ABSTRACT
Nonfilarial elephantiasis, renamed podoconiosis, has a worldwide distribution and causes considerable morbidity. Podoconiosis is more prevalent in Ethiopia than in any other part of Africa, and is spread over a larger area. The occurrence of podoconiosis among farming communities where people cultivate barefoot and by direct hoeing identifies the soil as the source of the disease. The soil found in the endemic areas is a red clay which is very slippery when wet and hardens and clings to the feet and legs if allowed to dry on them. The granulomata were surrounded by layers of lymphocytes, among which were dendritic cells, monocytes, mast cells, and often, numerous plasma cells. The present understanding of the disease and its relationship to geography and geology makes it possible to undertake effective control of podoconiosis. More generally it emphasizes the importance of geography in the discovery of the causes of a widespread disease.
