Tora Abebayehu, Tadele Getnet, Aseffa Abraham, McBride Colleen M, Davey Gail
Department of Sociology, College of Social Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Department of Sociology, College of Social Sciences, Wolaita Sodo University, Sodo, Ethiopia.
PLoS Negl Trop Dis. 2017 May 25;11(5):e0005564. doi: 10.1371/journal.pntd.0005564. eCollection 2017 May.
Several studies have suggested investigation of health beliefs in children to be an important pre-condition for primary prevention of disease. However, little effort has been made to understand these in the context of podoconiosis. This study therefore aimed to explore the health beliefs of school-age rural children in podoconiosis-affected families.
METHODOLOGY/PRINCIPAL FINDINGS: A cross sectional qualitative study was conducted in March 2016 in Wolaita Zone, Southern Ethiopia. Data were collected through in-depth individual interviews (IDIs) and focus group discussions (FGDs), with a total of one hundred seventeen 9 to15-year-old children recruited from podoconiosis affected families. The study revealed various misconceptions regarding risk factors for podoconiosis. Most children believed barefoot exposure to dew, worms, snake bite, frog urine, other forms of poison, and contact with affected people to be major causes of the disease. Their knowledge about the role of heredity and that of long term barefoot exposure to irritant mineral particles was also weak. Though most participants correctly appraised their susceptibility to podoconiosis in relation to regular use of footwear and foot hygiene, others based their risk perceptions on factors they think beyond their control. They described several barriers to preventive behaviour, including uncomfortable footwear, shortage and poor adaptability of footwear for farm activities and sports, and shortage of soap for washing. Children also perceived low self-efficacy to practice preventive behaviour in spite of the barriers.
CONCLUSION/SIGNIFICANCE: Health education interventions may enhance school-age children's health literacy and be translated to preventive action. Overcoming practical challenges such as shortage of footwear and other hygiene facilities requires other forms of interventions such as livelihood strengthening activities. Linking podoconiosis-affected families with local governmental or non-governmental organizations providing socio-economic support for households may assist school-age children in those families to sustainably engage in preventive behaviours.
多项研究表明，调查儿童的健康观念是疾病一级预防的重要前提条件。然而，在足分枝菌病方面，人们对这些观念的了解甚少。因此，本研究旨在探讨受足分枝菌病影响家庭中农村学龄儿童的健康观念。
方法/主要发现：2016年3月在埃塞俄比亚南部的沃莱塔地区进行了一项横断面定性研究。通过深入个人访谈（IDI）和焦点小组讨论（FGD）收集数据，共从受足分枝菌病影响的家庭中招募了117名9至15岁的儿童。该研究揭示了对足分枝菌病危险因素的各种误解。大多数儿童认为赤脚接触露水、蠕虫、蛇咬、青蛙尿液、其他形式的毒物以及与患病者接触是该病的主要病因。他们对遗传作用以及长期赤脚接触刺激性矿物颗粒作用的了解也很薄弱。尽管大多数参与者正确评估了他们在定期使用鞋类和足部卫生方面患足分枝菌病的易感性，但其他人则将他们的风险认知基于他们认为无法控制的因素。他们描述了预防行为的几个障碍，包括不舒服的鞋类、用于农场活动和运动的鞋类短缺及适应性差，以及用于洗涤的肥皂短缺。尽管存在这些障碍，儿童也认为自己实施预防行为的自我效能较低。
结论/意义：健康教育干预措施可能会提高学龄儿童的健康素养，并转化为预防行动。克服诸如鞋类和其他卫生设施短缺等实际挑战需要其他形式的干预措施，如加强生计活动。将受足分枝菌病影响的家庭与为家庭提供社会经济支持的地方政府或非政府组织联系起来，可能有助于这些家庭中的学龄儿童可持续地参与预防行为。
