Identifying contextually relevant lead exposures and risk practices/behaviors in Botswana and assessing caregiver lead knowledge levels

Abstract

Lead poisoning accounts for about 0.6% of the global burden of the disease; however, lead poisoning is under researched in low- and middle-income countries. We conducted this study to assess the risk factors associated with lead exposures, and we also assessed lead knowledge levels among caregivers of children under the age of 6 years. We administered a survey to 145 caregivers to collect demographic, socio-economic, housing and lead exposure information, and administered the validated Chicago Lead Knowledge Test (CLKT). Chi-square tests were used to describe the association between housing characteristics. 70 %, 55 % and 49 % of caregivers, respectively, reported seeing their children place these objects into their mouths, keys, jewelry and soil. Sixty-three percent of the respondents reported living near a busy road, and 46 % of the respondents reported visibly damaged paint in their homes. An association was observed between age of home and presence of damaged paint (P-value = 0.04). The median score on the CLKT was 50%. Over 50% of the participants incorrectly believed that most cases of childhood lead poisoning are caused by drinking water that contains lead, and 39% of the participants believed lead could be removed from water by boiling. These incorrect responses suggest the need to design interventions to increase awareness of sources of lead. Based on the high prevalence of risk factors for lead poisoning and the low lead knowledge score of caregivers, it may be beneficial to design education interventions to address knowledge gaps and empower individuals to prevent childhood lead exposure.

Keywords:

• Lead exposures
• awareness
• parents/caregivers
• children
• Gaborone Botswana

Acknowledgments

We would like to acknowledge the clinical staff who assisted by providing warm handoffs of study participants to research assistants and for providing spaces for survey administration. We would like to appreciate the following research assistants and personnel who were vital to the execution and completion of the project: Beauty Queen Dema, Refilwe Primrose Molemi, Obakeng Tahla, Letang Motsumi, Lame Basadi Montwedi, Joyce Gosetsemang Makoti, Fatima Maria Ratlou, Tirelo Puso, Thabang Tsele, Gaone Moetse, Susan Okatch, Katlego Michelle Maphorisa, Kaone Ditshai, Lesego Tshegofatso Sethaile.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was funded by college funds at Franklin and Marshall College; Hackman Summer Scholars Awards, Huffnagle Scholarship, and Mehlman Scholars Enrichment Experience Funds.

Notes on contributors

Harriet Okatch

Harriet Okatch is an assistant professor of public health at Thomas Jefferson University. Her primary research focusses on understanding the factors that contribute to elevated blood leads and identifying strategies to prevent lead exposure.

Chabaesele Makoti

Chabaesele Makoti is a final year at the University of Botswana majoring in Physics and Mathematics. He has a passion of community work.

Anuj Ghimirey

Anuj Ghimirey is a dental student at Temple University in Philadelphia and has contributed to several research projects to identify sources of lead in both Botswana and in Lancaster.

Hoi Lam

Hoi Lam is going into medical school and in her undergraduate studies, completed several projects on lead poisoning prevention including quantifying lead in soil and spices.

Jaala-Jasmyne Nkala

Jaala-Jasmyne Nkala is a senior majoring in Biology and Psychology with a minor in studio arts. She quantified lead in soil and contributed to efforts to increase awareness about residential lead remediation funding in Lancaster.

Najeda Regis

Najeda Regis is completing a Master’s in Public Health (Epidemiology) at Drexel University in Philadelphia and has completed research projects focussed on lead and on iron.