Using qualitative methods to explore lay explanatory models, health-seeking behaviours and self-care practices of podoconiosis patients in north-west Ethiopia

Background: 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. Methods: 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. Results: 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. Conclusion: 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

The effects of vacuum and freeze-drying on the physicochemical properties and in vitro digestibility of phenolics in oyster mushroom (Pleurotus ostreatus)

The oyster mushroom (Pleurotus ostreatus) was dehydrated by vacuum and freeze drier, and their proximate composition, physical properties (change in color and size, rehydration), phenolic compounds and antioxidant activities were compared. The bioaccessibility of phenolics and antioxidant activity were determined by using an in vitro digestion model coupled with a simulated intestinal barrier. The extraction yield, total phenol content, antioxidant activity and the number of individual phenolics were higher in vacuum dried mushrooms. Gallic acid, protocatechuic acid, p-hydroxybenzoic acid, p-coumaric acid, and o-coumaric acid were phenolic acids found in the extracts of oyster mushrooms. The different physical structures of food matrix attained by drying would influence the digestibility of bioactive compounds, a great portion of phenolics remained in the gut, and bioaccessibility index of mushroom phenolics identified in this study was between 17.8 and 41.9%. Regarding the color, size reduction, and rehydration properties, freeze drying was a preferable method for oyster mushroom preservation. However, vacuum drying was a better alternative in terms of extractability of phenolics from mushroom powders and their fate during in vitro gastrointestinal digestion