02181nas a2200193   4500000000100000008004100001100001200042700001300054700001200067700001300079700001200092700001300104245016400117856007800281300001300359490000700372520159400379022001401973       2016                            d1 aBanks H1 aTsegay G1 aWubie M1 aTamiru A1 aDavey G1 aCooper M00aUsing qualitative methods to explore lay explanatory models, health-seeking behaviours and self-care practices of podoconiosis Patients in North-West Ethiopia.  uhttp://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0004878  ae00048780 v103 a<p><strong>BACKGROUND: </strong>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.</p>

<p><strong>METHODS: </strong>In-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.</p>

<p><strong>RESULTS: </strong>Explanatory 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.</p>

<p><strong>CONCLUSION: </strong>A 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.</p>
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