Hematological profiles and preventive-practice characteristics among patients with podoconiosis: A case-control study in Musanze District, Rwanda

Abstract

Background Podoconiosis is a chronic, disfiguring, non-filarial form of lymphedema caused by prolonged barefoot exposure to irritant soil. An estimated four million people are affected globally, with cases documented in more than 32 countries, 18 of which are in Africa. In Rwanda, the disease affects an estimated 68.5 per 100,000 people across all districts. While literature on podoconiosis continues to grow, its hematological abnormalities remain relatively unexplored. Methodology/ Principal findings This case-control study aimed to investigate hematological profile in podoconiosis patients and associated factors. A total of 119 participants (50 cases and 69 controls), above 18 years old were enrolled. Data were collected at Heart and Sole Action clinic in Musanze, and laboratory analyses were conducted at INES-Ruhengeri Hematology Laboratory. Most participants were female, engaged in farming, and had no formal education. Podoconiosis patients were older than controls and demonstrated poor foot hygiene, inconsistent shoe use, and limited disease knowledge, with 40% reporting a family history and an average disease onset at 21.06 ± 13.15 years. Although the values for each patient fell within the normal reference range and no morphological abnormalities were observed on peripheral blood smears, quantitative differences were observed between cases and controls and revealed significantly reduced lymphocyte percentages, RBC indices (RBC, hemoglobin, hematocrit, MCHC). Conclusion/Significance These findings indicate systemic hematological difference likely linked to chronic immune activation, highlighting the importance of integrating hematological monitoring and targeted health education into podoconiosis prevention and management strategies. Future studies should also explore the link between blood alterations and disease severity.