Interpretations of education about gene-environment influences on health in rural Ethiopia: the context of a neglected tropical disease

Tora, Abebayehu; Ayode, Desta; Tadele, Getnet; Farrell, David; Davey, Gail; McBride, Colleen M.

doi:10.1093/inthealth/ihw016

Cited by 14 publications

(18 citation statements)

References 24 publications

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“…Barefoot exposure to soil was also raised by children as a cause of podoconiosis though the role of mineral particles in the soil was mentioned infrequently. This is congruent with previous studies which reported poor knowledge of adult community members about mineral particles in the soil as a causal agent of podoconiosis [ 8 – 10 , 12 , 43 , 44 ]. Regarding preventive measures, children were well aware of the importance of footwear and foot hygiene.…”

Section: Discussionsupporting

confidence: 92%

Health beliefs of school-age rural children in podoconiosis-affected families: A qualitative study in Southern Ethiopia

et al. 2017

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BackgroundSeveral 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 findingsA 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/SignificanceHealth 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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Section: Discussionsupporting

confidence: 92%

Health beliefs of school-age rural children in podoconiosis-affected families: A qualitative study in Southern Ethiopia

et al. 2017

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“…The Tome Gerira and Sura Koyo kebeles were selected because neither had been targeted in previous studies of podoconiosis. 19 , 20 , 26 …”

Section: Methodsmentioning

confidence: 99%

A cross-sectional survey to assess the risk factors associated with stigmatizing attitudes towards patients with podoconiosis among rural youth in southern Ethiopia

Engdawork

Davey

Ayode

et al. 2020

Transactions of the Royal Society of Tropical Medicine and Hygiene

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Background Many health conditions are associated with stigma due to beliefs about their causes and the physical changes experienced by patients. Among such conditions are several neglected tropical diseases (NTDs). Podoconiosis, classified as an NTD, is a form of lymphoedema caused by the co-influence of genetic and environmental factors. It is a major public health problem in Ethiopia and is associated with intense stigma. Despite this, little is known about the factors contributing to stigmatizing attitudes against patients with the disease. Methods A cross-sectional survey was conducted in southern Ethiopia to analyse the attitudes of rural youth and associated risk factors for stigmatizing attitudes towards patients with podoconiosis, with the aim of informing stigma reduction strategies. Results The survey included 336 randomly selected youth. Of the 177 (52.7%) youth who held more stigmatizing attitudes toward patients with podoconiosis, 105 (59.3%) were females and 171 (96.6%) did not have affected friends. Accurate knowledge about gene–environment influences and rejection of infectious causes of podoconiosis were associated with less stigmatizing attitudes. Conclusions Improving understanding of the gene–environment interaction and dispelling beliefs about infectious causes may reduce negative attitudes about podoconiosis. Affected youth may play an important role as agents of change to spread non-stigmatizing messages.

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“…Previous work on the African continent has illustrated that genomic information could be a tool to reduce gendered blame by fostering dialogue about the role of biology and inheritance in disease causation ( Marsh et al, 2011 ). Community-based interventions may be successful in countering such narratives ( Tora et al, 2016 ). Yet what our experience demonstrated is that it is not straightforward to use genomic explanations of illness to foster discussions about gendered blame in an environment where there is apparent factual evidence to support it.…”

Section: Examples Where the Design And Conduct Of mentioning

confidence: 99%

Stigma in African genomics research: Gendered blame, polygamy, ancestry and disease causal beliefs impact on the risk of harm

Vries

Landouré

Wonkam

2020

Social Science & Medicine

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A recurring concern in genomics research is the possibility that it could lead to stigma for participants, their families and the population groups they belong to. Little evidence exists to explain how and when this ought to be a concern in genomics research in Africa whilst there is growing international evidence drawing into question the direct link between stigma and genetics. In this paper, we interrogate practical instances from African genomics research where stigma was identified as a concern in an attempt to nuance and refine accounts of when stigma should be considered as an ethical issue. The paper describes examples involving gendered blame, polygamy, beliefs in supernatural disease causation and sensitive information about group lineage. We propose that the concern may not be about stigma so much as broader research-related harm, including for instance reputational harm to population groups. Furthermore, we propose to shift the analytical gaze from establishing causal relationships to exploring the intersection of genomics with pre-existing stigma. Finally, we emphasize the importance of ensuring genomics researchers are culturally competent, meaning able to recognise when cultural factors impact on the possibility that genomics research could cause harm.

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Interpretations of education about gene-environment influences on health in rural Ethiopia: the context of a neglected tropical disease

Cited by 14 publications

References 24 publications

Health beliefs of school-age rural children in podoconiosis-affected families: A qualitative study in Southern Ethiopia

Health beliefs of school-age rural children in podoconiosis-affected families: A qualitative study in Southern Ethiopia

A cross-sectional survey to assess the risk factors associated with stigmatizing attitudes towards patients with podoconiosis among rural youth in southern Ethiopia

Stigma in African genomics research: Gendered blame, polygamy, ancestry and disease causal beliefs impact on the risk of harm

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