02592nas a2200217   4500000000100000008004100001260002500042653001700067653003900084653001800123653001300141653001800154100001300172700001300185700001400198700001500212700001500227700001200242245014900254520197100403       2017                            d  bWiley Online Library10aPodoconiosis10aNeglected tropical diseases (NTDs)10aInterventions10aEthiopia10aEffectiveness1 aBrooks J1 aErsser S1 aCowdell F1 aGardiner E1 aMengistu A1 aMatts P00aA randomised controlled trial to evaluate the effect of a new skin care regimen on skin barrier function in those with podoconiosis in Ethiopia.3 a<p>Background<br />
Podoconiosis affects an estimated 3 million people in Ethiopia with a further 19 million at risk. Volcanic soil and pathogens enter skin breaches in the feet causing inflammation, lymphoedema and hyperkeratosis. There is no robust evidence on optimal podoconiosis skin care regimens to improve SBF.</p>

<p>Objectives<br />
To evaluate the effectiveness of a new, low-cost, evidence-based intervention to improve SBF in the lower limbs of those with podoconiosis.</p>

<p>Methods<br />
A randomized control trial (RCT) was conducted over 3 months in two podoconiosis clinics (n=193). The intervention comprised 2% glycerine (v/v) added to a reduced amount of soaking water. The control group received the current skin care regimen. Primary outcome measures were trans-epidermal water loss (TEWL) and stratum corneum hydration (SCH) at four specific sites on the lower limbs.</p>

<p>Results<br />
Improvement in SBF was observed in both groups across all measurement sites and time points, although this was significantly greater in the experimental group. TEWL reduced in both groups at all sites. For example, on top of the foot the estimated group difference in TEWL at the fourth visit was 1.751 (SE=0.0390) in favour of the experimental group (t=3.154, df=189.580, p=0.002, 95% CI (0.0656 to 2.846)), indicating a greater reduction in the experimental group. Similarly, at the same site the estimated group difference in SCH at the fourth visit was -2.041(CI=0.572) in favour of the experimental group (t=-3.565, df=186.739, p=&lt;0.001), 95% CI (-3.168 to -0.911)), indicating a greater increase in the experimental group. There were also significantly greater reductions in odour, number of wounds and largest foot circumference in the experimental compared to the control group.</p>

<p>Conclusions<br />
The addition of 2% glycerine (v/v) to a reduced volume (83% reduction) of soaking water significantly improved SBF</p>