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The Gastrointestinal Laboratory, The Rayne Institute, St Thomas’ Hospital, London SE1 7EH, UK
Podoconiosis, or non-filarial elephantiasis, was named and characterized by the late Ernest Price (Price 1988, 1990). He described the clinical features of swelling and deformity of the legs associated with enlargement of the draining lymph nodes. Histopathological examination of these nodes showed them to contain bi-refringent particles. He identified the epidemiological association between the local type of soil and the disease, and finally he confirmed this association by microanalysis of the particles in diseased tissue, showing them to be sub-micron aluminosilicate and silica, which are characteristics of the clay fractions of the local soil. It remains unclear what it is within the heterogeneous range of microparticles identified in tissue, and soil factors, that is responsible for the toxicity, and what are the host factors that determine certain individuals to be sensitive to them. Prevention of progression of the disease could be achieved by preventing further uptake of particles by using adequate footwear.
