ABSTRACT
Central centrifugal cicatricial alopecia (CCCA) is a common cause of hair loss among patients of African and/or Caribbean descent, and there is little data exploring the quality of life of patients with this condition. This pilot demonstrates that CCCA has a significant impact on overall quality of life, and patients may benefit from resources to address psychosocial aspects of this diagnosis.
Subject(s)
Dermatitis , Quality of Life , Humans , Black or African American , Alopecia/diagnosis , Alopecia/etiology , Cicatrix/etiology , Black PeopleABSTRACT
BACKGROUND: Oculocutaneous albinism is disproportionately prevalent in Africa; however, the medical and psychosocial characteristics of people living with albinism (PWA) in Botswana have not been studied. OBJECTIVE: To characterize the demographics, health-related factors, sun-protective behaviors, and psychosocial challenges of PWA in Botswana. METHODS: Overall, 50 PWA and 99 patients without albinism (non-PWA) were recruited and surveyed. RESULTS: Higher proportions of PWA lived in rural villages compared with non-PWA (odds ratio [OR], 2.59; 95% confidence interval [CI], 1.26-5.34). PWA reported limited access to health care more frequently compared with non-PWA (OR, 2.72; 95% CI, 1.11-6.62). High proportions of PWA adopted sun-protective measures, including sunscreen, clothing, and sunlight avoidance. Despite high rates of feeling accepted by family and peers, PWA had increased odds of feeling unaccepted by their community (OR, 15.16; 95% CI, 5.25-31.81), stigmatized by society (OR, 9.37; 95% CI, 3.43-35.62), and affected by stigma in social interactions (OR, 2.21; 95% CI, 1.08-4.54) compared with non-PWA. Three-quarters of PWA had witnessed mistreatment of PWA. LIMITATIONS: Study limitations include the small sample size, convenience sampling, and a non-validated survey instrument. CONCLUSION: PWA faced increased medical and psychosocial challenges compared with non-PWA in Botswana. Our findings can begin to inform public health strategies aimed at promoting improved health care, education, and social inclusion for this population in Botswana and other regions in Africa.
ABSTRACT
BACKGROUND: Livestock can promote resilience in low-income communities through a number of pathways. Livestock development programs seek to amplify these benefits but often fail to consider the costs to intended beneficiaries or the effect of prevailing gender norms. OBJECTIVE: To explore perceptions of livestock ownership among female smallholder livestock keepers in Nyanza Region, Kenya, and unpack how the distribution of livestock benefits and investments varies by gender within households. METHODS: We used multiple ethnographic techniques, including Photovoice, a photo-elicitation interview method, focus group discussions, and pile sorts, with female smallholder livestock owners (n = 18) participating in an ongoing cohort study. Transcripts were coded using a combination of a priori constructs and grounded theory. RESULTS: We found that livestock benefited households by providing financial security, food security, social benefits, and human time and labor savings. However, these benefits largely promoted long-term household resilience rather than immediate gains. Livestock ownership also had major costs to household time and labor, which were overwhelmingly borne by women and children. Despite this investment, women had limited livestock ownership rights, decision-making power, control over income, or access to meat. CONCLUSIONS: Our findings suggest that livestock ownership requires significant investments of household time and labor, which disproportionately burden women. Prevailing gender inequalities may therefore constrain the net benefit of livestock ownership for many women and their households in some contexts. Livestock development programs must assess both program benefits and costs at multiple levels to ensure that women's participation in livestock production leads to improved individual and household outcomes.
