Exploring parents’ knowledge, attitudes and practices on honey and botulism in the West Bank, Palestine: a cross-sectional study

Background Although nutritionally beneficial, honey may harbor Clostridium botulinum spores, posing risks to infant botulism (IB). Infants under one year are vulnerable due to immature gut flora, with IB potentially causing severe symptoms, such as respiratory failure. Despite global awareness, cult...

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Main Authors: Bashar Yaser Hasan Awad, Farah Bilal Yousef Shahin, Mohammad Yaser Hasan Awad, Haya Jebreen Mohammed Warasna, Amal Mahfoud, Afnan W. M. Jobran, Tarek A. Owais
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Annals of Medicine
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Online Access:https://www.tandfonline.com/doi/10.1080/07853890.2025.2489012
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author Bashar Yaser Hasan Awad
Farah Bilal Yousef Shahin
Mohammad Yaser Hasan Awad
Haya Jebreen Mohammed Warasna
Amal Mahfoud
Afnan W. M. Jobran
Tarek A. Owais
author_facet Bashar Yaser Hasan Awad
Farah Bilal Yousef Shahin
Mohammad Yaser Hasan Awad
Haya Jebreen Mohammed Warasna
Amal Mahfoud
Afnan W. M. Jobran
Tarek A. Owais
author_sort Bashar Yaser Hasan Awad
collection DOAJ
description Background Although nutritionally beneficial, honey may harbor Clostridium botulinum spores, posing risks to infant botulism (IB). Infants under one year are vulnerable due to immature gut flora, with IB potentially causing severe symptoms, such as respiratory failure. Despite global awareness, cultural beliefs influenced caregivers’ practices in Palestine. This study evaluated Palestinian parents’ knowledge, beliefs, and feeding practices regarding honey to guide targeted interventions.Methods This cross-sectional study  (August–September 2024) surveyed 469 Palestinian parents (aged ≥18 years) from 10 West Bank cities, excluding 88 ineligible responses. A validated questionnaire assessed their knowledge, attitudes, and practices. Data were analyzed using the R software (frequency, Chi-squared/Fisher’s tests; p < 0.05).Results Most participants were female (89%), under 30 years old (53%), and highly educated (77%). While 58% knew of honey-linked IB, only 32% identified C. botulinum as the causative agent. Notably, 15.8% fed honey to infants aged <12 months and 62.5% introduced complementary feeding at 6–12 months. Age and income-influenced practices, with many believing that honey aids digestion or supplements nutrition.Conclusions The findings reveal gaps in knowledge and widespread cultural beliefs about the benefits of honey, which contribute to unsafe feeding practices. Health interventions in Palestine should incorporate these insights to improve awareness and to prevent IB.
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spelling doaj-art-236dce53865747a886b5acacb45bf81e2025-08-20T02:08:35ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2489012Exploring parents’ knowledge, attitudes and practices on honey and botulism in the West Bank, Palestine: a cross-sectional studyBashar Yaser Hasan Awad0Farah Bilal Yousef Shahin1Mohammad Yaser Hasan Awad2Haya Jebreen Mohammed Warasna3Amal Mahfoud4Afnan W. M. Jobran5Tarek A. Owais6Faculty of Medicine, Palestine Polytechnic University, Hebron, PalestineFaculty of Medicine, Palestine Polytechnic University, Hebron, PalestineFaculty of Medicine, Palestine Polytechnic University, Hebron, PalestineFaculty of Medicine, Palestine Polytechnic University, Hebron, PalestineFaculty of Medicine, Tishreen University, Latakia, SyriaFaculty of Medicine, Al-Quds University, Jerusalem, PalestineFaculty of Pharmacy, Beni Suef University, Beni Suef, EgyptBackground Although nutritionally beneficial, honey may harbor Clostridium botulinum spores, posing risks to infant botulism (IB). Infants under one year are vulnerable due to immature gut flora, with IB potentially causing severe symptoms, such as respiratory failure. Despite global awareness, cultural beliefs influenced caregivers’ practices in Palestine. This study evaluated Palestinian parents’ knowledge, beliefs, and feeding practices regarding honey to guide targeted interventions.Methods This cross-sectional study  (August–September 2024) surveyed 469 Palestinian parents (aged ≥18 years) from 10 West Bank cities, excluding 88 ineligible responses. A validated questionnaire assessed their knowledge, attitudes, and practices. Data were analyzed using the R software (frequency, Chi-squared/Fisher’s tests; p < 0.05).Results Most participants were female (89%), under 30 years old (53%), and highly educated (77%). While 58% knew of honey-linked IB, only 32% identified C. botulinum as the causative agent. Notably, 15.8% fed honey to infants aged <12 months and 62.5% introduced complementary feeding at 6–12 months. Age and income-influenced practices, with many believing that honey aids digestion or supplements nutrition.Conclusions The findings reveal gaps in knowledge and widespread cultural beliefs about the benefits of honey, which contribute to unsafe feeding practices. Health interventions in Palestine should incorporate these insights to improve awareness and to prevent IB.https://www.tandfonline.com/doi/10.1080/07853890.2025.2489012Honeyinfant botulismWest BankmothersClostridium botulinum
spellingShingle Bashar Yaser Hasan Awad
Farah Bilal Yousef Shahin
Mohammad Yaser Hasan Awad
Haya Jebreen Mohammed Warasna
Amal Mahfoud
Afnan W. M. Jobran
Tarek A. Owais
Exploring parents’ knowledge, attitudes and practices on honey and botulism in the West Bank, Palestine: a cross-sectional study
Annals of Medicine
Honey
infant botulism
West Bank
mothers
Clostridium botulinum
title Exploring parents’ knowledge, attitudes and practices on honey and botulism in the West Bank, Palestine: a cross-sectional study
title_full Exploring parents’ knowledge, attitudes and practices on honey and botulism in the West Bank, Palestine: a cross-sectional study
title_fullStr Exploring parents’ knowledge, attitudes and practices on honey and botulism in the West Bank, Palestine: a cross-sectional study
title_full_unstemmed Exploring parents’ knowledge, attitudes and practices on honey and botulism in the West Bank, Palestine: a cross-sectional study
title_short Exploring parents’ knowledge, attitudes and practices on honey and botulism in the West Bank, Palestine: a cross-sectional study
title_sort exploring parents knowledge attitudes and practices on honey and botulism in the west bank palestine a cross sectional study
topic Honey
infant botulism
West Bank
mothers
Clostridium botulinum
url https://www.tandfonline.com/doi/10.1080/07853890.2025.2489012
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