02382nas a2200277   4500000000100000008004100001260003400042653002400076653005700100653002100157653001700178653002600195653001500221653003100236653002000267653001100287100002100298700001600319700001300335700001300348700001300361700001500374245016300389520152700552022002502079       2024                            d  bOxford University Press (OUP)10aInfectious Diseases10aPublic Health, Environmental and Occupational Health10aGeneral Medicine10aParasitology10aHeart and Sole Africa10alymphedema10aNeglected tropical disease10aQuality of Life10aRwanda1 aGebreselassie AF1 aShimelash N1 aKallon A1 aMkondo G1 aHuston T1 aSchurer JM00a‘We no longer experience the same pain’: a cross-sectional study assessing the impact of Heart and Sole Africa's podoconiosis prevention education program3 a<p><strong>Background:</strong> Podoconiosis is a non-infectious neglected tropical disease caused by long-term exposure to irritant volcanic soils. It results in severe physical, psychological and financial consequences. Heart and Sole Africa (HASA) is a non-governmental, community-based organization providing management to podoconiosis patients in Rwanda. We sought to analyze the impact of their program on the lives of patients.</p>

<p><strong>Methods:</strong> Quantitative surveys recorded the participants’ demographics, adherence to HASA's management recommendations and changes in quality of life (QOL). Qualitative questions were used to gather respondent perspectives on HASA programming.</p>

<p><strong>Results:</strong> We interviewed 127 patients from HASA's Musanze (n=47) and Burera (n=80) clinics. Almost all participants (98.4%) reported statistically significant (p&amp;lt;0.01) improvements in their QOL, and more than one-half (51.2%) had a favorable adherence score of &gt;80%. Qualitative feedback identified specific challenges to adherence and recognition of program success in symptom management.</p>

<p><strong>Conclusions:</strong> Our study demonstrated the value of community-based podoconiosis programming in improving the lives of patients. Practices such as regular feet washing, emollient application, shoe wearing and limb raising can result in a marked reduction of morbidity. Our findings support the argument for scaling up these management practices across Rwanda.</p>
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