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Feng J, Wang X, Zhang X, Hu H, Xue J, Cao C, Xu J, Yang P, Li S. Effect of Health Education on Schistosomiasis Control Knowledge, Attitude, and Practice after Schistosomiasis Blocking: Results of a Longitudinal Observational Study in the Field. Trop Med Infect Dis 2023; 8:tropicalmed8050267. [PMID: 37235315 DOI: 10.3390/tropicalmed8050267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/28/2023] [Accepted: 04/29/2023] [Indexed: 05/28/2023] Open
Abstract
OBJECTIVES Schistosomiasis is a zoonotic infectious disease that seriously harms people's physical and mental health. As early as 1985, the WHO suggested that health education and health promotion should be the focus of schistosomiasis prevention work. This study aimed to explore the effect of health education on controlling the risk of schistosomiasis transmission after schistosomiasis blocking and to provide a scientific basis for the further improvement of intervention strategies after schistosomiasis interruption in China and other endemic countries. METHODS In Jiangling County, Hubei Province, China, one severe, one moderate, and one mildly endemic village were selected as the intervention group; two severe, two moderate, and two mildly endemic villages were selected as the control group. In towns with different epidemic types, a primary school was randomly selected for intervention. In September 2020, a baseline survey was carried out through a questionnaire survey to understand the knowledge, attitudes, and practices (KAP) of adults and students concerning schistosomiasis control. Next, two rounds of health education interventions for schistosomiasis control were carried out. The evaluation survey was conducted in September 2021 and the follow-up survey conducted in September 2022. RESULTS Compared with the baseline survey, the qualified rate of the KAP on schistosomiasis prevention of the control group in the follow-up survey increased from 79.1% (584/738) to 81.0% (493/609) (p > 0.05); in the intervention group, the qualified rate of the KAP on schistosomiasis control increased from 74.9% (286/382) to 88.1% (260/295) (p < 0.001). In the baseline survey, the qualified rate of the KAP of the intervention group was lower than that of the control group, and in the follow-up survey, the qualified rate of the KAP of the intervention group was 7.2% higher than that of the control group (p < 0.05). Compared with the baseline survey, the accuracy rates of the KAP of the intervention group's adults were higher than those of the control group, with statistical significance (p < 0.001). Compared with the baseline survey, the qualified rate of the students' KAP in the follow-up survey increased from 83.8% (253/302) to 97.8% (304/311) (p < 0.001). In the follow-up survey, the accuracy rate of the knowledge, attitudes, and practices of the students was significantly different from the baseline accuracy (p < 0.001). CONCLUSION a health education-led risk control model of schistosomiasis can significantly improve schistosomiasis control knowledge among adults and students, establishing correct attitudes and leading to the development of correct hygiene habits.
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Affiliation(s)
- Jiaxin Feng
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - Xinyi Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - Xia Zhang
- Jiangling Center for Disease Control and Prevention, Jingzhou 434000, China
| | - Hehua Hu
- Jiangling Center for Disease Control and Prevention, Jingzhou 434000, China
| | - Jingbo Xue
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - Chunli Cao
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - Jing Xu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - Pin Yang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - Shizhu Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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Chanhanga N, Mindu T, Mogaka J, Chimbari M. The Impact of Targeted Treatment and Mass Drug Administration Delivery Strategies on the Prevalence and Intensity of Schistosomiasis in School Aged Children in Africa: A Systematic Review. Infect Drug Resist 2023; 16:2453-2466. [PMID: 37138838 PMCID: PMC10150034 DOI: 10.2147/idr.s395382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 03/16/2023] [Indexed: 05/05/2023] Open
Abstract
Schistosomiasis is a public health problem in more than 78 countries in the world. The disease is most prevalent among children than adults due to their high exposure to infectious water sources. Various interventions such as mass drug administration (MDA), snail control, safe water provision and health education have been implemented independently or jointly to control, reduce and ultimately eliminate Schistosomiasis. This scoping review focused on studies reporting the impact of different delivery strategies of targeted treatment and MDA on the prevalence and intensity of schistosomiasis infection in school aged children in Africa. The review focused on Schistosoma haematobium and Schistosoma mansoni species. A systematic search for eligible literature from peer-reviewed articles was done from Google Scholar, Medline, PubMed and EBSCO host databases. The search yielded twenty-seven peer-reviewed articles. All articles found reported a decrease in the prevalence of schistosomiasis infection. Five studies (18.5%) reported a prevalence change below 40%, eighteen studies (66.7%) reported a change between 40% and 80%, and four studies (14.8%) reported a change above 80%. The infection intensity post-treatment was varied: twenty-four studies reported a decrease, while two studies reported an increase. The review showed that the impact of targeted treatment on the prevalence and intensity of schistosomiasis depended on the frequency at which it was offered, complementary interventions, and its uptake by the target population. Targeted treatment can significantly control the infection burden, but cannot eliminate the disease. Constant MDA programs coupled with preventative and health promotional programs are required to reach the elimination stage.
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Affiliation(s)
- Nathan Chanhanga
- School of Nursing and Public Health, University of KwaZulu Natal, Durban, South Africa
| | - Tafadzwa Mindu
- School of Nursing and Public Health, University of KwaZulu Natal, Durban, South Africa
- Correspondence: Tafadzwa Mindu, Email
| | - John Mogaka
- School of Nursing and Public Health, University of KwaZulu Natal, Durban, South Africa
| | - Moses Chimbari
- School of Nursing and Public Health, University of KwaZulu Natal, Durban, South Africa
- Research and Innovation, Great Zimbabwe University, Masvingo, Zimbabwe
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3
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Naqvi FA, Das JK, Salam RA, Raza SF, Lassi ZS, Bhutta ZA. Interventions for Neglected Tropical Diseases Among Children and Adolescents: A Meta-analysis. Pediatrics 2022; 149:186947. [PMID: 35503336 DOI: 10.1542/peds.2021-053852e] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Neglected tropical diseases (NTDs) are a group of communicable diseases affecting the poorest populations around the world. OBJECTIVE To assess the effectiveness of interventions, including mass drug administration (MDA), water, sanitation, and hygiene (WASH), vector control, health education, and micronutrients supplementation, for NTDs among children and adolescents. METHODS We conducted a literature search on the Cochrane Controlled Trials Register, Medline, and other databases until December 2020. We included randomized controlled trials and quasi-experimental studies conducted among children and adolescents. Two authors independently screened studies for relevance. Two authors independently extracted data, assessed the risk of bias, performed metaanalysis, and rated the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation. RESULTS We included 155 studies (231 articles) involving 262 299 participants. For soil-transmitted helminthiasis, MDA may reduce the prevalence of Ascaris, Trichuris, and hookworm by 58%, 36%, and 57%, respectively. We are uncertain of the effect of health education, WASH, and iron supplementation on soil-transmitted helminthiasis prevalence. For Schistosomiasis, health education probably reduces the intensity and prevalence of S. mansoni, whereas micronutrient supplementation may reduce anemia prevalence and the infection intensity of S. hematobium compared with no supplementation. We are uncertain of the effect of MDA and vector control on Schistosomiasis outcomes. For trachoma, health education probably reduces the prevalence of active Trachoma, whereas we are uncertain of the effect of MDA, WASH, and vector control on Trachoma outcomes. There is limited data on the effectiveness of interventions for NTDs targeting children and adolescents. CONCLUSION Future studies are needed to evaluate the relative effectiveness and cost-effectiveness of various interventions specifically targeting children and adolescents.
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Affiliation(s)
- Fatima Abbas Naqvi
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Jai K Das
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Rehana A Salam
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Syeda Fatima Raza
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan
| | - Zohra S Lassi
- Robinson Research Institute, the University of Adelaide, Adelaide, Australia.,Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Zulfiqar A Bhutta
- Division of Women and Child Health, Aga Khan University Hospital, Karachi, Pakistan.,Centre for Global Child Health, The Hospital for Sick Children (SickKids), Toronto, Ontario, Canada
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The Dynamics of Hepatic Fibrosis Related to Schistosomiasis and Its Risk Factors in a Cohort of China. Pathogens 2021; 10:pathogens10121532. [PMID: 34959487 PMCID: PMC8703886 DOI: 10.3390/pathogens10121532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/17/2021] [Accepted: 11/21/2021] [Indexed: 11/17/2022] Open
Abstract
China has had a long history against schistosomiasis japonica. The most serious prognosis of chronic schistosome infection is hepatic fibrosis, which develops into advanced schistosomiasis if the process is not effectively controlled. After a more than seven decades endeavor, China has gained remarkable achievements in schistosomiasis control and achieved transmission control nationwide (infection rate of schistosomes in residents and domestic animals both less than 1%) by 2015. However, new advanced schistosomiasis cases emerge annually in China, even in areas where the transmission of schistosomiasis had been interrupted. In the present study, the residents (>5 years old) in a schistosomiasis endemic village were examined for schistosomiasis every year during 1995-2019 by the modified Kato-Katz thick smear method and/or miracidium hatching technique. Residents who were identified to have an active infection method were treated with praziquantel at a dose of 40 mg/kg body weight. Ultrasonography was carried out to assess the liver morbidity related to schistosomiasis in 1995 and 2019, respectively. The prevalence of schistosomiasis among residents presented a downward trend annually, from 17.89% (175/978) in 1995 to 0 (0/475) in 2019. Among 292 residents who received ultrasound scan both in 1995 and 2019, 141 (48.29%) presented stable liver damage, while liver fibrosis was developed severely in 86 (29.45%) and reversed in 65 (22.26%) residents. Univariate and multivariate analysis showed that anti-fibrosis treatment was the protective factor against schistosomiasis hepatic fibrosis. Males, residents aged 38 and above, fishermen, and people who did not receive anti-fibrosis treatment were groups with higher risk of liver fibrosis development. Our results revealed that although the infection rate of schistosome dropped significantly in endemic areas, liver fibrosis was still developing among some residents, even though they had received deworming treatment. Liver protection/anti-fibrosis treatment should be administered in endemic regions and regions with historically uncontrolled transmission to slow down the deterioration of hepatic fibrosis among patients in schistosomiasis endemic areas.
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Dejon-Agobé JC, Zinsou JF, Honkpehedji YJ, Edoa JR, Adegbité BR, Beh-Mba R, Kremsner PG, Adegnika AA, Grobusch MP. Knowledge, attitudes and practices pertaining to urogenital schistosomiasis in Lambaréné and surrounding areas, Gabon. Parasit Vectors 2021; 14:486. [PMID: 34551819 PMCID: PMC8456596 DOI: 10.1186/s13071-021-04905-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 07/29/2021] [Indexed: 11/12/2022] Open
Abstract
Background Control of schistosomiasis remains a priority in endemic areas. Local epidemiological data are necessary for a tailored control programme, including data on population behaviour in relation to the disease. The objective of this study was to assess schistosomiasis-related knowledge, attitudes and practices in the general population of Lambaréné, a small city in Gabon, in order to optimise the design and implementation of a local control programme that is tailored to need. Methods The study was cross-sectional in nature. Eligible adults and children living in the study area who volunteered (with informed consent) to participate in the study were interviewed using standardised questionnaires, one of which was a simplified version of the primary questionnaire for participants aged 6–13 years. Data on the participants’ knowledge, attitudes and practices that enhance the risk for contracting schistosomiasis were collected. Results A total of 602 participants were included. The mean (± standard deviation) age was 21.2 (± 15.0) years, the female:male gender ratio was 1.6 and 289 (48%) participants completed the simplified version the questionnaire. Of the 602 participants, 554 (92%) reported past or current contact with freshwater, 218 (36%) reported a history of a diagnosis of schistosomiasis and 193 (32%) reported past intake of praziquantel medication. The overall levels of knowledge and adequate attitudes toward schistosomiasis among young adults and adults were 68 and 73%, respectively. The proportion of participants pursuing risk-enhancing practices (REP) was 60% among the whole study population. Location was significantly associated with differences in knowledge and REP levels. A history of confirmed schistosomiasis and larger family size were significantly associated with an increase in good knowledge and REP levels. However, the indication of freshwater-associated activities was only associated with a significant increase in the REP level. Conclusions The results of this survey reveal a high level of population exposure to schistosomiasis, which is in line with known prevalence of schistosomiasis in Lambaréné and its surroundings. The local population has a reasonable level of knowledge of and adequate attitudes toward schistosomiasis but the level of REP is high, particularly in areas where piped water is absent. In terms of interventions, improving hygiene should have the highest priority, but in a context where provision of safe water is difficult to achieve, the effectiveness of praziquantel treatment and the education of at-risk populations on the need for protective behaviours should be a prominent feature of any local control programme. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-021-04905-0.
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Affiliation(s)
- Jean Claude Dejon-Agobé
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon.,Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam Infection and Immunity, Amsterdam Public Health, Amsterdam University Medical Center, location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Jeannot Fréjus Zinsou
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon.,Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands.,Fondation pour la Recherche Scientifique, 72 BP45, Cotonou, Bénin
| | - Yabo Josiane Honkpehedji
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon.,Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands.,Fondation pour la Recherche Scientifique, 72 BP45, Cotonou, Bénin
| | - Jean Ronald Edoa
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
| | - Bayodé Roméo Adegbité
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon.,Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam Infection and Immunity, Amsterdam Public Health, Amsterdam University Medical Center, location AMC, University of Amsterdam, Amsterdam, The Netherlands.,Fondation pour la Recherche Scientifique, 72 BP45, Cotonou, Bénin
| | - Romuald Beh-Mba
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
| | - Peter Gottfried Kremsner
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon.,Institut Für Tropenmedizin, Eberhard Karls Universität Tübingen, Tübingen, Germany.,German Center for Infection Research (DZIF), Tübingen, Germany
| | - Ayola Akim Adegnika
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon.,Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands.,Fondation pour la Recherche Scientifique, 72 BP45, Cotonou, Bénin.,Institut Für Tropenmedizin, Eberhard Karls Universität Tübingen, Tübingen, Germany.,German Center for Infection Research (DZIF), Tübingen, Germany
| | - Martin Peter Grobusch
- Centre de Recherches Médicales de Lambaréné (CERMEL), Lambaréné, Gabon. .,Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam Infection and Immunity, Amsterdam Public Health, Amsterdam University Medical Center, location AMC, University of Amsterdam, Amsterdam, The Netherlands. .,Institut Für Tropenmedizin, Eberhard Karls Universität Tübingen, Tübingen, Germany. .,Masanga Medical Research Unit, Masanga, Sierra Leone. .,Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
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Favre TC, Massara CL, Beck LCNH, Cabello RKSA, Pieri OS. Adherence to diagnosis followed by selective treatment of schistosomiasis mansoni and related knowledge among schoolchildren in an endemic area of Minas Gerais, Brazil, prior to and after the implementation of educational actions. Parasite Epidemiol Control 2021; 13:e00208. [PMID: 33732914 PMCID: PMC7941185 DOI: 10.1016/j.parepi.2021.e00208] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/21/2020] [Accepted: 02/25/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction Brazilian guidelines for schistosomiasis elimination recommend regular search of infection carriers and their timely treatment. This study evaluates the effect of educational actions (EAs) among schoolchildren on adherence to diagnosis and treatment, as well as on knowledge of the disease. Methods In April/2013, a questionnaire was applied to 6th-to-8th-grade pupils of eight public schools to evaluate prior knowledge of disease and self-reported risk behavior. Baseline parasitological survey (PS) was done in May/2013, followed by selective treatment and cure assessment. The schools were then randomly allocated to experimental (EG) and control (CG) groups, with and without EAs, respectively. EAs were conducted for 3 months from August/2013. Questionnaire was reapplied in November/2013, April/2014, October/2014, and October/2015 to evaluate changes in knowledge about the disease and self-reported risk behavior. Two further annual PSs (May/2014 and May/2015), each followed by treatment of positives, allowed to evaluate between-group differences and intra-group changes in adherence to diagnosis and treatment, and to follow-up prevalence and intensity of infection. Results Adherence to diagnosis did not differ significantly between EG (84.1%) and CG (81.1%) at baseline but was significantly higher in EG in subsequent PSs. Overall, adherence to treatment was higher than 90% in all three PSs; cure was 98.4%, egg-reduction was 99.8% and reinfection, 2.8%. Prevalence fell significantly in EC (from 23.5% to 6.8%) and CG (from 21.8% to 2.4%), the same occurring with intensity (from 54.2 to 4.6 epg in EG and from 38.4 to 1.3 epg in CG). Disease knowledge increased significantly in EG and CG; knowledge about disease transmission increased significantly more in the EG. Self-reported risk behavior remained above 67% and did not differ significantly between EG and CG. Conclusion EAs increased adherence of schoolchildren and improved knowledge about the disease, confirming that EAs are an important tool to enhance schoolchildren participation in control campaigns. Educational actions improved adherence to stool testing. Disease knowledge also improved with educational actions. Risk behavior stayed high despite educational actions.
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Affiliation(s)
- Tereza Cristina Favre
- Environmental and Health Education Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil
| | - Cristiano Lara Massara
- Helmintology and Medical Malacology Research Group, René Rachou Institute, Fiocruz, Minas Gerais, Brazil
| | | | | | - Otavio Sarmento Pieri
- Environmental and Health Education Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil
- Corresponding author.
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Aya Pastrana N, Lazo-Porras M, Miranda JJ, Beran D, Suggs LS. Social marketing interventions for the prevention and control of neglected tropical diseases: A systematic review. PLoS Negl Trop Dis 2020; 14:e0008360. [PMID: 32555705 PMCID: PMC7299328 DOI: 10.1371/journal.pntd.0008360] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 05/04/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Social marketing is an approach to behavior change that contributes to disease prevention and control. This study aimed to understand how social marketing interventions have addressed neglected tropical diseases (NTDs). It examined the characteristics, breadth of coverage, and outcomes of social marketing interventions focused on the prevention and control of these diseases. METHODOLOGY/PRINCIPAL FINDINGS Studies published in any language between January 1971 and April 2017, targeting at least one of the 17 NTDs prioritized in the World Health Organization (WHO) NTD Roadmap were considered. Included studies had interventions that applied both, at least one core social marketing concept, "social behavioral influence", and one social marketing technique, "integrated intervention mix", described in the Hierarchical Model of Social Marketing. This review is registered with PROSPERO CRD42017063858. Twenty interventions, addressing eight NTDs, met the inclusion criteria. They focused on behaviors related to four of the five WHO public health strategies for NTDs. Most interventions incorporated the concepts "relationship building" and "public / people orientation focus", and the technique "insight-driven segmentation". All the interventions reported changing behavioral determinants such as knowledge, 19 reported behavior change, and four influenced health outcomes. CONCLUSION/SIGNIFICANCE Evidence from this study shows that social marketing has been successfully used to address behaviors related to most of the five public health strategic interventions for NTDs recommended by the WHO. It is suggested that social marketing interventions for the prevention and control of NTDs be grounded on an understanding of the audience and adapted to the contexts intervened. Building stakeholder relationships as early as possible, and involving the publics could help in reaching NTD outcomes. Elements of the intervention mix should be integrated and mutually supportive. Incorporating health education and capacity building, as well as being culturally appropriate, is also relevant. It is recommended that ongoing discussions to formulate the targets and milestones of the new global Roadmap for NTDs integrate social marketing as an approach to overcome these diseases.
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Affiliation(s)
- Nathaly Aya Pastrana
- BeCHANGE Research Group, Institute for Public Communication, Università della Svizzera italiana, Lugano, Switzerland
| | - Maria Lazo-Porras
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - J. Jaime Miranda
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - David Beran
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
- Swiss School of Public Health+, Zurich, Switzerland
| | - L. Suzanne Suggs
- BeCHANGE Research Group, Institute for Public Communication, Università della Svizzera italiana, Lugano, Switzerland
- Swiss School of Public Health+, Zurich, Switzerland
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Guan Z, Dai SM, Zhou J, Ren XB, Qin ZQ, Li YL, Lv S, Li SZ, Zhou XN, Xu J. Assessment of knowledge, attitude and practices and the analysis of risk factors regarding schistosomiasis among fishermen and boatmen in the Dongting Lake Basin, the People's Republic of China. Parasit Vectors 2020; 13:273. [PMID: 32487266 PMCID: PMC7268453 DOI: 10.1186/s13071-020-04157-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 05/28/2020] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Fishermen and boatmen are a population at-risk for contracting schistosomiasis due to their high frequency of water contact in endemic areas of schistosomiasis in the People's Republic of China (P. R. China). To develop specific interventions towards this population, the present study was designed to assess the knowledge, attitudes and practices (KAPs) towards schistosomiasis of fishermen and boatmen, and to identify the risk factors associated with schistosome infection using a molecular technique in a selected area of Hunan Province in P. R. China. METHODS A cross sectional survey was conducted in the Dongting Lake Basin of Yueyang County, Hunan Province. A total of 601 fishermen and boatmen were interviewed between October and November 2017. Information regarding sociodemographic details and KAPs towards schistosomiasis were collected using a standardized questionnaire. Fecal samples of participants were collected and tested by polymerase chain reaction (PCR). Logistic regression analysis was conducted to explore the risk factors related to the positive results of PCR. RESULTS Of the 601 respondents, over 90% knew schistosomiasis and how the disease was contracted, the intermediate host of schistosomes and preventive methods. The majority of respondents had a positive attitude towards schistosomiasis prevention. However, only 6.66% (40/601) of respondents had installed a latrine on their boats, while 32.61% (196/601) of respondents defecated in the public toilets on shore. In addition, only 4.99% (30/601) respondents protected themselves while exposed to freshwater. The prevalence of schistosomiasis, as determined by PCR, among fishermen and boatmen in Yueyang County was 13.81% (83/601). Age, years of performing the current job, number of times receiving treatment, and whether they were treated in past three years were the main influencing factors of PCR results among this population. CONCLUSIONS Fishermen and boatmen are still at high risk of infection in P. R. China and gaps exist in KAPs towards schistosomiasis in this population group. Chemotherapy, and health education encouraging behavior change in combination with other integrated approaches to decrease the transmission risk in environments should be improved.
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Affiliation(s)
- Zhou Guan
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People’s Republic of China
- Key Laboratory of Parasite and Vector Biology, National Health Commission, Shanghai, People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, Shanghai, People’s Republic of China
- Chinese Center for Tropical Diseases Research, Shanghai, People’s Republic of China
| | - Si-Min Dai
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People’s Republic of China
- Key Laboratory of Parasite and Vector Biology, National Health Commission, Shanghai, People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, Shanghai, People’s Republic of China
- Chinese Center for Tropical Diseases Research, Shanghai, People’s Republic of China
| | - Jie Zhou
- Hunan Institute of Schistosomiasis Control, Yueyang, People’s Republic of China
| | - Xiao-Bing Ren
- Yueyang County Office for Preventive and Control on Schistosomiasis, Yueyang, People’s Republic of China
| | - Zhi-Qiang Qin
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People’s Republic of China
- Key Laboratory of Parasite and Vector Biology, National Health Commission, Shanghai, People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, Shanghai, People’s Republic of China
- Chinese Center for Tropical Diseases Research, Shanghai, People’s Republic of China
| | - Yin-Long Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People’s Republic of China
- Key Laboratory of Parasite and Vector Biology, National Health Commission, Shanghai, People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, Shanghai, People’s Republic of China
- Chinese Center for Tropical Diseases Research, Shanghai, People’s Republic of China
| | - Shan Lv
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People’s Republic of China
- Key Laboratory of Parasite and Vector Biology, National Health Commission, Shanghai, People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, Shanghai, People’s Republic of China
- Chinese Center for Tropical Diseases Research, Shanghai, People’s Republic of China
| | - Shi-Zhu Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People’s Republic of China
- Key Laboratory of Parasite and Vector Biology, National Health Commission, Shanghai, People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, Shanghai, People’s Republic of China
- Chinese Center for Tropical Diseases Research, Shanghai, People’s Republic of China
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People’s Republic of China
- Key Laboratory of Parasite and Vector Biology, National Health Commission, Shanghai, People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, Shanghai, People’s Republic of China
- Chinese Center for Tropical Diseases Research, Shanghai, People’s Republic of China
| | - Jing Xu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People’s Republic of China
- Key Laboratory of Parasite and Vector Biology, National Health Commission, Shanghai, People’s Republic of China
- WHO Collaborating Centre for Tropical Diseases, Shanghai, People’s Republic of China
- Chinese Center for Tropical Diseases Research, Shanghai, People’s Republic of China
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9
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Aya Pastrana N, Somerville C, Suggs LS. The gender responsiveness of social marketing interventions focused on neglected tropical diseases. Glob Health Action 2020; 13:1711335. [PMID: 31955668 PMCID: PMC7006634 DOI: 10.1080/16549716.2019.1711335] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 12/24/2019] [Indexed: 11/17/2022] Open
Abstract
Background: Gender is a determinant of health that intersects with other social stratifiers to shape the health and well-being of populations. Despite the recognition of gender in the global health agenda, limited evidence exists about the integration of gender considerations in interventions, including social marketing interventions, for the prevention and control of neglected tropical diseases. Social marketing is an ethical approach to behavior change aiming to benefit individuals, communities, and society. Since behaviors are gendered and affect disease transmission and healthcare patterns, one would expect social marketing interventions to be gender responsive.Objective: This study aims to understand the extent to which social marketing interventions focusing on neglected tropical diseases are gender responsive.Methods: This study uses data from social marketing interventions collected in a systematic review, this study examined 20 interventions addressing eight neglected tropical diseases in 13 countries. A modified version of the World Health Organization Gender Assessment Tool (GAT) was used to determine the gender responsiveness of the interventions, which was complemented by coding for intersectional sex and gender data. These results are presented in 12 themes.Results: One schistosomiasis intervention implemented in China was assessed as gender responsive. It was not possible to answer many questions from the GAT due to limited data reported in the publications describing the interventions. Despite this, strengths and limitations were found in all the interventions in relation to the use of sex and gender concepts, the disaggregation of data, the consideration of environmental factors, and the involvement of women or men in the different stages of the interventions.Conclusions: Many interventions showed positive actions towards gender responsiveness. However, only one was classified as gender responsive. Others failed to supply enough data for assessment. Recommendations about how sex and gender could be integrated into social marketing interventions are provided.
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Affiliation(s)
- Nathaly Aya Pastrana
- BeCHANGE Research Group, Institute for Public Communication, Università della Svizzera italiana, Lugano, Switzerland
| | - Claire Somerville
- Gender Centre, Graduate Institute of International and Development Studies, Geneva, Switzerland
| | - L. Suzanne Suggs
- BeCHANGE Research Group, Institute for Public Communication, Università della Svizzera italiana, Lugano, Switzerland
- Swiss School of Public Health+, Zurich, Switzerland
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10
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Kalinda C, Mutengo M, Chimbari M. A meta-analysis of changes in schistosomiasis prevalence in Zambia: implications on the 2020 elimination target. Parasitol Res 2019; 119:1-10. [PMID: 31773307 DOI: 10.1007/s00436-019-06534-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 10/28/2019] [Indexed: 12/18/2022]
Abstract
Schistosomiasis affects more than 4 million school-aged children in Zambia, mostly in rural communities due to unsafe water and inadequate sanitation facilities. Although several studies were done in Zambia between 1976 and 2019, empirical estimates of the disease burden remain unavailable. Therefore, appraisal of the current schistosomiasis burden is pertinent in the re-evaluation of schistosomiasis-control strategies in Zambia. A random-effect model was used to estimate the prevalence of schistosomiasis infection in Zambia across different age groups for the period between 1976 and 2019. A literature search was done in the following databases: PubMed, ISI Web of Science, Google Scholar, CINAHL, and African Journals Online. Twenty-eight studies with relevant prevalence data were identified and included in the analysis. The pooled prevalence estimate of Schistosoma haematobium and Schistosoma mansoni across studies for the entire period was 35.5% (95% CI: 25.8-45.9) and 34.9% (95% CI: 20.7-50.6), respectively. Prevalence estimates among school-aged children for S. haematobium and S. mansoni were 32.2% (95% CI: 21.1-44.7) and 18.1% (95% CI: 3.0-38.4), respectively. The reported pooled prevalence estimate for S. haematobium among the adults was 54% (95% CI: 23.2-83.7). Only two studies collected information from preschool aged children. Substantial heterogeneity (I2 = 100%, p < 0.0001) was observed among the studies. Although a reduction in disease prevalence was observed from 1990 to 2010, this was not sustained after 2010. In this meta-analysis, S. haematobium was more prevalent compared to S. mansoni, with more cases observed among school-aged children (SAC). Thus, control programs should target age groups that are highly infected or are at high risk of infection.
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Affiliation(s)
- Chester Kalinda
- University of Namibia, Katima Mulilo Campus, Box 1096, Katima Mulilo, Namibia. .,Department of Public Health, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Howard College Campus, Durban, 4001, South Africa.
| | - Mable Mutengo
- Institute of Basic and Biomedical Sciences, Levy Mwanawasa Medical University, P.O Box 33991, Lusaka, Zambia
| | - Moses Chimbari
- Department of Public Health, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Howard College Campus, Durban, 4001, South Africa
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11
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Martel RA, Osei BG, Kulinkina AV, Naumova EN, Abdulai AA, Tybor D, Kosinski KC. Assessment of urogenital schistosomiasis knowledge among primary and junior high school students in the Eastern Region of Ghana: A cross-sectional study. PLoS One 2019; 14:e0218080. [PMID: 31194804 PMCID: PMC6563970 DOI: 10.1371/journal.pone.0218080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 05/24/2019] [Indexed: 11/29/2022] Open
Abstract
Background Knowledge of urogenital schistosomiasis can empower individuals to limit surface water contact and participate in mass drug administration campaigns, but nothing is currently known about the schistosomiasis knowledge that schoolchildren have in Ghana. We developed and implemented a survey tool aiming to assess the knowledge of urogenital schistosomiasis (treatment, transmission, prevention, symptoms) among science teaches and primary and junior high school students in the Eastern Region of Ghana. Methods We developed a 22-question knowledge survey tool and administered it to 875 primary and 938 junior high school students from 74 schools in 37 communities in the Eastern Region of Ghana. Teachers (n = 57) answered 20 questions matched to student questions. We compared knowledge scores (as percent of correct answers) across topics, gender, and class year and assessed associations with teacher’s knowledge scores using t-tests, chi-squared tests, univariate, and multivariate linear regression, respectively. Results Students performed best when asked about symptoms (mean±SD: 76±21% correct) and prevention (mean±SD: 69±25% correct) compared with transmission (mean±SD: 50±15% correct) and treatment (mean±SD: 44±23% correct) (p<0.0005). Teachers performed best on prevention (mean±SD: 93±12% correct, p<0.0005) and poorest on treatment (mean±SD: 69±16% correct, p<0.001). When listing five facts about urogenital schistosomiasis, teachers averaged 2.9±1.2 correct. Multiple regression models suggest that gender, class year, teacher score, and town of residency explain ~27% of variability in student scores. On average, junior high school students outperformed primary school students by 10.2 percentage points (CI95%: 8.6–11.8); boys outperformed girls by 3.5 percentage points (CI95%: 2.3–4.7). Conclusions Our survey parsed four components of student and teacher knowledge. We found strong knowledge in several realms, as well as knowledge gaps, especially on transmission and treatment. Addressing relevant gaps among students and science teachers in UGS-endemic areas may help high-risk groups recognize risky water contact activities, improve participation in mass drug administration, and spark interest in science by making it practical.
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Affiliation(s)
- Rachel A. Martel
- Department of Community Health, Tufts University School of Arts and Sciences, Medford, Massachusetts, United States of America
| | - Bernard Gyamfi Osei
- University College of Agriculture and Environmental Studies, Bunso, Eastern Region, Ghana
| | - Alexandra V. Kulinkina
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, Massachusetts, United States of America
| | - Elena N. Naumova
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, Medford, Massachusetts, United States of America
- Division of Nutrition Data Science, Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, United States of America
| | | | - David Tybor
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, United States of America
| | - Karen Claire Kosinski
- Department of Community Health, Tufts University School of Arts and Sciences, Medford, Massachusetts, United States of America
- * E-mail:
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12
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Qian MB, Zhou CH, Zhu HH, Zhu TJ, Huang JL, Chen YD, Zhou XN. Assessment of health education products aimed at controlling and preventing helminthiases in China. Infect Dis Poverty 2019; 8:22. [PMID: 30909961 PMCID: PMC6434872 DOI: 10.1186/s40249-019-0531-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 03/07/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Helminthiases have placed a huge burden of disease on the population in China. However, widespread control activities have led to significant achievements. As health education has been widely disseminated and plays an important role in the control and elimination of these diseases, we collected health education products aimed at controlling and preventing helminthiases in China. We analyzed their characteristics and assessed their quality. METHODS Firstly, health education products aimed at controlling and preventing helminthiases were collected from a diverse range of organizations. Secondly, the expert brainstorming and Delphi methods were applied to establish an evaluation system, which was then used to assess the collected products systematically. Those deemed excellent were awarded. Characteristics - including type, source, targeted disease(s), targeted population, and languages - of the collected products and the awarded products were presented here. RESULTS In total, 96 health education products on helminthiases were collected from 53 organizations. Most products belonged to either the graphic design (47) or daily-use (24) category. Seventy were collected from Centers for Disease Control and Prevention and 20 from institutes or control stations of parasitic diseases, primarily at the provincial and county levels. Regarding disease targets of the products, 67 focused on a single helminthiasis, 25 on multiple helminthiases, and the remaining four on non-specific diseases. Of the 67 single helminthiasis-focused products, most targeted schistosomiasis (37), followed by echinococcosis (16). The majority of products (79) targeted the general population, while 11 targeted students specifically. Regarding languages, 86 products were only in Chinese, while the other ten were in both Chinese and the minority languages of China. Out of these ten products, one targeted schistosomiasis and the other nine targeted echinococcosis. Thirty-four products were awarded. The characteristics of the awarded products were similar to those of the collected products. CONCLUSIONS A diverse range of health education products have been designed and applied for the prevention and control of helminthiases in China. Many products have good features such as specifying the targeted diseases and populations. However, there are significant gaps in terms of both the quantity and quality of products pertaining to some of the diseases. Experiences from the awarded products could be drawn upon to design more products aimed at a range of different helminthiases.
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Affiliation(s)
- Men-Bao Qian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, China.,Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, China.,National Center for International Research on Tropical Diseases, Shanghai, 200025, China.,World Health Organization Collaborating Center for Tropical Diseases, Shanghai, 200025, China
| | - Chang-Hai Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, China.,Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, China.,National Center for International Research on Tropical Diseases, Shanghai, 200025, China.,World Health Organization Collaborating Center for Tropical Diseases, Shanghai, 200025, China
| | - Hui-Hui Zhu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, China.,Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, China.,National Center for International Research on Tropical Diseases, Shanghai, 200025, China.,World Health Organization Collaborating Center for Tropical Diseases, Shanghai, 200025, China
| | - Ting-Jun Zhu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, China.,Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, China.,National Center for International Research on Tropical Diseases, Shanghai, 200025, China.,World Health Organization Collaborating Center for Tropical Diseases, Shanghai, 200025, China
| | - Ji-Lei Huang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, China.,Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, China.,National Center for International Research on Tropical Diseases, Shanghai, 200025, China.,World Health Organization Collaborating Center for Tropical Diseases, Shanghai, 200025, China
| | - Ying-Dan Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, China.,Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, China.,National Center for International Research on Tropical Diseases, Shanghai, 200025, China.,World Health Organization Collaborating Center for Tropical Diseases, Shanghai, 200025, China
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, 200025, China. .,Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200025, China. .,National Center for International Research on Tropical Diseases, Shanghai, 200025, China. .,World Health Organization Collaborating Center for Tropical Diseases, Shanghai, 200025, China.
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13
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Asian Schistosomiasis: Current Status and Prospects for Control Leading to Elimination. Trop Med Infect Dis 2019; 4:tropicalmed4010040. [PMID: 30813615 PMCID: PMC6473711 DOI: 10.3390/tropicalmed4010040] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 02/12/2019] [Accepted: 02/12/2019] [Indexed: 12/22/2022] Open
Abstract
Schistosomiasis is an infectious disease caused by helminth parasites of the genus Schistosoma. Worldwide, an estimated 250 million people are infected with these parasites with the majority of cases occurring in sub-Saharan Africa. Within Asia, three species of Schistosoma cause disease. Schistosoma japonicum is the most prevalent, followed by S. mekongi and S. malayensis. All three species are zoonotic, which causes concern for their control, as successful elimination not only requires management of the human definitive host, but also the animal reservoir hosts. With regard to Asian schistosomiasis, most of the published research has focused on S. japonicum with comparatively little attention paid to S. mekongi and even less focus on S. malayensis. In this review, we examine the three Asian schistosomes and their current status in their endemic countries: Cambodia, Lao People's Democratic Republic, Myanmar, and Thailand (S. mekongi); Malaysia (S. malayensis); and Indonesia, People's Republic of China, and the Philippines (S. japonicum). Prospects for control that could potentially lead to elimination are highlighted as these can inform researchers and disease control managers in other schistosomiasis-endemic areas, particularly in Africa and the Americas.
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14
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Li Y, Teng Z, Ruan S, Li M, Feng X. A mathematical model for the seasonal transmission of schistosomiasis in the lake and marshland regions of China. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2018; 14:1279-1299. [PMID: 29161861 DOI: 10.3934/mbe.2017066] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Schistosomiasis, a parasitic disease caused by \textit{ Schistosoma Japonicum}, is still one of the most serious parasitic diseases in China and remains endemic in seven provinces, including Hubei, Anhui, Hunan, Jiangsu, Jiangxi, Sichuan, and Yunnan. The monthly data of human schistosomiasis cases in Hubei, Hunan, and Anhui provinces (lake and marshland regions) released by the Chinese Center for Disease Control and Prevention (China CDC) display a periodic pattern with more cases in late summer and early autumn. Based on this observation, we construct a deterministic model with periodic transmission rates to study the seasonal transmission dynamics of schistosomiasis in these lake and marshland regions in China. We calculate the basic reproduction number R0, discuss the dynamical behavior of solutions to the model, and use the model to fit the monthly data of human schistosomiasis cases in Hubei. We also perform some sensitivity analysis of the basic reproduction number R0 in terms of model parameters. Our results indicate that treatment of at-risk population groups, improving sanitation, hygiene education, and snail control are effective measures in controlling human schistosomiasis in these lakes and marshland regions.
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Affiliation(s)
- Yingke Li
- College of Mathematics and System Sciences, Xinjiang University, Urumqi, Xinjiang 830046, China
| | - Zhidong Teng
- College of Mathematics and System Sciences, Xinjiang University, Urumqi, Xinjiang 830046, China
| | - Shigui Ruan
- Department of Mathematics, University of Miami, Coral Gables, FL 33146, United States
| | - Mingtao Li
- Complex Systems Research Center, Shanxi University, Taiyuan, Shanxi 030006, China
| | - Xiaomei Feng
- Department of Mathematics, Yuncheng University, Yuncheng, Shanxi 044000, China
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15
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Essé C, Koffi VA, Kouamé A, Dongo K, Yapi RB, Moro HM, Kouakou CA, Palmeirim MS, Bonfoh B, N’Goran EK, Utzinger J, Raso G. "Koko et les lunettes magiques": An educational entertainment tool to prevent parasitic worms and diarrheal diseases in Côte d'Ivoire. PLoS Negl Trop Dis 2017; 11:e0005839. [PMID: 28934198 PMCID: PMC5630154 DOI: 10.1371/journal.pntd.0005839] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 10/06/2017] [Accepted: 07/31/2017] [Indexed: 11/26/2022] Open
Abstract
Background Integrated control programs, emphasizing preventive chemotherapy along with health education, can reduce the incidence of soil-transmitted helminthiasis and schistosomiasis. The aim of this study was to develop an educational animated cartoon to improve school children’s awareness regarding soil-transmitted helminthiasis, diarrheal diseases, and related hygiene practices in Côte d’Ivoire. The key messages included in the cartoon were identified through prior formative research to specifically address local knowledge gaps. Methodology In a first step, preliminary research was conducted to assess the knowledge, attitudes, practices, and beliefs of school-aged children regarding parasitic worm infections and hygiene, to identify key health messages to be included in an animated cartoon. Second, an animated cartoon was produced, which included the drafting of the script and story board, and the production of the cartoon’s initial version. Finally, the animated cartoon was pilot tested in eight selected schools and further fine-tuned. Principal findings According to the questionnaire results, children believed that the consumption of sweet food, eating without washing their hands, sitting on the floor, and eating spoiled food were the main causes of parasitic worm infections. Abdominal pain, diarrhea, lack of appetite, failure to grow, and general fatigue were mentioned as symptoms of parasitic worm infections. Most of the children knew that they should go to the hospital for treatment if they experienced symptoms of parasitic worm diseases. The animated cartoon titled “Koko et les lunettes magiques” was produced by Afrika Toon, in collaboration with a scientific team composed of epidemiologists, civil engineers, and social scientists, and the local school children and teachers. Pilot testing of the animated cartoon revealed that, in the short term, children grasped and kept key messages. Most of the children who were shown the cartoon reported to like it. Acceptance of the animated cartoon was high among children and teachers alike. The messaging was tailored to improve knowledge and practices for prevention of helminthiases and diarrheal diseases through prior identification of knowledge gaps. Integration of such education tools into the school curriculum, along with deworming campaigns, might improve sustainability of control and elimination efforts against helminthiases and diarrheal diseases. Soil-transmitted helminthiases, schistosomiasis, and diarrhea remain important public health issues in sub-Saharan Africa. Health educational animated cartoons can help raise awareness and improve hygiene practices, and thus contribute to the control and elimination of these diseases. For the development of an educational animated cartoon, we first evaluated the knowledge, attitudes, practices, and beliefs of school-aged children in Côte d’Ivoire regarding soil-transmitted helminthiases, diarrhea, and schistosomiasis in order to identify setting-specific health messages for our animated cartoon. We found that children believed that the consumption of sweet food, eating without washing their hands, sitting on the floor, and eating spoiled food were the main causes of parasitic worm infections. As a next step, the alpha version of the animated cartoon was produced and given the title: “Koko et les lunettes magiques”. The animated cartoon was pre-tested in eight schools and further developed. Our study found that children could retain most of the information provided by the animated cartoon. It is suggested that such a tool, integrated into the school curriculum, together with deworming campaigns in Côte d’Ivoire, might improve the sustainability of control and elimination efforts against soil-transmitted helminthiases, diarrhea, and schistosomiasis.
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Affiliation(s)
- Clémence Essé
- Unité de Formation et de Recherche des Sciences de l’Homme et de la Société, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
- Département Recherche et Développement, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Véronique A. Koffi
- Unité de Formation et de Recherche des Sciences de l’Homme et de la Société, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
- Département Recherche et Développement, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Kouassi Dongo
- Département Recherche et Développement, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
| | - Richard B. Yapi
- Département Recherche et Développement, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
| | - Honorine M. Moro
- Unité de Formation et de Recherche des Sciences de l’Homme et de la Société, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
- Département Recherche et Développement, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Christiane A. Kouakou
- Unité de Formation et de Recherche des Sciences de l’Homme et de la Société, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
- Département Recherche et Développement, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Marta S. Palmeirim
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Bassirou Bonfoh
- Département Recherche et Développement, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Eliézer K. N’Goran
- Département Recherche et Développement, Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Giovanna Raso
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
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16
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Xia C, Bergquist R, Lynn H, Hu F, Lin D, Hao Y, Li S, Hu Y, Zhang Z. Village-based spatio-temporal cluster analysis of the schistosomiasis risk in the Poyang Lake Region, China. Parasit Vectors 2017; 10:136. [PMID: 28270197 PMCID: PMC5341164 DOI: 10.1186/s13071-017-2059-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Accepted: 02/23/2017] [Indexed: 02/08/2023] Open
Abstract
Background The Poyang Lake Region, one of the major epidemic sites of schistosomiasis in China, remains a severe challenge. To improve our understanding of the current endemic status of schistosomiasis and to better control the transmission of the disease in the Poyang Lake Region, it is important to analyse the clustering pattern of schistosomiasis and detect the hotspots of transmission risk. Results Based on annual surveillance data, at the village level in this region from 2009 to 2014, spatial and temporal cluster analyses were conducted to assess the pattern of schistosomiasis infection risk among humans through purely spatial (Local Moran’s I, Kulldorff and Flexible scan statistic) and space-time scan statistics (Kulldorff). A dramatic decline was found in the infection rate during the study period, which was shown to be maintained at a low level. The number of spatial clusters declined over time and were concentrated in counties around Poyang Lake, including Yugan, Yongxiu, Nanchang, Xingzi, Xinjian, De’an as well as Pengze, situated along the Yangtze River and the most serious area found in this study. Space-time analysis revealed that the clustering time frame appeared between 2009 and 2011 and the most likely cluster with the widest range was particularly concentrated in Pengze County. Conclusions This study detected areas at high risk for schistosomiasis both in space and time at the village level from 2009 to 2014 in Poyang Lake Region. The high-risk areas are now more concentrated and mainly distributed at the river inflows Poyang Lake and along Yangtze River in Pengze County. It was assumed that the water projects including reservoirs and a recently breached dyke in this area were partly to blame. This study points out that attempts to reduce the negative effects of water projects in China should focus on the Poyang Lake Region.
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Affiliation(s)
- Congcong Xia
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, 200032, China.,Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, 200032, China.,Laboratory for Spatial Analysis and Modeling, School of Public Health, Fudan University, Shanghai, 200032, China.,Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, 200032, China
| | | | - Henry Lynn
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, 200032, China.,Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, 200032, China.,Laboratory for Spatial Analysis and Modeling, School of Public Health, Fudan University, Shanghai, 200032, China.,Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, 200032, China
| | - Fei Hu
- Jiangxi Institute of Schistosomiasis Prevention and Control, Nanchang, 330000, China
| | - Dandan Lin
- Jiangxi Institute of Schistosomiasis Prevention and Control, Nanchang, 330000, China
| | - Yuwan Hao
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200032, China
| | - Shizhu Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, 200032, China.
| | - Yi Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, 200032, China. .,Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, 200032, China. .,Laboratory for Spatial Analysis and Modeling, School of Public Health, Fudan University, Shanghai, 200032, China. .,Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, 200032, China.
| | - Zhijie Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Fudan University, Shanghai, 200032, China. .,Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, 200032, China. .,Laboratory for Spatial Analysis and Modeling, School of Public Health, Fudan University, Shanghai, 200032, China. .,Collaborative Innovation Center of Social Risks Governance in Health, School of Public Health, Fudan University, Shanghai, 200032, China.
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Xiao H, Peng M, Yan H, Gao M, Li J, Yu B, Wu H, Li S. An instrument based on protection motivation theory to predict Chinese adolescents' intention to engage in protective behaviors against schistosomiasis. Glob Health Res Policy 2016; 1:15. [PMID: 29202064 PMCID: PMC5693510 DOI: 10.1186/s41256-016-0015-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 09/23/2016] [Indexed: 11/10/2022] Open
Abstract
Background Further advancement in schistosomiasis prevention requires new tools to assess protective motivation, and promote innovative intervention program. This study aimed to develop and evaluate an instrument developed based on the Protection Motivation Theory (PMT) to predict protective behavior intention against schistosomiasis among adolescents in China. Methods We developed the Schistosomiasis PMT Scale based on two appraisal pathways of protective motivation- threat appraisal pathway and coping appraisal pathway. Data from a large sample of middle school students (n = 2238, 51 % male, mean age 13.13 ± 1.10) recruited in Hubei, China was used to evaluated the validity and reliability of the scale. Results The final scale contains 18 items with seven sub-constructs. Cronbach's Alpha coefficients for the entire instrument was 0.76, and for the seven sub-constructs of severity, vulnerability, intrinsic reward, extrinsic reward, response efficacy, self-efficacy and response cost was 0.56, 0.82, 0.75, 0.80, 0.90, 0.72 and 0.70, respectively. The construct validity analysis revealed that the one level 7 sub-constructs model fitted data well (GFI = 0.98, CFI = 0.98, RMSEA = 0.03, Chi-sq/df = 3.90, p < 0.001). Predictive validity showed that both the PMT instrument score and the 7 sub-construct scores were significantly correlated with the intention engaged in protective behavior against schistosomiasis (p < 0.05). Conclusions This study provides a reliable and valid tool to measure protective motivation in schistosomiasis prevention control. Further studies are needed to develop more effective intervention programs for schistosomiasis prevention.
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Affiliation(s)
- Han Xiao
- School of Health Science, Wuhan University, Wuhan, Hubei China.,Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Minjin Peng
- School of Health Science, Wuhan University, Wuhan, Hubei China.,Department of Infection Control, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei China
| | - Hong Yan
- School of Health Science, Wuhan University, Wuhan, Hubei China.,Global Health Institute, Wuhan University, Wuhan, Hubei China
| | - Mengting Gao
- School of Health Science, Wuhan University, Wuhan, Hubei China.,Global Health Institute, Wuhan University, Wuhan, Hubei China
| | - Jingjing Li
- School of Health Science, Wuhan University, Wuhan, Hubei China.,Global Health Institute, Wuhan University, Wuhan, Hubei China.,Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Bin Yu
- Department of Epidemiology, University of Florida, Gainesville, FL USA
| | - Hanbo Wu
- School of Demography, College of Arts and Social Science, The Australian National University, Canberra, ACT Australia
| | - Shiyue Li
- School of Health Science, Wuhan University, Wuhan, Hubei China.,Global Health Institute, Wuhan University, Wuhan, Hubei China
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Gazzinelli MF, Lobato L, Andrade G, Matoso LF, Diemert DJ, Gazzinelli A. Improving the understanding of schistosomiasis among adolescents in endemic areas in Brazil: A comparison of educational methods. PATIENT EDUCATION AND COUNSELING 2016; 99:1657-1662. [PMID: 27180618 PMCID: PMC5028251 DOI: 10.1016/j.pec.2016.04.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 03/20/2016] [Accepted: 04/17/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of two teaching strategies, both guided by the concept of dialogicity, on adolescents' knowledge about schistosomiasis and adherence to diagnostic fecal testing. METHODS Two teaching strategies related to schistosomiasis were developed, an educational video and group conversation, which were tested in two groups of students aged 10-15 years old. Before and after the intervention, a questionnaire was applied to assess participants' knowledge about schistosomiasis and, after the intervention, two fecal samples were requested from each participant. Comparisons were performed by paired t- and McNemar tests. RESULTS Both strategies resulted in statistically significant improvements in knowledge between the pre- and post-tests. Students who watched the video had a higher return rate of fecal samples and percentage of correct questionnaire answers, mainly on questions about schistosomiasis infection. CONCLUSION Teaching strategies based on dialogue favored the construction of concepts about schistosomiasis that can influence the adoption of positives attitudes related to health. PRACTICAL IMPLICATIONS Using teaching strategies based on the concept of dialogicity can favor the increase of knowledge of school age children about schistosomiasis and can influence behavioral change related to health.
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Affiliation(s)
- Maria Flávia Gazzinelli
- School of Nursing, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; National Institute of Science and Technology in Tropical Diseases-INCT-DT, Brazil
| | - Lucas Lobato
- School of Nursing, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Gisele Andrade
- School of Nursing, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Leonardo Ferreira Matoso
- School of Nursing, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; National Institute of Science and Technology in Tropical Diseases-INCT-DT, Brazil
| | - David J Diemert
- Research Center for Neglected Diseases of Poverty, School of Medicine and Health Sciences, George Washington University, Washington DC, USA
| | - Andréa Gazzinelli
- School of Nursing, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; National Institute of Science and Technology in Tropical Diseases-INCT-DT, Brazil.
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Mwai J, Njenga S, Barasa M. Knowledge, attitude and practices in relation to prevention and control of schistosomiasis infection in Mwea Kirinyaga county, Kenya. BMC Public Health 2016; 16:819. [PMID: 27538885 PMCID: PMC4991016 DOI: 10.1186/s12889-016-3494-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 08/12/2016] [Indexed: 12/03/2022] Open
Abstract
Background Schistosomiasis remains a major public health problem in Kenya. Inadequate knowledge, attitudes and practices (KAP) on causative factors are some of the critical factors for the increased prevalence. The study assessed KAP on the control and prevention of schistosomiasis infection in Mwea division, Kirinyaga County-Kenya. Four hundred and sixty five house-hold heads were enrolled in this study by use of simple random sampling technique. Methods The study employed an analytical descriptive cross sectional design utilizing both quantitative and qualitative data collection methods. A pretested structured questionnaire, Focus Group Discusions (FGDs) and Key Informant Interviews (KII) guides were used for data collection. Descriptive statistics and Chi square tests and Fisher’s exact tests were computed where applicable. Data from the FGDs and KIIs were analyzed using NUID.IST NUIRO.6 software. Results Significant associations between knowledge and demographic factors i.e. age (p = 0.011), education level (p = 0.046), were reported. Handwashing after visiting the toilet (p = 0.001), having a toilet facility at home (p = 0.014); raring animals at home (p = 0.031), households being affected by floods (p = 0.005) and frequency of visits to the paddies (p = 0.037) had a significant association with respondents practices and schistosomiasis infection. Further significance was reported on households being affected by floods during the rainy season (p < 0.001), sources of water in a household (p < 0.047) and having a temporary water body in the area (p = 0.024) with increase in schistosomiasis infection. Results revealed that respondents practices were not significantly associated with gender (p = 0.060), marital status (p = 0.71), wearing of protective gear (p = 0.142) and working on the paddies (p = 0.144). Conclusions This study reveals that knowledge about the cause, transmission, symptoms and prevention of schistosomiasis among the Mwea population was inadequate, and that this could be a challenging obstacle to the elimination of schistosomiasis in these communities. Due to various dominant risk factors, different control strategies should be designed. Therefore, there is a need for integrated control programme to have a lasting impact on transmission of schistosomiasis infection. Control programs like mass drug administration need to go beyond anti-helminthic treatment and that there is a need of a more comprehensive approach including access to clean water, sanitation and hygiene. School and community-based health education is also imperative among these communities to significantly reduce the transmission and morbidity from schistosomiasis.
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Affiliation(s)
- J Mwai
- Kenya Medical Research Institute, Box 54840-00200, Nairobi, Kenya.
| | - S Njenga
- Kenya Medical Research Institute, Box 54840-00200, Nairobi, Kenya
| | - M Barasa
- Kenya Medical Research Institute, Box 54840-00200, Nairobi, Kenya
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Xu J, Bergquist R, Qian YJ, Wang Q, Yu Q, Peeling R, Croft S, Guo JG, Zhou XN. China-Africa and China-Asia Collaboration on Schistosomiasis Control: A SWOT Analysis. ADVANCES IN PARASITOLOGY 2016; 92:435-66. [PMID: 27137455 DOI: 10.1016/bs.apar.2016.02.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Schistosomiasis, a disease caused by a trematode, parasitic worm, is a worldwide public health problem. In spite of great progress with regard to morbidity control, even elimination of this infection in recent decades, there are still challenges to overcome in sub-Saharan Africa and endemic areas in Southeast Asia. Regarded as one of the most successful countries with respect to schistosomiasis control, The People's Republic of China has accumulated considerable experience and learnt important lessons in various local settings that could benefit schistosomiasis control in other endemic countries. Based on an analysis of conceived strengths, weaknesses, opportunities and threats (SWOT) of potential collaborative activities with regard to schistosomiasis in Africa and Asia, this article addresses the importance of collaborative efforts and explores the priorities that would be expected to facilitate the transfer of Chinese experience to low- and middle-income countries in Africa and Asia.
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Affiliation(s)
- J Xu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, The People's Republic of China; Key Laboratory of Parasite & Vector Biology, Ministry of Public Health, Shanghai, The People's Republic of China; WHO Collaborating Center for Tropical Diseases, Shanghai, The People's Republic of China
| | - R Bergquist
- Geospatial Health, University of Naples Federico II, Naples, Italy
| | - Y-J Qian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, The People's Republic of China; Key Laboratory of Parasite & Vector Biology, Ministry of Public Health, Shanghai, The People's Republic of China; WHO Collaborating Center for Tropical Diseases, Shanghai, The People's Republic of China
| | - Q Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, The People's Republic of China; Key Laboratory of Parasite & Vector Biology, Ministry of Public Health, Shanghai, The People's Republic of China; WHO Collaborating Center for Tropical Diseases, Shanghai, The People's Republic of China
| | - Q Yu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, The People's Republic of China; Key Laboratory of Parasite & Vector Biology, Ministry of Public Health, Shanghai, The People's Republic of China; WHO Collaborating Center for Tropical Diseases, Shanghai, The People's Republic of China
| | - R Peeling
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - S Croft
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - J-G Guo
- World Health Organization, Geneva, Switzerland
| | - X-N Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, The People's Republic of China; Key Laboratory of Parasite & Vector Biology, Ministry of Public Health, Shanghai, The People's Republic of China; WHO Collaborating Center for Tropical Diseases, Shanghai, The People's Republic of China
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Uneke CJ, Ezeoha AE, Uro-Chukwu H, Ezeonu CT, Ogbu O, Onwe F, Edoga C. Enhancing the Capacity of Policy-Makers to Develop Evidence-Informed Policy Brief on Infectious Diseases of Poverty in Nigeria. Int J Health Policy Manag 2015; 4:599-610. [PMID: 26340489 PMCID: PMC4556576 DOI: 10.15171/ijhpm.2015.100] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 05/16/2015] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The lack of effective use of research evidence in policy-making is a major challenge in most low- and middle-income countries (LMICs). There is need to package research data into effective policy tools that will help policy-makers to make evidence-informed policy regarding infectious diseases of poverty (IDP). The objective of this study was to assess the usefulness of training workshops and mentoring to enhance the capacity of Nigerian health policy-makers to develop evidence-informed policy brief on the control of IDP. METHODS A modified "before and after" intervention study design was used in which outcomes were measured on the target participants both before the intervention is implemented and after. A 4-point Likert scale according to the degree of adequacy; 1 = "grossly inadequate," 4 = "very adequate" was employed. The main parameter measured was participants' perceptions of their own knowledge/understanding. This study was conducted at subnational level and the participants were the career health policy-makers drawn from Ebonyi State in the South-Eastern Nigeria. A one-day evidence-to-policy workshop was organized to enhance the participants' capacity to develop evidence-informed policy brief on IDP in Ebonyi State. Topics covered included collaborative initiative; preparation and use of policy briefs; policy dialogue; ethics in health policy-making; and health policy and politics. RESULTS The preworkshop mean of knowledge and capacity ranged from 2.49-3.03, while the postworkshop mean ranged from 3.42-3.78 on 4-point scale. The percentage increase in mean of knowledge and capacity at the end of the workshop ranged from 20.10%-45%. Participants were divided into 3 IDP mentorship groups (malaria, schistosomiasis, lymphatic filariasis [LF]) and were mentored to identify potential policy options/recommendations for control of the diseases for the policy briefs. These policy options were subjected to research evidence synthesis by each group to identify the options that have the support of research evidence (mostly systematic reviews) from PubMed, Cochrane database and Google Scholar. After the evidence synthesis, five policy options were selected out of 13 for malaria, 3 out of 10 for schistosomiasis and 5 out of 11 for LF. CONCLUSION The outcome suggests that an evidence-to-policy capacity enhancement workshop combined with a mentorship programme can improve policy-makers' capacity for evidence-informed policy-making (EIP).
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Affiliation(s)
- Chigozie Jesse Uneke
- Department of Medical Microbiology/Parasitology, Faculty of Clinical Medicine, Ebonyi State University, Abakaliki, Nigeria
- Health Policy & systems Research Project (Knowledge Translation Platform), Ebonyi State University, Abakaliki, Nigeria
| | - Abel Ebeh Ezeoha
- Health Policy & systems Research Project (Knowledge Translation Platform), Ebonyi State University, Abakaliki, Nigeria
- Department of Banking & Finance, Ebonyi State University, Abakaliki, Nigeria
| | - Henry Uro-Chukwu
- Health Policy & systems Research Project (Knowledge Translation Platform), Ebonyi State University, Abakaliki, Nigeria
- National Obstetrics Fistula Centre, Abakaliki, Nigeria
| | - Chinonyelum Thecla Ezeonu
- Health Policy & systems Research Project (Knowledge Translation Platform), Ebonyi State University, Abakaliki, Nigeria
- Department of Paediatrics, Ebonyi State University, Abakaliki, Nigeria
| | - Ogbonnaya Ogbu
- Health Policy & systems Research Project (Knowledge Translation Platform), Ebonyi State University, Abakaliki, Nigeria
- Department of Applied Microbiology, Ebonyi State University, Abakaliki, Nigeria
| | - Friday Onwe
- Health Policy & systems Research Project (Knowledge Translation Platform), Ebonyi State University, Abakaliki, Nigeria
- Department of Sociology/Anthropology, Ebonyi State University, Abakaliki, Nigeria
| | - Chima Edoga
- Health Policy & systems Research Project (Knowledge Translation Platform), Ebonyi State University, Abakaliki, Nigeria
- Catholic Relief Services (Nigeria Program), Abakaliki, Nigeria
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Lee BY, Bartsch SM, Gorham KM. Economic and financial evaluation of neglected tropical diseases. ADVANCES IN PARASITOLOGY 2015; 87:329-417. [PMID: 25765199 DOI: 10.1016/bs.apar.2015.01.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Economic and financing studies are particularly important for decision-making when resources are scarce or considerably limited. This is the case for neglected tropical diseases (NTDs). In fact, the definition of NTDs is an economic one. The shortage of resources for NTD control may be due in large part to the fact that the burden of NTDs and economic value of control measures have not been fully characterized. A number of economic study methodologies are available: cost of illness can quantify the extent, magnitude, and change of a problem; cost of intervention studies can outline the feasibility and guide the design of a policy or intervention; and cost-benefit, cost-effectiveness, and return-on-investment studies can determine the potential value of different interventions and policies. NTDs have unique characteristics that require special consideration in such analyses. Hence, approaches used for other diseases may need modifications to capture the full impact of NTDs. While the existing literature has made important findings, there is a need for substantially more work, as many NTDs and their associated interventions and policies require more evaluation. With increasing work in this area, NTDs may not be as 'neglected' in the future as they are now.
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Affiliation(s)
- Bruce Y Lee
- Public Health Computational and Operations Research (PHICOR) and International Vaccine Access Center (IVAC), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sarah M Bartsch
- Public Health Computational and Operations Research (PHICOR) and International Vaccine Access Center (IVAC), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Katrin M Gorham
- Public Health Computational and Operations Research (PHICOR) and International Vaccine Access Center (IVAC), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Integrated control programmes for schistosomiasis and other helminth infections in P.R. China. Acta Trop 2015; 141:332-41. [PMID: 24361182 DOI: 10.1016/j.actatropica.2013.11.028] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 10/26/2013] [Accepted: 11/30/2013] [Indexed: 02/08/2023]
Abstract
The prevalence of human schistosomiasis and soil-transmitted helminthiasis (STH) has decreased significantly in the People's Republic of China (P.R. China), particularly after 2005 when the national control programmes were reinforced by forming of integrated control strategies. Furthermore, social-economic development also contributed to the decrease of schistosome and soil-transmitted helminth infections. The prevalence of the zoonotic helminthiasis, including clonorchiasis and echinococcosis, on the other hand, is either underestimated or has in fact increased due to changes in social and environmental factors. In comparison with the control strategies in force and their effects on those four kinds of helminthiasis, the challenges and control priorities for the potential transfer from control to elimination of each disease is reviewed, to provide evidence for policy-makers to act upon.
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Liu L, Yang GJ, Zhu HR, Yang K, Ai L. Knowledge of, attitudes towards, and practice relating to schistosomiasis in two subtypes of a mountainous region of the People's Republic of China. Infect Dis Poverty 2014; 3:16. [PMID: 24955240 PMCID: PMC4064289 DOI: 10.1186/2049-9957-3-16] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 04/22/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Schistosomiasis japonica is still endemic in the People's Republic of China (P.R. China) in five provinces of lake and marshland regions and in two provinces of mountainous regions. Studies elucidated that individual and community perception, attitudes towards schistosomiasis, and hygiene behaviors were crucial factors for preventing schistosomiasis. This study sought to assess the knowledge of, attitudes towards, and practices (KAP) relating to schistosomiasis in two subtypes of a mountainous region in Eryuan County, Yunnan Province, P.R. China. The study's aim is to make suggestions for establishing more specific and effective control measures for disease transmission and interruption in two subtypes of a mountainous region with low-level infection rates. METHODS A cross-sectional study of 3,000 inhabitants was carried out in the Yongle (plateau basin) and Xinzhuang (plateau canyon) communities of Eryuan County, Yunnan Province in November and December 2011. Stratified cluster random sampling was undertaken using a uniform set of quantitative questionnaires administered by trained assistants. This was further supported with qualitative data from in-depth interviews (IDIs) conducted with ten farmers and ten students. All participants were examined for schistosomiasis using both a serological test (indirect hemagglutination assay [IHA]) and a stool examination (Kato-Katz). RESULTS The total schistosomiasis knowledge rate in Yongle (83.4%) was significantly lower than that in Xinzhuang (95.5%). In both communities, among the respondents aged 15 years or below, more than one third didn't know the name, endemic areas, and animal reservoirs of schistosomiasis. The majority of respondents in Eryuan acquired their schistosomiasis knowledge from doctors, followed by handouts and hearing from others. The infection rate was once the highest in Yongle, but is now the highest in Xinzhuang, where there are more risk factors for schistosomiasis, such as frequently grazing cattle, digging vegetables or cutting grass in the field, as well as raising cattle by free grazing. CONCLUSION In short, Eryuan County's overall knowledge rate of schistosomiasis was found to be high. Due to various dominating risk factors, different control strategies should be designed keeping in mind the two different subtypes of endemic areas for schistosomiasis in mountainous regions, namely plateau basins and plateau canyons.
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Affiliation(s)
- Lu Liu
- Key Laboratory of Parasitic Disease Control and Prevention (Ministry of Health), Jiangsu Provincial Key Laboratory of Parasite Molecular Biology, Wuxi, Jiangsu Province 214064, People's Republic of China
| | - Guo-Jing Yang
- Key Laboratory of Parasitic Disease Control and Prevention (Ministry of Health), Jiangsu Provincial Key Laboratory of Parasite Molecular Biology, Wuxi, Jiangsu Province 214064, People's Republic of China
| | - Hong-Ru Zhu
- Key Laboratory of Parasitic Disease Control and Prevention (Ministry of Health), Jiangsu Provincial Key Laboratory of Parasite Molecular Biology, Wuxi, Jiangsu Province 214064, People's Republic of China
| | - Kun Yang
- Key Laboratory of Parasitic Disease Control and Prevention (Ministry of Health), Jiangsu Provincial Key Laboratory of Parasite Molecular Biology, Wuxi, Jiangsu Province 214064, People's Republic of China
| | - Lin Ai
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, and Key Laboratory on Biology of Parasite and Vector, Ministry of Health, and WHO Collaborating Center for Malaria, Schistosomiasis and Filariasis, Shanghai, People's Republic of China
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Wang S, Carlton EJ, Chen L, Liu Y, Spear RC. Evaluation of an educational intervention on villagers' knowledge, attitude and behaviour regarding transmission of Schistosoma japonicum in Sichuan province, China. Acta Trop 2013; 127:226-35. [PMID: 23711611 DOI: 10.1016/j.actatropica.2013.05.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 05/16/2013] [Accepted: 05/19/2013] [Indexed: 02/07/2023]
Abstract
Health education is an important component of efforts to control schistosomiasis. In China, while education programmes have been implemented intensively, few articles in recent years in either the Chinese or English literature report randomised, controlled interventions of the impacts on knowledge, attitudes and behaviours. Thus, we designed and carried out a cluster-randomised controlled education intervention trial that targeted 706 adults from rural areas in 28 villages in Sichuan, China. We evaluated the effects of the intervention on five endpoints: (1) schistosomiasis knowledge, (2) attitudes towards infection testing and treatment, (3) use of personal protective equipment (PPE), (4) reducing defecation in the field, and (5) reducing dermal contact with potentially contaminated water sources. The results indicated that people in both the intervention and control groups showed improvement in knowledge, attitudes and reduction in field-defecation in the follow-up surveys. However, there was little evidence that suggested statistically significant differences between the two groups regarding any endpoint. Participation in intervention classes was associated with age, gender, occupation and education level. Our study suggests short-term health education interventions may not be effective in improving schistosomiasis knowledge or in the adoption of health-protective behaviours. This might be partially due to the spontaneous learning process of people subject to repeated surveys and other disease control activities. Considering the difficulties of occupation-associated behaviour change and knowledge reinforcement in general, longer-term education programmes should be considered in the future.
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Bieri FA, Gray DJ, Williams GM, Raso G, Li YS, Yuan L, He Y, Li RS, Guo FY, Li SM, McManus DP. Health-education package to prevent worm infections in Chinese schoolchildren. N Engl J Med 2013; 368:1603-12. [PMID: 23614586 DOI: 10.1056/nejmoa1204885] [Citation(s) in RCA: 122] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Soil-transmitted helminths are among the most prevalent sources of human infections globally. We determined the effect of an educational package at rural schools in Linxiang City District, Hunan province, China, where these worms are prevalent. The intervention aimed to increase knowledge about soil-transmitted helminths, induce behavioral change, and reduce the rate of infection. METHODS We conducted a single-blind, unmatched, cluster-randomized intervention trial involving 1718 children, 9 to 10 years of age, in 38 schools over the course of 1 school year. Schools were randomly assigned to the health-education package, which included a cartoon video, or to a control package, which involved only the display of a health-education poster. Infection rates, knowledge about soil-transmitted helminths (as assessed with the use of a questionnaire), and hand-washing behavior were assessed before and after the intervention. Albendazole was administered in all the participants at baseline and in all the children who were found to be positive for infection with soil-transmitted helminths at the follow-up assessment at the end of the school year. RESULTS At the follow-up assessment, the mean score for the knowledge of helminths, calculated as a percentage of a total of 43 points on a questionnaire, was 90% higher in the intervention group than in the control group (63.3 vs. 33.4, P<0.001), the percentage of children who washed their hands after using the toilet was nearly twice as high in the intervention group (98.9%, vs. 54.2% in the control group; P<0.001), and the incidence of infection with soil-transmitted helminths was 50% lower in the intervention group than in the control group (4.1% vs. 8.4%, P<0.001). No adverse events were observed immediately (within 15 minutes) after albendazole treatment. CONCLUSIONS The health-education package increased students' knowledge about soil-transmitted helminths and led to a change in behavior and a reduced incidence of infection within 1 school year. (Funded by UBS Optimus Foundation, Zurich, Switzerland; Australian New Zealand Clinical Trials Registry number, ACTRN12610000048088.).
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A mathematical model for the transmission of Schistosoma japonicum in consideration of seasonal water level fluctuations of Poyang Lake in Jiangxi, China. Parasitol Int 2013; 62:118-26. [DOI: 10.1016/j.parint.2012.10.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Revised: 09/26/2012] [Accepted: 10/26/2012] [Indexed: 11/20/2022]
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Bieri FA, Gray DJ, Raso G, Li YS, McManus DP. A systematic review of preventive health educational videos targeting infectious diseases in schoolchildren. Am J Trop Med Hyg 2013; 87:972-8. [PMID: 23222138 DOI: 10.4269/ajtmh.2012.12-0375] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
We conducted a systematic review of preventive health educational videos targeting infectious diseases in schoolchildren to formulate recommendations for establishing an evidence base for future studies. We included studies that evaluated interventions involving video-based health education in schools to improve knowledge and attitudes and to change behavior regarding different infections. The majority of the 11 studies we reviewed concluded that videos were well received by schools, teachers, and children, and are promising and effective health education tools, having a positive impact on knowledge and attitudes. However, there is a pressing need for more standardized, high-quality studies to draw evidence-based conclusions on the value of educational videos targeting infectious diseases. Therefore, we provide a descriptive summary of the results and make recommendations for studies using preventive educational videos targeting infectious diseases in schoolchildren on the basis of our experiences gained in a video-based cluster randomized trial.
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Affiliation(s)
- Franziska A Bieri
- Queensland Institute of Medical Research, Herston, Brisbane, Queensland, Australia.
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The new national integrated strategy emphasizing infection sources control for schistosomiasis control in China has made remarkable achievements. Parasitol Res 2013; 112:1483-91. [DOI: 10.1007/s00436-013-3295-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2012] [Accepted: 01/11/2013] [Indexed: 10/27/2022]
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Zhou LY, Deng Y, Steinmann P, Yang K. The effects of health education on schistosomiasis japonica prevalence and relevant knowledge in the People's Republic of China: a systematic review and meta-analysis. Parasitol Int 2012. [PMID: 23201566 DOI: 10.1016/j.parint.2012.11.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Schistosomiasis japonica continues to be an important zoonotic disease in the People's Republic of China (P.R. China), despite decades of dedicated control efforts. Different interventions for its control including chemotherapy of humans and animals, mollusciciding, environmental modification, and health education have been implemented at various stages of the control efforts and in different combinations, resulting in remarkable achievements. Here, we present a systematic review and meta-analysis of the documented effectiveness of health education to reduce schistosomiasis japonica transmission in P.R. China. A total of 10 relevant publications were identified and included in the meta-analysis. The reported results indicate that the prevalence of Schistosoma japonicum infection in humans and schistosomiasis-related knowledge are significantly influenced by health education. The implementation of health education over more than 2 years was associated with an overall schistosomiasis japonica prevalence decrease of 6% (95% CI: 2%, 11%) and an overall increase of 51% (95% CI: 41%, 61%) in schistosomiasis-related knowledge after controlling for confounding factors. Among control groups, the prevalence of schistosomiasis japonica and relevant knowledge levels were not significantly influenced. The relative risk (RR) of an infection with S. japonicum following health education lasting more than 2 years was 0.43 (95% CI: 0.24, 0.78). In summary, a considerable effectiveness of health education with regard to preventing S. japonicum infections in P.R. China and increasing relevant knowledge is documented in the extant literature. This suggests that the effectiveness of health education may be considerable, particularly after its long-term implementation.
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Affiliation(s)
- Li-Ying Zhou
- School of Humanities, Jiangnan University, Wuxi, PR China
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Awareness and knowledge of schistosomiasis infection and prevention in the "Three Gorges Dam" reservoir area: a cross-sectional study on local residents and health personnel. Acta Trop 2011; 120:238-44. [PMID: 21945272 DOI: 10.1016/j.actatropica.2011.09.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2010] [Revised: 08/05/2011] [Accepted: 09/06/2011] [Indexed: 11/20/2022]
Abstract
BACKGROUND Schistosomiasis is a severe public health problem in China. It has been predicted that the ecological changes caused by the "Three Gorges Dam", the world's largest hydropower project, could potentially aggravate the spread of schistosomiasis in the area. This study focused on investigating (a) local residents' knowledge on the potential risks of schistosomiasis and (b) the capability of local health personnel in preventing schistosomiasis. MATERIALS AND METHODS A quantitative survey combined with qualitative interviews was conducted in three counties of the reservoir area during November and December 2008. A total of 1386 inhabitants and 180 local health personals participated in questionnaire survey; 18 inhabitants, 21 health professionals, and 8 local government officials were interviewed. RESULTS Of the surveyed inhabitants, 66.3% had no access to safe drinking water; 47.9% had water-contact regularly through farming or swimming; 58.7% did not have hygienic toilets; and only 13.7% used methane for energy. Besides, only 3.8% of the inhabitants had knowledge scores higher than 6 points within the range 0-10. Educational level, occupation and income were significant predictors of knowledge score (P<0.05). Only about 5% of the inhabitants had some knowledge on schistosomiasis. Among health professionals surveyed, 6.7% had college or higher education; 26.7% had prior schistosomiasis control experience; 75.6% did not receive any relevant training in the past year; and only 52.2% had basic knowledge of schistosomiasis. The logistic regression analysis identified occupation and time at work as significant factors to their knowledge level (P<0.05). Moreover, the surveillance work was often severely hindered by a shortage of funding, and challenged by monitoring of migrant population. There were very limited training opportunities for the health workers, and almost no health education for inhabitants, if any, neither efficient nor effective. CONCLUSION Although there were multiple risks for potential Schistosoma japonicum infections in the study area, the knowledge level on schistosomiasis and surveillance was relatively low both in local residents and health personnel. Thus, more health education and professional training are urgently required to local residents and health personnel, respectively. By considering limited activities in surveillance and health education been implemented, a strategy plan on intervention to ensure a stronger inter-sectoral cooperation is recommended in order to reduce schistosomiasis transmission risks in this area.
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What is the role of health education in the integrated strategy to control transmission of Schistosoma japonicum in China? Parasitol Res 2011; 110:2081-2. [PMID: 22127388 DOI: 10.1007/s00436-011-2721-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Accepted: 11/17/2011] [Indexed: 10/15/2022]
Abstract
In 2009, Wang et al.'s field trial published in the New England Journal of Medicine, reported that a comprehensive strategy aiming to reduce the roles of humans and cattle as sources of Schistosoma japonicum infection in snails was implemented and proved effective and promising in dramatically reducing the percentage of infected humans and snails, which had been extended to other endemic provinces in China afterwards. This implies that the integrated schistosomiasis-control strategies of interventions including political will, financial support and residents' participation to control human and bovine sources of S. japonicum infection in snails may direct to successfully interrupt the parasitic transmission and to ultimately eliminate schistosomiasis. Confusingly, however, the role of health education, which is a critical part of the integrated strategy and should play an active role in schistosomiasis control, was not reflected. We wish the authors to provide the readers a better and clearer statement of the role of health education as part of the integrated control strategy and so we write this comment.
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Bergquist R, Tanner M. Controlling Schistosomiasis in Southeast Asia. ADVANCES IN PARASITOLOGY 2010; 72:109-44. [DOI: 10.1016/s0065-308x(10)72005-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Location of active transmission sites of Schistosoma japonicum in lake and marshland regions in China. Parasitology 2009; 136:737-46. [PMID: 19416552 DOI: 10.1017/s0031182009005885] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Schistosomiasis control in China has, in general, been very successful during the past several decades. However, the rebounding of the epidemic situation in some areas in recent years raises concerns about a sustainable control strategy of which locating active transmission sites (ATS) is a necessary first step. This study presents a systematic approach for locating schistosomiasis ATS by combining the approaches of identifying high risk regions for schisotosmiasis and extracting snail habitats. Environmental, topographical, and human behavioural factors were included in the model. Four significant high-risk regions were detected and 6 ATS were located. We used the normalized difference water index (NDWI) combined with the normalized difference vegetation index (NDVI) to extract snail habitats, and the pointwise 'P-value surface' approach to test statistical significance of predicted disease risk. We found complicated non-linear relationships between predictors and schistosomiasis risk, which might result in serious biases if data were not properly treated. We also found that the associations were related to spatial scales, indicating that a well-designed series of studies were needed to relate the disease risk with predictors across various study scales. Our approach provides a useful tool, especially in the field of vector-borne or environment-related diseases.
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Li YS, Raso G, Zhao ZY, He YK, Ellis MK, McManus DP. Large water management projects and schistosomiasis control, Dongting Lake region, China. Emerg Infect Dis 2008; 13:973-9. [PMID: 18214167 DOI: 10.3201/eid1307.060848] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Construction of the Three Gorges Dam across the Yangtze River will substantially change the ecology of the Dongting Lake in southern China. In addition, the Chinese Central and Hunan Provinces' governmental authorities have instigated a Return Land to Lake Program that will extend the Dongting Lake surface area from the current 2,681 km2 to 4,350 km2. The previous construction of embankments and the large silt deposits made by the Yangtze River and other connecting rivers have contributed to frequent disastrous flooding. As a consequence of the 2 water projects, > 2 million persons and their domestic animals are being resettled. This article provides an overview of the historical background of these 2 large water management projects, the associated population movement, and their impact on future transmission and control of schistosomiasis in the Dongting Lake area. The dam will likely substantially extend the range of the snail habitats and increase schistosome transmission and schistosomiasis cases.
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Affiliation(s)
- Yue-Sheng Li
- Hunan Institute of Parasitic Diseases, Yueyang, People's Republic of China
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Gazzinelli MF, Reis DCD, Kloos H, Velásquez-Melendez G, Dutra IR, Gazzinelli A. The impact of two education methods on knowledge of schistosomiasis transmission and prevention among schoolchildren in a rural community in northern Minas Gerais, Brazil. Mem Inst Oswaldo Cruz 2008; 101 Suppl 1:45-53. [PMID: 17308747 DOI: 10.1590/s0074-02762006000900008] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2006] [Accepted: 06/26/2006] [Indexed: 11/21/2022] Open
Abstract
The objective of this study was to analyse the effect of using two health education approaches on knowledge of transmission and prevention of schistosomiasis of school children living in a rural endemic area in the state of Minas Gerais, Brazil. The 87 children participating in the study were divided into three groups based on gender, age and presence or absence of Schistosoma mansoni infection. In the first group the social representation model and illness experience was used. In the second group, we used the cognitive model based on the transmission of information. The third group, the control group, did not receive any information related to schistosomiasis. Ten meetings were held with all three groups that received a pre-test prior to the beginning of the educational intervention and a post-test after the completion of the program. The results showed that knowledge levels in Group 1 increased significantly during the program in regard to transmission (p = 0.038) and prevention (p = 0.001) of schistosomiasis. Groups 2 and 3 did not show significant increase in knowledge between the two tests. These results indicate that health education models need to consider social representation and illness experience besides scientific knowledge in order to increase knowledge of schistosomiasis transmission and prevention.
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Affiliation(s)
- Maria Flávia Gazzinelli
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Av. Alfredo Balena 190, 30130-100 Belo Horizonte, MG, Brazil
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Li YS, Raso G, Zhao ZY, He YK, Ellis MK, McManus DP. Large water management projects and schistosomiasis control, Dongting Lake region, China. Emerg Infect Dis 2007; 13. [PMID: 18214167 PMCID: PMC2878251 DOI: 10.3201/eid1307.070848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Construction of the Three Gorges Dam across the Yangtze River will substantially change the ecology of the Dongting Lake in southern China. In addition, the Chinese Central and Hunan Provinces' governmental authorities have instigated a Return Land to Lake Program that will extend the Dongting Lake surface area from the current 2,681 km2 to 4,350 km2. The previous construction of embankments and the large silt deposits made by the Yangtze River and other connecting rivers have contributed to frequent disastrous flooding. As a consequence of the 2 water projects, > 2 million persons and their domestic animals are being resettled. This article provides an overview of the historical background of these 2 large water management projects, the associated population movement, and their impact on future transmission and control of schistosomiasis in the Dongting Lake area. The dam will likely substantially extend the range of the snail habitats and increase schistosome transmission and schistosomiasis cases.
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Affiliation(s)
- Yue-Sheng Li
- Hunan Institute of Parasitic Diseases, Yueyang, People’s Republic of China,Queensland Institute of Medical Research, Brisbane, Queensland, Australia
| | - Giovanna Raso
- Queensland Institute of Medical Research, Brisbane, Queensland, Australia,University of Queensland, Brisbane, Queensland, Australia
| | - Zheng-Yuan Zhao
- Hunan Institute of Parasitic Diseases, Yueyang, People’s Republic of China,Central South University, Changsha, People’s Republic of China
| | - Yong-Kang He
- Hunan Institute of Parasitic Diseases, Yueyang, People’s Republic of China
| | - Magda K. Ellis
- Queensland Institute of Medical Research, Brisbane, Queensland, Australia
| | - Donald P. McManus
- Queensland Institute of Medical Research, Brisbane, Queensland, Australia
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Guo JG, Cao CL, Hu GH, Lin H, Li D, Zhu R, Xu J. The role of 'passive chemotherapy' plus health education for schistosomiasis control in China during maintenance and consolidation phase. Acta Trop 2005; 96:177-83. [PMID: 16112637 DOI: 10.1016/j.actatropica.2005.07.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In order to explore the possibility of further optimising schistosomiasis control during the maintenance and consolidation phase in China, two highly endemic villages were selected to compare the strategy of 'passive chemotherapy' plus health education to that of mass chemotherapy singly. Emphasis was placed on treatment coverage with praziquantel among individuals infected with Schistosoma japonicum and costs incurred for treating an infected person. The results show that the former strategy was almost as good as the latter producing treatment coverage rates among egg-positives of 96.2-97.1% during 2 years, while corresponding rates of 100% were achieved in the village where mass chemotherapy was employed. Importantly, the cost of the former strategy was only about half that of mass chemotherapy, i.e. 49.0% in the first year and 54.6% in the following. Moreover, 'passive chemotherapy' together with health education can conveniently be integrated into the primary health care system making it an attractive strategy for schistosomiasis control during the maintenance and consolidation phase.
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Affiliation(s)
- Jia-Gang Guo
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, China.
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Li YS, Zhao ZY, Ellis M, McManus DP. Applications and outcomes of periodic epidemiological surveys for schistosomiasis and related economic evaluation in the People's Republic of China. Acta Trop 2005; 96:266-75. [PMID: 16202595 DOI: 10.1016/j.actatropica.2005.07.020] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The great success in schistosomiasis control in China is attributable to a range of factors. Periodic epidemiological surveys (PES) used for monitoring and adapting control interventions over time are an integral feature of the national schistosomiasis control programme. PES have enabled the dynamic trends of schistosomiasis epidemics to be closely pursued and have assisted in analysing subtle changes in endemicity. The results can be summarised mathematically allowing the variation in efficacy of control measures to be readily determined and enabling control strategies to be adjusted and updated. PES have been used in both cross-sectional and longitudinal pilot studies selected by appropriate sampling methods. In the early 1990s, when the World Bank Loan Project for schistosomiasis control commenced, economic evaluations were initiated in parallel. Cost-effectiveness analysis became a necessary tool to identify the most financially feasible yet effective options among a range of alternative control strategies. There was, however, a lack of standardised approaches rendering study comparisons across sites difficult. The global burden of disease study established the disability adjusted life year (DALY) as a measure of population health, combining in a single indicator years lost from premature death and years of life lived with disability. However, a recent meta-analysis reveals that the burden of schistosomiasis is underestimated, and hence, needs to be revised. It is envisaged that after the revision of DALYs lost due to schistosomiasis japonica, they will become an essential measure in future schistosomiasis control assessments in China and in other schistosome-endemic areas of the world.
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Affiliation(s)
- Yue-Sheng Li
- Hunan Institute of Parasitic Diseases, Yueyang, Hunan 414000, China.
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