Journal of Community Medicine & Public Health
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Journal of Community Medicine & Public Health Chanie T. J Community Med Public Health 1: 103. Research Article DOI: 10.29011/2577-2228.100003 Knowledge, and Practice on the Importance of Shoe Wearing to Pre- vent Podoconiosis and Its Associated Factors among Households in the Rural Community of Aneded District, North West Ethiopia, 2015 Tenaw Chanie* Department of Public Health University, JSI-L10K Research and Training Inc. Institute, Ethiopia *Corresponding author: Tenaw Chanie, Department of Public Health University, JSI-L10K Research and Training Inc. Institute, Ethiopia. Tel: +2510582221270; Fax: +2510582262403; Email: [email protected] Citation: Chanie T (2017) Knowledge, and Practice on the Importance of Shoe Wearing to Prevent Podoconiosis and Its Associated Factors among Households in the Rural Community of Aneded District, North West Ethiopia, 2015. J Community Med Public Health 1: 103. DOI: 10.29011/2577-2228.100003 Received Date: 14 July, 2017; Accepted Date: 06 September, 2017; Published Date: 13 September, 2017 Abstract Introduction: Podoconiosis infection is one of the NTDs occurring among barefoot people in areas of extreme poverty. It pro- motes poverty through effects on education, economic productivity and disability. It is estimated up to one million cases exist in Ethiopia. Promotion of consistent shoe-wearing practices have advantages in controlling podoconiosis. Better understanding of the behaviors influencing use of footwear will lead to improved ability to measure shoe wearing practice and will be important for those implementing footwear programs. But, many practical and social barriers prevented the desire to wear shoes from being translated into practice. Objective: The aim of this study is to assess knowledge and practice of Aneded district rural community on the importance of shoe wearing to prevent Podoconiosis and its associated factors North West Ethiopia. Methodology: Community based cross-sectional study was conducted on 4 randomly selected rural kebeles, and 422 respon- dents were participated in Aneded District, East Gojjam Zone from February-March/2015 G.C using systematic sampling meth- od with proportional allocation of number of samples. Data were collected using a structured and pre-tested questionnaire through face to face interview. Data were entered into epi-data ver.3.1 and exported to spas v.16 statistical software. Descriptive results were presented by narration, tables and graphs. Logistic regression model was used for binary and multivariate analysis of associ- ated factors. Factors that were analyzed in binary logistic analysis and with p- value ≤ 0.25 were again entered into multivariate logistic analysis model. The cut off point for significantly associated factors in multivariate logistic analysis was 0.05. Accord- ingly, factors with p-value less than 0.05 and significantly associated were drawback of being bare foot. Result: There were 422 respondents participated in this study. The response rate was 99%. Out of the total respondents, 236(56.5%) were males. Among all respondents 257(61.5%) knew the cause of podoconiosis and there were 279(66.7) barefoot respondents during the time of interview. Variables significantly associated with barefoot were marital status, knowing the draw- back of barefoot, attending radio program and graduation in health extension packages with AOR of 4.6(1.6, 25),0.3 (0.1, 0.4),0.3 (0.2, 0.5) and 0.5 (0.3, 0.9) 95% CI respectively. Conclusion and Recommendation: the knowledge of the respondents was good unlike their practice. So, strengthen and expand health education program on the importance of shoe wearing and the preventive strategy of podoconiosis is mandatory. 1 Volume 1; Issue 01 Citation: Chanie T (2017) Knowledge, and Practice on the Importance of Shoe Wearing to Prevent Podoconiosis and Its Associated Factors among Households in the Rural Community of Aneded District, North West Ethiopia, 2015. J Community Med Public Health 1: 103. Keywords: Barefoot; Graduation; Knowledge; Marriage; Pod- no help and no voice [31]. It is estimated that Ethiopia has the oconiosis; Practice; Radio Program highest total number of cases per country.The soil type thought to be associated with the diseases covers approximately one-fifth Introduction of the country and the fertility of the soil in such areas attracts an agricultural population of 20.5 million people. 11 million Background Ethiopians (18% of the population) are at risk through exposure Podoconiosis is one of the NTDs occurring among bare- to the irritant soil and it is estimated that at least 1 million people foot people in areas of extreme poverty, which promote poverty are affected. The world health organization estimated that Ethiopia through effects on education, economic productivity and disability loses 200 million United States Dollar (USD) every year because [1]. Podoconiosis is non-infectious elephantiasis disease affect- of the lost work hours of suffers [34]. NTDs is gaining increasing ing barefoot people with prolonged exposure to red clay soil. It is attention and better understanding of the knowledge that influence common in tropical Africa, Central America and northern India. use of footwear will lead to improved ability to measure shoe use Podoconiosis presents as bilateral below knee swelling and can and will be important for those implementing footwear programs. be prevented and controlled by consistently washing feet, wearing Podoconiosis is relatively well described in southern Ethiopia, but shoes, and using antiseptics and emollients [2]. There are mainly remains neglected in other parts of the Ethiopian highlands [11] two types of elephantiasis, lymphatic filariasis and non-filarial el- thus the study will assess knowledge and practice of foot wear and ephantiasis called Podoconiosis. Lymphatic filariasis is caused by factors that influence shoe wearing behaviors among people living parasitic worms, while Podoconiosis is a non-parasitic disease [3]. in rural community of Aneded District. Even though the pathogenesis of the diseases has not yet been in- Literature Review vestigated in depth, it is believed to be caused by fine particles in the soil that penetrate the skin and induce an inflammatory reaction Podoconiosis and some soil-transmitted helminthes infec- in the lymphatic system [4].The chemicals come in contact with tions are Neglected Tropical Diseases (NTDs.) occurring among the bare skin under the feet and move upwards to the lymphatic barefoot people in areas of extreme poverty, and both promote vessels, blocking them and causing an infection. The resulting poverty through effects on education, economic productivity and condition is known as podoconiosis [5,6]. disability [1]. Podoconiosis is a Neglected Tropical Disease (NTD) that is prevalent in red clay soil-covered highlands of tropical Af- Ecological and observational evidence suggests that con- rica, Central and South America, and northern India. It is estimated sistent use of shoes prevents diseases by protection from soil ex- that up to one million cases exist in Ethiopia [2]. The prevalence posure. Shoe distribution to children of treated patients has been of Podoconiosis in the population aged 15 years and above was accompanied by messages linking foot hygiene and shoe use to found to be 3.3%. 87% of cases were in the economically active reduce risk of diseases. It is estimated that the total number of age group (15-64 years). On average, patients sought treatment cases per country is highest in Ethiopia [7-10]. In Ethiopia, the five years after the start of the leg swelling [2]. basalt area covering more than 200,000 km2 and the fertility of the soil attracts agricultural population. Eleven million Ethiopians Podoconiosis is non- infectious elephantiasis distinct from (18% of the population) are at risk through exposure to the irritant lymphatic filariasis that affects barefoot individuals exposed to red soil, and estimate based on prevalence data from an endemic area clay soil of volcanic origin. In particular, Podoconiosis is prevalent in southern Ethiopia suggests that between 500,000 and 1 million among barefoot subsistence farmers that live and work in these people are affected [34]. areas [3]. Even though the pathogenesis of the diseases has not yet been investigated in depth, it is believed to be caused by fine par- Statement of the problem ticles in the soil that penetrate the skin and induce an inflammatory Podoconiosis is a chronic non-infectious disease resulting reaction in the lymphatic system [4]. in below-knee swelling of the legs in bare-footed people living in The disease results in bilateral progressive swelling of the red clay soil areas. It is an important and yet neglected problem in lower legs, usually limited below the level of the knees. Based on tropical Africa, central and south America, and north India [6]. It the disease progression, Podoconiosis is classified into five stag- is considerable public health problem in more than ten Africans es where the first and second stages have swelling limited below countries including Ethiopia [20]. It is not an infection, there is ev- ankle which is either reversible overnight (stage one) or not (stage idence to suggest that this reaction is determined by genetic factors two). The third stage of the disease has water bag like or nodu- and therefore not every person exposed to this type of soil will be lar swelling above the level of the ankle. The fourth stage entails affected. Contact with soil is made by walking barefoot and devel- above knee swelling whereas the fifth stage involves joint fixation ops over a period of time [6,16]. Podoconiosis is a modern, silent as a result of surrounding soft tissue overgrowth [11,12]. public health disaster made up of hundreds of thousands of men, women and children suffering the sham of skin diseases, most with Non- filarial elephantiasis (Podoconiosis) is believed to be 2 Volume 1; Issue 01 Citation: Chanie T (2017) Knowledge, and Practice on the Importance of Shoe Wearing to Prevent Podoconiosis and Its Associated Factors among Households in the Rural Community of Aneded District, North West Ethiopia, 2015.