The Prevalence and Etiology of Lymphedema among Residents of  Mt. Elgon Sub-county and its Environs in Bungoma County, Kenya

Abstract

Lymphedema is characterized by swollen lower limbs, arms and genitalia. Possible causes are filarial worm infection transmitted by infected mosquitoes, or it can be of non-filarial worm aetiology and may be due to some elements in red clay soils derived from volcanic deposits which penetrates exposed people causing lymphedema. Some cases presenting with lymphedema symptoms have been observed in medical health facilities in Mt. Elgon region in Bungoma County. However, information on its prevalence and etiology is lacking. We conducted an observational cross-sectional field survey in Kaptama, Kaborom, Kapsokwony, Cheptais, Kamasielo, Kamusinde and Kimilili wards to determine the prevalence and etiology of lymphedema. Human blood and mosquito specimens from the study areas were examined for filarial worm infection. Soil samples from the study areas were analyzed for suspected constituent elements. The study revealed low prevalence (17.4 per 100,000) of lymphedema with 38 cases being recorded in the assessed study sites. The distribution of the lymphedema cases in the wards differed significantly (χ2 = 15.76, d.f. =3, p = 0.0013) with significant (χ2 = 17.64, d.f. =1, p< 0.0001) majority being female, 27(71.05%) compared to male, 11(28.95%). All the human cases and the mosquito samples tested negative for filarial worm infection. The suspected irritant soil elements that can cause lymphedema, including Silicon, Aluminium, Magnesium, Sodium, Potassium and Iron were all present in the soil although their concentration varied from one study area to another. The study concluded that the observed lymphedema in the study area is of low prevalence caused by non-filarial worm etiology and is most likely caused by the irritant soil elements. We recommend for further research to explore the specific responsible element(s), alternative etiologies and the potential co-morbidities risks associated with lymphatic disorders in the study area. Risk factors awareness will improve residents understanding and better management of lymphedema in the community.