Children at risk for podoconiosis report inaccurate risk factors

Although podoconiosis — otherwise known as nonfilarial elephantiasis, or ”mossy foot” — is a common and preventable disease in areas of Ethiopia where it is endemic, children from families genetically predisposed to the disease reported inaccurate beliefs regarding its risk factors and prevention.

“Previous studies among adults in communities endemic for podoconiosis have reported a higher level of misconceptions regarding the cause and prevention of podoconiosis,”Abebyehu Tora, MA, from Addis Ababa University in Ethiopia, and colleagues wrote. “The beliefs that podoconiosis is contagious, caused by worms in the soil, indiscriminately inherited among relatives, caused by evil eye, curse, witch or cold weather were found to have negative consequences on preventive behavioral choices.”

To evaluate whether school-aged children who were members of families affected by podoconiosis shared these beliefs about risk factors, Tora and colleagues conducted a cross-sectional qualitative study in Wolaita Zone, Southern Ethiopia in March 2016. The researchers led focus group discussions and more in-depth individual interviews that included 117 children between the ages of 9 and 15 years, each of whom had a family member affected by podoconiosis.

According to the survey, many of the children thought that barefoot exposure to dew, worms, snake bites, frog urine, other poisons and contact with infected individuals increased their risk for developing the infection, despite the inaccuracy of these beliefs. Along with their weak understanding of risk factors, these children also did not comprehend how genetics and barefoot exposure to mineral particles contributed to contracting the disease.

Although most children understood that using footwear and washing their feet regularly could prevent infection, some believed that forces such as evil eye, curses, witches or cold weather, were uncontrollable risk factors for infection. The most frequently cited reason for not maintaining preventive measures included being uncomfortable in footwear, a shortage of footwear and poor adaptability of footwear for farm activities and sports, and a shortage of soap for washing. The children also believed that they did not have the self-efficacy to implement these behaviors with these barriers in mind.

“A health education intervention with culturally and linguistically appropriate genetics information for adults suggests the possibility of enhancing genetic literacy in low income rural settings,” Tora and colleagues wrote. “School-aged children may also benefit from similar health education interventions tailored to their cognitive scope.” — by Katherine Bortz

Disclosure: The researchers report no relevant financial disclosures.