03090nas a2200289 4500000000100000008004100001653003900042653001700081653001300098653002100111653002000132653001300152653001500165653001900180653002500199100001100224700001300235700001300248700001400261700001200275245012500287856009800412300001300510490000700523520225600530022001402786 2017 d10aNeglected tropical diseases (NTDs)10aPodoconiosis10aEthiopia10aHealth Education10aSchool children10aFootwear10aPrevention10aHealth beliefs10aQualitative Research1 aTora A1 aTadele G1 aAseffa A1 aMcBride C1 aDavey G00aHealth beliefs of school-age rural children in podoconiosis-affected families: A qualitative study in Southern Ethiopia. uhttp://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0005564&type=printable ae00055640 v113 a

BACKGROUND: 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.

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