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- Title
The extent of protective footwear use among school-age rural children at high risk for podoconiosis and socio-economic correlates: A household cross-sectional survey in Southern Ethiopia.
- Authors
Tora, Abebayehu; Tadele, Getnet; Davey, Gail; McBride, Colleen M.
- Abstract
Background: Podoconiosis is preventable if genetically susceptible people wear shoes starting from an early age and do so consistently. However, lack of routine use of footwear is one of the major risk factors for podoconiosis and several other foot-related Neglected Tropical Diseases (NTDs). This study is aimed at describing the extent of footwear use among school-age rural children susceptible to the disease and investigating associated socioeconomic factors. Methods: Cross sectional surveys were conducted in 330 randomly selected households in Wolaita zone, southern Ethiopia. A household head and a child aged between 9 and 15 years were recruited from each household. Household heads provided socioeconomic data while children were asked about their footwear ownership and footwear use. Results: Nearly half (49.5%) of the children reported either walking barefoot or wearing under-protective footwear in a range of situations. Girls, older children, those in higher school grades, who belonged to families with higher socio-economic status, and those who owned a larger number of pairs of footwear reported more protective use of footwear. The linear regression model constituting the adequacy of footwear ownership and interaction term (i.e. family socioeconomic status by adequacy of footwear ownership) variables explained 30% of variance in the protective use of footwear (AR2 = 0.307). The interaction effect of adequate ownership of footwear and family socioeconomic status consistently predicted the protective use of footwear among children (β = -0.175, p<0.01) though the main effect of adequacy of footwear ownership was stronger (β = 0.507, p<0.001). Conclusion: Increased adoption of protective footwear is needed to effectively prevent school-age children living in endemic areas from developing podoconiosis and other neglected tropical diseases. Interventions aimed to improve the protective footwear use should consider approaches that also increase the socio-economic capacity of families in podoconiosis endemic communities. Author summary: Podoconiosis is preventable if genetically susceptible people wear shoes starting from an early age and do so consistently. However, lack of routine use of footwear since early childhood has been observed to be a major covariate of vulnerability to podoconiosis. The present study assessed the extent of protective footwear use and associated family socioeconomic factors among school-age rural children at high risk of the disease. Household heads and their children (aged between 9 and 15 years) participated in household surveys. Nearly half (49.5%) of the children were found to have less-protective use of footwear, either walking barefoot or wearing under-protective footwear in a range of situations. Girls, older children, those in higher school grades, those from families with higher socio-economic status, and those who owned a larger number of pairs of footwear reported more protective use of footwear. The protective footwear use among children is likely to increase with increase in family socioeconomic status and number of pairs of different types of footwear owned by the children. Increased adoption of protective footwear is needed to prevent school-age children living in endemic areas from developing podoconiosis and other neglected tropical diseases. Interventions aimed to encourage ownership of multiple pairs of footwear should use approaches that also increase the socio-economic capacity of podoconiosis-affected families.
- Subjects
ETHIOPIA; SAFETY shoes; RURAL children; NEGLECTED diseases; HOUSEHOLD surveys; GIRLS; SOCIOECONOMIC status
- Publication
PLoS Neglected Tropical Diseases, 2021, Vol 15, Issue 10, p1
- ISSN
1935-2727
- Publication type
Article
- DOI
10.1371/journal.pntd.0009791