from all FTS positive cases for microscopic examination of Wuchereria bancrofti larva, microfilariae. From a total of 105 identified elephantiasis cases, 69.5% were podoconiosis cases and 30.5% were LF cases. Among 32 serologically positive cases, only 15.6% cases were found positive by parasitological blood diagnosis. Considerable cases of podoconiosis (37%) were at age range 26–40 years, whereas smallest cases (16.4%) were at 10–25 years. Among cases of podoconiosis and LF, 77 subjects have been developed overt chronic leg(s) swelling; 85.7% of them showed bilateral swelling below knee and 14.3% of them showed unilateral swelling with stage II swelling 41.1%. Regarding risk factors, odds of podoconiosis was greatly lower in participants who washed their legs daily when compared to those who washed their legs sometimes ( $P=0.002$ ). Odds of LF was higher in people who used bed nets/IRS and they were more protected than those who did not use bed nets/IRS ( $P=0.03$ ). Odds of LF was high in cases farming besides rivers and/or perform irrigation work ( $P=0.003$ ). The highest silicon concentration 4.65 mg/10 gm in Urgaha is coinciding with the highest podoconiosis cases (23.3%) of the village. Family history was a significant risk factor for the disease ( $P\le 0.001$ ). Age (26–40 years), sex, and leg hygiene were also strong risk factors. Both etiologies of elephantiasis, LF and podoconiosis, are geographically overlapped in Jeldu district.