Health professionals' attitudes and misconceptions regarding podoconiosis: potential impact on integration of care in southern Ethiopia

Offering long-term community care for patients with podoconiosis (endemic non-filarial elephantiasis) is challenging, and requires co-operation between patients and their families, the community and health care professionals. Health professionals who harbour misconceptions about podoconiosis or stigmatize patients are likely to deliver substandard services and propagate such attitudes within the community. In January 2007, we used a structured self-administered questionnaire to assess knowledge of and attitudes towards podoconiosis among 275 health professionals in public and private health institutions in southern Ethiopia. Nearly all (97.8%) health professionals held at least one significant misconception about the cause of podoconiosis, and 97.1% responded incorrectly to one or more questions about signs and symptoms of podoconiosis. Around half (53.9%) incorrectly considered podoconiosis to be an infectious disease and were afraid of acquiring podoconiosis while providing care. All (100%) held one or more stigmatizing attitudes towards people with podoconiosis. These high levels of misconceptions and stigmatizing attitudes suggest negative effects of health professionals, seriously undermining integration between themselves, patients and community partners. We recommend pre- and in-service training of health professionals to overcome these misconceptions, to diminish stigma and to improve integration among those offering community care of patients with podoconiosis.