WP5: Doxycycline for treatment of non-filarial LE due to podoconiosis – a randomised, placebo controlled pilot trial.

This task is designed to determine if a doxycycline treatment regimen will improve podoconiosis (non-filarial LE) condition, assess variation in vasculogenesis regulators before and after treatment with doxycycline and to collect skin swabs from treated individuals for microbiome study. Podoconiosis or non-filarial elephantiasis is a non-communicable disease that is acquired through prolonged exposure to red clay soils of volcanic origins when tiny silica crystals appear to be absorbed through the feet. The public health and socioeconomic importance of podoconiosis in rural areas is indicated by its debilitating effects, which prevent more severely affected persons from pursuing farming and other activities involving extensive walking with currently no available treatment options. In filarial LE, 200 mg/day doxycycline treatment for 6 weeks has previously been shown to halt or even reverse the progression of disease severity. As a proof-of-concept, the beneficial off-target effects of doxycycline observed in patients with filarial LE will be investigated using the current standard doxycycline treatment regimen to determine if an improvement of LE and/or halt in disease progression is also observed in non-filarial LE patients. This study will be led by Prof. Samuel Wanji.