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Decades Of Walking Barefoot In Volcanic Soil Linked To Elephantiasis Outbreak In Uganda

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Elephantiasis is a painful and debilitating condition typically caused by a microscopic parasitic worm about the width of a human hair.

This worm becomes embedded in the host's lymph nodes, resulting in an accumulation of bodily fluid that would normally be drained by the lymphatic system.

This form of elephantiasis, called lymphatic filariasis, is spread from person to person through mosquito bites and leads to swollen limbs, thickened skin, ulcers, and infections.

According to the U.S. Centers for Disease Control and Prevention, lymphatic filariasis is one of the leading causes of permanent disability worldwide. This disfiguring disease leaves people unable to work to sustain themselves or even move easily.

A recent outbreak of elephantiasis in western Uganda was found, however, to be originated by something else.

Elephantiasis Caused By Exposure To Volcanic Rock Crystals

After failing to discover any traces of the worm, researchers from the Makerere University in Kampala, Uganda, working together with the Uganda Ministry of Health, the World Health Organization, and the CDC, observed that the affected patients had only one thing in common: a history of farming in volcanic soil without wearing shoes.

The new cases of elephantiasis were identified in a remote community living at an altitude of 4,000 feet in the foothills of the Kamwenge District. Until now, this region hadn't been flagged as a risk area for the inflammatory disease.

This dry region, which is only showered by roughly 4 feet of rain throughout the year, has a particular type of soil, made up of fragmented volcanic rocks dating back 2.5 million years ago.

This volcanic soil retains irritant mineral crystals that can penetrate the skin, causing itching, pain, scarring, and swelling in repeated cycles of inflammation.

Locals from the isolated village attested to working barefoot on their farms, which led researchers to believe all 52 patients were in fact suffering from podoconiosis, another form of the disease.

Triggered by prolonged exposure of the soles to volcanic soil, this type of elephantiasis produces a build-up of scar tissue that eventually blocks lymphatic vessels, resulting in heavy swelling and open sores in the lower legs.

The researchers detailed their findings in a paper, published April 10 in The American Journal of Tropical Medicine and Hygiene.

Podoconiosis Outbreak Can Be Stopped By Wearing Shoes

Podoconiosis is not an infectious disease and its early symptoms (pain, itching, and swelling) are easily dismissed as normal signs of exertion consistent with working on a farm.

This means "people can be suffering from podoconiosis for decades before it becomes obvious that they are developing elephantiasis," explains Christine Kihembo, study lead author and epidemiologist at Makerere University, in a statement.

Kihembo, who also works with the Ugandan Ministry of Health, believes these farmers have been "probably suffering silently without help for more than 30 years," ever since they moved in the area and became exposed to the volcanic soil.

WHO reports the disease is widely spread across Africa, with at least a million documented cases in Ethiopia and more than half a million in Cameroon. The surest way to prevent podoconiosis is regular foot hygiene, doubled by wearing shoes at all times.

Nevertheless, proper care can be difficult to follow in poor, rural areas, notes Kihembo, who admits that people living in these communities face "many hardships, and going barefoot is not generally viewed as one of them."

The stigma of this condition fuels even more isolation, and lack of information on the causes of the disease leaves podoconiosis undiagnosed and untreated. The people affected by it are at risk of developing "secondary infections due to the ulcers on the skin," accelerating the decline of their health.

To raise awareness about podoconiosis detection and treatment, a public health education campaign is now underway in the region, to inform locals about the importance of better foot hygiene.

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