Rural youths' understanding of gene x environmental contributors to heritable health conditions: The case of podoconiosis in Ethiopia

Abstract

ObjectivesAssess the feasibility of engaging youth to disseminate accurate information about gene by environmental (GxE) influences on podoconiosis, a neglected tropical lymphedema endemic in southern Ethiopia.MethodsA cross sectional survey was conducted with 377 youth randomly selected from 2 districts of Southern Ethiopia. Measures included GxE knowledge (4 true/false statements), preventive action knowledge (endorse wearing shoes and foot hygiene), causal misconceptions (11 items related to contagion) and confidence to explain GxE (9 disagree/agree statements).ResultsOver half (59%) accurately endorsed joint contributions of gene and environment to podoconiosis and preventive mechanisms (e.g., wearing protective shoes and keeping foot hygiene). Multivariable logistic regression showed that youth with accurate understanding about GxE contributors reported having: some education, friends or kin who were affected by the condition, and prior interactions with health extension workers. Surprisingly, higher accurate GxE knowledge was positively associated with endorsing contagion as a causal factor. Accuracy of GxE and preventive action knowledge were positively associated with youth’s confidence to explain podoconiosis-related information.ConclusionsYouth have the potential to be competent disseminators of GxE information about podoconiosis. Interventions to foster confidence among youth in social or kin relationships with affected individuals may be most promising. Efforts to challenge youth’s co-existing inaccurate beliefs about contagion could strengthen the link of GxE explanations to preventive actions.

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

“… 6 Interaction with HEWs has been shown to be associated with greater gene–environment knowledge and reduced beliefs in infectious causes. 29 Overall, our data appear to support the notion that improving the accurate understanding of disease could be highly effective against stigmatizing attitudes.…”

“…Indeed, in our previous report regarding rural youth's understanding of the gene–environment contribution to podoconiosis, we found that youth with a formal education had more accurate knowledge about causes of podoconiosis. 29 However, a higher level of education did not have a direct effect on reported stigma beyond accurate knowledge. Thus rural youth across different education levels might benefit from educational programmes designed specifically to reduce their stigmatizing attitudes towards individuals affected by podoconiosis.…”

“…This is supported by our prior report from the same research project showing that friendship with patients helped rural youth to develop accurate knowledge and dispelled misconceptions about the causes of podoconiosis. 29 Furthermore, the possible intimate and enduring personal relationships in friendship circles may have helped youth to develop a more humane and positive attitude towards patients. This finding is consistent with a prior study on HIV-related stigma, where familiarity with PLWHA was associated with less stigmatizing attitudes.…”

“…This study is part of a larger project on enhancing Ethiopian youth's literacy on gene–environment contributions to health using the context of podoconiosis. 29 Data were collected between August and September 2016. In line with the United Nations definition, 30 youth ages 15–24 y were targeted.…”

“…Our previous report showed that youth who have contact with HEWs have more accurate knowledge of podoconiosis. 29 Thus contact with HEWs, women trained in health promotion and disease prevention for ≥1 y and deployed in their local community, was assessed. Youth who had had contact with HEWs at home in the year prior to the survey were compared with those reporting no contact.…”