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GepubliceerdJozef van der Linden Laatst gewijzigd meer dan 8 jaar geleden
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What is Podoconiosis? - 1 Non-infectious elephantiasis (“swelling of limb like an elephant’s”) caused by long term exposure of bare feet to irritant soil. The most neglected tropical disease?
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What is podoconiosis? (1) Non-filarial elephantiasis Non-infectious Caused by long term exposure of bare feet to irritant soil The most neglected tropical disease?
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What is podoconiosis? (2) ‘Gene + soil exposure = disease’ Susceptible people who go barefoot have high risk
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Differential diagnosis Filarial lymphedema Asymmetrical Also upperleg (and elsewhere) Lowland
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Why is it important in Ethiopia? At least one million people affected in Ethiopia 5% prevalence in areas of irritant soil & subsistence farming Profound social stigma
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Countries where podoconiosis is endemic or has been described. Deribe K, Tomczyk S, Tekola-Ayele F (2013) Ten Years of Podoconiosis Research in Ethiopia. PLoS Negl Trop Dis 7(10): e2301. doi:10.1371/journal.pntd.0002301 http://www.plosntd.org/article/info:doi/10.1371/journal.pntd.0002301
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Podoconiosis: an issue across tropical Africa Other countries known to be affected: Uganda Kenya Tanzania Rwanda Congo (east) Cameroon (north-west)
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What can be done about podoconiosis? Podoconiosis is Preventable (if shoes are worn consistently) Treatable (using good foot hygiene, bandages, socks and shoes) People with podoconiosis can return to a full role in society.
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Prevention To PREVENT podoconiosis education through schools, kebeles, churches, mosques, events from young childhood: shoes
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What is Podoconiosis? - 1 Non-infectious elephantiasis (“swelling of limb like an elephant’s”) caused by long term exposure of bare feet to irritant soil. The most neglected tropical disease?
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Treatment To TREAT people with podoconiosis foot hygiene, soap, antiseptic, ointment, pressure bandages, socks and shoes different clinics different programs
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Foot Hygiene Wash feet with soap and soak in clean, cool water with antiseptic berekina (bleach), aceto, eucalyptus, neem, gentianviolet,salt which is the best antiseptic/antifungal ?????
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Skin care
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Medische behandeling Antibiotica: alleen bij erysipelas Chirurgie: alleen evt. nodulectomie (dun-gesteelde noduli : afbinden)
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Elevation & Movement Ankle circles & calf raises to improve lymphatic circulation Raise end of bed with a brick Elevate leg on small stool when sitting
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Zwachtels/kousen Doel: in sokken/schoenen passen Patientenselectie: schoon, moeten schoenen (kunnen) dragen moeten het zelf kunnen/willen doen wegdrukbaar oedeem? Instructie: startmeting, maandelijks vervolgen moet strak voelen, geen pijn voor de nacht af, voor de dag om bij problemen (pijn) onmiddellijk af en retour kliniek
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Zwachtels? Ethiopische zwachtels (firma Asmi): te veel stretch, maar toch wel resultaat duur: € 3,32 per 4 (1 persoon) nog niet in Nekemte? Nederlandse zwachtels: nadeel: persoonlijke import, te weinig voordeel: “gratis” juxta fit/lite: makkelijk??
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Simple Treatment is Effective Before After
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Summary Podoconiosis is NOT INFECTIOUS – no virus, bacterium or parasite is responsible Podoconiosis is PREVENTABLE – by avoiding contact with irritant soil, primarily by wearing shoes Podoconiosis is TREATABLE – using simple measures, for which patients can take responsibility
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Simple Treatment is Effective Before After
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