Prevalence of podoconiosis and its associated factors in the Dawuro Zone, Southwest Ethiopia: community-based cross-sectional study

Abstract

Background Podoconiosis a non-infectious geochemical ailment that predominantly affects barefoot subsistence farmers in prolonged contact with irritant red clay soil of volcanic origins, primarily impacting the lower limbs. This condition manifests in the absence of parasitic infection and is thus referred to as endemic non-filarial elephantiasis; it is a completely preventable non-communicable tropical disease. This study aimed to assess the prevalence of podoconiosis and to identify associated factors within the population in the Dawuro Zone, Southwest Ethiopia. Methods A community-based cross-sectional study was conducted on selected households (participants) from designated woredas from September 2024 to June 2025. The heads of the households were interviewed using a structured questionnaire, and every individual within the household was examined for the clinical manifestations of podoconiosis by experienced, trained data collectors. Binary and multiple logistic regression analyses were performed. The strength of associations was expressed using adjusted odds ratios (AORs) with 95% confidence intervals (CIs). A p-value < 0.05 was considered statistically significant. Result The prevalence of podoconiosis in the Dawuro Zone was 11.6% (40 cases). A higher prevalence was observed among individuals aged 25–34 years (3.5%) and >45 years (3.2%), as well as among men (9.0%) compared to women (2.6%). Farmers (5.2%) were more affected. Rural residents (7.2%) had a higher burden than urban residents (4.3%). In the multivariate analysis, occupational status (AOR = 8.1, 95% CI: 1.75–37.4, p < 0.001), low family income (<1,000 ETB) (AOR = 3.10, 95% CI: 0.78–10.44, p = 0.047), foot hygiene practices (AOR = 5.7, 95% CI: 1.56–20.96, p = 0.008), a lack of knowledge about the cause of podoconiosis (AOR = 6.1, 95% CI: 0.75–49.35, p = 0.003), and the presence of stigma within the community (AOR = 7.75, 95% CI: 1.22–49.3, p = 0.004) showed strong independent associations. Conclusion This study revealed that podoconiosis remains a significant public health problem in the Dawuro Zone, Southwest Ethiopia. The disease was strongly associated with socio-demographic, environmental, and behavioral factors, particularly rural residence, barefoot exposure, poor foot hygiene, low income, and living in highland areas with irritant soil. Limited awareness of podoconiosis, low levels of preventive practices, and extremely poor treatment-seeking behavior further contributed to the persistence of the condition in the community.