Abstract
BackgroundPodoconiosis (endemic non-filarial elephantiasis) is a chronic, non-infectious disease resulting from exposure of bare feet to red-clay soil in tropical highlands. This study examined lay beliefs about three under-researched aspects of podoconiosis patients’ care: explanatory models, health-seeking behaviours and self-care.MethodsIn-depth interviews and focus group discussions were undertaken with 34 participants (19 male, 15 female) between April-May 2015 at podoconiosis treatment centres across East and West Gojjam regions in north-west Ethiopia.ResultsExplanatory models for podoconiosis included contamination from blood, magic, soil or affected individuals. Belief in heredity or divine punishment often delayed clinic attendance. All participants had tried holy water treatment and some, holy soil. Herbal treatments were considered ineffectual, costly and appeared to promote fluid escape. Motivators for clinic attendance were failure of traditional treatments and severe or disabling symptoms. Patients did not report self-treatment with antibiotics. Self-care was hindered by water being unavailable or expensive and patient fatigue.ConclusionA pluralistic approach to podoconiosis self-treatment was discovered. Holy water is widely valued, though some patients prefer holy soil. Priests and traditional healers could help promote self-care and “signpost” patients to clinics. Change in behaviour and improving water access is key to self-care.
Highlights
Podoconiosis is a chronic non-infectious disease affecting individuals whose feet have been exposed to red clay soil found in the tropical highland areas. [1] A very recent study from Molla et al demonstrates the importance of phyllosilicate clay minerals, smectite, mica groups and quartz in the pathogenesis of podoconiosis.[2]
Podoconiosis is a disease that is caused by long-term exposure to red clay soil found in tropical highland areas
Podoconiosis was described as a gradual onset of swelling that started in the toes and spread up the legs and considered distinct from other diseases that caused swelling elsewhere, such as in the face from “kidney disease”
Summary
Podoconiosis (endemic non-filarial elephantiasis) is a chronic, non-infectious disease resulting from exposure of bare feet to red-clay soil in tropical highlands. This study examined lay beliefs about three under-researched aspects of podoconiosis patients’ care: explanatory models, health-seeking behaviours and self-care
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