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Elephantiasis, known as Podoconiosis, might also occur without parasitic infestations. Most rampant among poor farmers inside the central and eastern servings of the African continent, plus Central America, Podoconiosis, or Nonfilarial Elephantiasis, generally affects the reduced legs and feet with extremely painful swelling and cracks in the skin, that may be prevented by just wearing shoes in high altitude areas around volcanoes, where red clay and high alkaline content may enter and clog the lymphatic system with symptoms which could not appear for as many as three decades after doing so. In males, the scrotum could get enlarged and the male organ can get retracted under thick, non elastic skin that is hot and painful. Adults in the intestine may cause intestinal obstruction, penetration of the intestinal wall, occlusion of the bile duct, the pancreatic duct or the appendix, toxic effects (nausea, vomiting). Some common side effects can be seen generally like- constipation, dizziness, loss in appetite, pain burning or tingling inside the hands or feet, excessive tiredness, diarrhea, changes in sex drive or ability, shaking hands that you cannot control, vomiting, hyperhidrosis, dry mouth, gas or bloating, weight changes, drowsiness, excitement, difficulty in falling asleep or staying asleep, sore throat, nervousness, headache, upset stomach etc. You must also try to read the patient instructions and medication guide. The pain increases in intensity rapidly if surgical intervention is just not done in time the condition may become life threatening. Countries where Elephantiasis rates are most endemic include Ethiopia, Uganda, Tanzania, Egypt, Sudan, Kenya, Rwanda, and Burundi. Usually with proper treatment the tapeworm infection goes away. 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