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Meñe GR, Dejon-Agobé JC, Angue BMA, Meñe MF, Echube JME, Abdulla S, Adegnika AA. Knowledge, attitudes, and practices related to soil-transmitted helminth infections among residents of Bata district, Equatorial Guinea; a cross-sectional study. BMC Public Health 2024; 24:1962. [PMID: 39044267 PMCID: PMC11264363 DOI: 10.1186/s12889-024-19528-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 07/18/2024] [Indexed: 07/25/2024] Open
Abstract
BACKGROUND Soil-transmitted helminth (STH) infection control remains a priority in endemic regions where local epidemiological data are needed for sustainable control strategies, particularly regarding population knowledge, attitudes, and practices (KAP). Our work assessed KAP toward STH infection and associated factors among residents of Bata district, Equatorial Guinea. METHODS A community-based cross-sectional study was conducted among 14 randomly selected communities in the Bata district. Eligible participants were interviewed face-to-face using a standardized questionnaire. Participants aged under 18 years were interviewed in the presence of their parents or legal guardians. For participants aged less than ten, a simplified version of the main questionnaire was developed focusing on children's practices toward STH and was administered to their parents or legal guardians. RESULTS A total of 399 participants were included in the present analysis. Among them, 58% responded to the main questionnaire. The mean (± SD) age of participants aged 10 and over was 37.5 (± 22.2) years, and 60% of them were females, while the mean (± SD) age of those aged less than ten was 5.0 (± 2.5) years. The respondents' overall knowledge, attitudes, and practices to STH were rated as bad (33%), very good (77%), and good (55%), respectively. Knowledge was significantly associated with education level (p = 0.04) with the knowledge level lower for participants with no formal education than for those with secondary/university education (β = -0.56, 95% CI: -1.00 - -0.12, p = 0.01); Appropriate attitudes level was significantly associated with occupation (p = 0.02) and education levels (p = 0.049) with the appropriate attitude level lower for students than for farmers/fishers (β = -1.24, 95% CI: -2.17--0.32, p = 0.01) and for primary-level participants than for those with secondary/university education (β = -0.68, 95% CI: -1.23--0.13, p = 0.02); while appropriate practice level were significantly associated with age (p = 0.01), occupation (p = 0.01), and education (p = 0.02), with the appropriate practices level increasing with age (β = 0.03, 95% CI: 0.005 - 0.05, p = 0.01) and lower in participants with no formal education than in those with secondary/university education (β = -1.19, -2.05 - -0.32, p = 0.007). CONCLUSION The present study revealed a lack of knowledge about STH in the study population, particularly regarding disease causes and transmission ways, highlighting the need for the implementation of integrated health education strategies, both at the community and school levels.
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Affiliation(s)
- Gertrudis Ribado Meñe
- National University of Equatorial Guinea/Environmental Faculty, Malabo, Equatorial Guinea.
- Ecole Doctorale Régionale d'Afrique Centrale, Franceville, Gabon.
- Centre de Recherche Médicales de Lambaréné (CERMEL), Lambaréné, Gabon.
| | - Jean Claude Dejon-Agobé
- Centre de Recherche Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tubingen, Tubingen, Germany
| | | | - Maximiliano Fero Meñe
- National University of Equatorial Guinea/Environmental Faculty, Malabo, Equatorial Guinea
| | | | - Salim Abdulla
- Department of Intervention, Ifakara Health Institute, Dar-es-Salaam, Tanzania
| | - Ayôla Akim Adegnika
- Centre de Recherche Médicales de Lambaréné (CERMEL), Lambaréné, Gabon
- Institute of Tropical Medicine, University of Tubingen, Tubingen, Germany
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
- German Center for Infection Research, Tubingen, Germany
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Akinsolu FT, Abodunrin OR, Olagunju MT, Adewole IE, Ola OM, Abel C, Sanni-Adeniyi R, Rahman NO, Akanni OO, Njuguna DW, Soneye IY, Salako AO, Ezechi OC, Varga OE, Akinwale OP. Health workers' perspectives on school-based mass drug administration control programs for soil-transmitted helminthiasis and schistosomiasis in Ogun State, Nigeria. PLoS One 2024; 19:e0302509. [PMID: 38718082 PMCID: PMC11078364 DOI: 10.1371/journal.pone.0302509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 04/05/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Soil-transmitted helminthiasis (STH) and schistosomiasis (SCH) are among the most prevalent neglected tropical diseases (NTDs), affecting 1.5 billion globally, with a significant burden in sub-Saharan Africa, particularly Nigeria. These diseases impair health and contribute to socio-economic challenges, especially in children, undermining educational and future economic prospects. The 2030 NTD Roadmap highlights Mass Drug Administration (MDA) as a critical strategy for controlling these NTDs, targeting vulnerable populations like school-age children. Despite some successes, challenges persist, indicating the need for deeper insights into program implementation. This study focuses on the perspectives of health workers implementing MDA in selected local government areas (LGAs) of Ogun State, Nigeria, aiming to identify challenges and enablers that align with the broader NTD 2030 goals. METHODOLOGY/PRINCIPAL FINDINGS The study used a qualitative research approach involving focus group discussions and in-depth interviews with health workers engaged in neglected tropical disease control programs in Ogun State, Nigeria, between July and September 2022. A semi-structured questionnaire guided the exploration of ideas, and the data were analyzed using the QRS Nvivo 12 software package. The study found that the school-based MDA control program's efficacy largely relies on strong collaborations and partnerships, particularly with educators, community heads, and other stakeholders. These alliances and strategic communication methods, like town announcements and media campaigns, have been pivotal in reaching communities. However, the program does grapple with hurdles such as parental misconceptions, limited funds, insufficient staffing, and misalignment with the Ministry of Education. It is recommended to boost funding, foster early stakeholder involvement, enhance mobilization techniques, and consider introducing a monitoring card system similar to immunization. CONCLUSIONS/SIGNIFICANCE The MDA Integrated Control Programs for STH and SCH in Ogun State schools demonstrate a holistic approach, integrating knowledge, collaboration, communication, and feedback. Health workers have shown commitment and adeptness in their roles. However, achieving maximum efficacy requires addressing critical barriers, such as parental misconceptions and funding challenges. Adopting the recommended strategies, including proactive communication, increased remuneration, and introducing a tracking system, can significantly enhance the program's reach and impact. The involvement of all stakeholders, from health workers to community leaders and parents, is essential for the program's sustainability and success.
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Affiliation(s)
- Folahanmi T. Akinsolu
- Department of Public Health, Lead City University, Ibadan, Oyo State, Nigeria
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Lagos State, Nigeria
| | - Olunike R. Abodunrin
- Department of Public Health, Lead City University, Ibadan, Oyo State, Nigeria
- Department of Planning and Research, Lagos State Health Management Agency, Lagos, Lagos State, Nigeria
| | - Mobolaji T. Olagunju
- Department of Epidemiology and Biostatistics, Nanjing Medical University, Nanjing, China
| | - Ifeoluwa E. Adewole
- Department of Public Health, Lead City University, Ibadan, Oyo State, Nigeria
| | - Oluwabukola M. Ola
- Department of Public Health, Lead City University, Ibadan, Oyo State, Nigeria
| | - Chukwuemeka Abel
- Department of Public Health, Lead City University, Ibadan, Oyo State, Nigeria
| | | | - Nurudeen O. Rahman
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Olukunmi O. Akanni
- Department of Public Health, Lead City University, Ibadan, Oyo State, Nigeria
| | - Diana W. Njuguna
- School of Nursing, Dedan Kimathi University of Technology, Nyeri, Kenya
| | - Islamiat Y. Soneye
- Department of Public Health, Ogun State Ministry of Health, Ota, Ogun State, Nigeria
| | - Abideen O. Salako
- Department of Public Health, Lead City University, Ibadan, Oyo State, Nigeria
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Lagos State, Nigeria
| | - Oliver C. Ezechi
- Department of Public Health, Lead City University, Ibadan, Oyo State, Nigeria
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Lagos State, Nigeria
| | - Orsolya E. Varga
- Department of Public Health and Epidemiology, University of Debrecen, Debrecen, Hungary
| | - Olaoluwa P. Akinwale
- Department of Public Health, Lead City University, Ibadan, Oyo State, Nigeria
- Clinical Sciences Department, Nigerian Institute of Medical Research, Lagos, Lagos State, Nigeria
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Sukmawati E, Wijaya M, Hilmanto D. Participatory Health Cadre Model to Improve Exclusive Breastfeeding Coverage with King's Conceptual System. J Multidiscip Healthc 2024; 17:1857-1875. [PMID: 38699558 PMCID: PMC11063463 DOI: 10.2147/jmdh.s450634] [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: 11/19/2023] [Accepted: 03/19/2024] [Indexed: 05/05/2024] Open
Abstract
Objective The purpose of this research is to develop a participatory health cadre model to enhance exclusive breastfeeding coverage through initial stages using the Imogene King model. Methods This study employs a mixed-methods approach with sequential exploratory designs. Qualitative research utilized in-depth interviews with informants including the head of the community health center, nutrition officers from the health center, the coordinator of Maternal and Child Health (MCH) midwives, village midwives, breastfeeding mothers, families of breastfeeding mothers, and health cadres. Quantitative research respondents consist of health cadres. The quantitative study utilizes a quasi-experimental method with a design paradigm known as the one-group pre and post-test design to measure health cadre perception on exclusive breastfeeding. Results This study yields elements from Imogene King that form a participatory health cadre model to enhance exclusive breastfeeding coverage, consisting of interaction, perception, communication, transaction, role, growth and development, time, and space. Transactions represent the objective integration of the health cadre participation model, as demonstrated by the behavioral shifts observed in mothers regarding breastfeeding their infants. The t-test results indicate that exclusive breastfeeding monitoring training is effective and successful in enhancing exclusive breastfeeding coverage (Sig. value = 0.000 < 0.05). In addition, the effectiveness of exclusive breastfeeding monitoring training falls within the category of good or high. Conclusion The research findings indicate the success of the participatory health cadre model in improving exclusive breastfeeding coverage.
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Affiliation(s)
- Ellyzabeth Sukmawati
- Doctoral Program in Medical Sciences, Universitas Padjadjaran, Bandung, 40161, Indonesia
| | - Merry Wijaya
- Medical Sciences, Universitas Padjadjaran, Bandung, 40161, Indonesia
| | - Dany Hilmanto
- Department of Child Health Sciences, Medical Sciences, Universitas Padjadjaran, Bandung, 40161, Indonesia
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Mationg MLS, Williams GM, Tallo VL, Olveda RM, Aung E, Alday P, Reñosa MD, Daga CM, Landicho J, Demonteverde MP, Santos ED, Bravo TA, Bieri FA, Bedford A, Li Y, Clements ACA, Steinmann P, Halton K, Stewart DE, McManus DP, Gray DJ. "The Magic Glasses Philippines": a cluster randomised controlled trial of a health education package for the prevention of intestinal worm infections in schoolchildren. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 18:100312. [PMID: 35024651 PMCID: PMC8671727 DOI: 10.1016/j.lanwpc.2021.100312] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/01/2021] [Accepted: 09/01/2021] [Indexed: 11/01/2022]
Abstract
Background Soil-transmitted helminths (STH) cause substantial disease and disability globally. Health education has proven complementary to school-based drug administration programs for STH control. We determined the generalizability of the impact of "The Magic Glasses" health education package for STH prevention in schoolchildren in Laguna province, the Philippines, having previously shown its positive impact in China. Methods We conducted a cluster-randomised controlled trial, in schoolchildren, aged 9-10 years, across 40 schools over one year. Schools were randomly assigned either to the "Magic Glasses Philippines" health education intervention package (consisting of a cartoon video, classroom discussions, drawing and essay competition) complementing the standard health education activities of the Philippines Departments of Health and Education, or to a control group, which involved only the standard health education activities. The primary trial outcomes were the proportion of STH infected schoolchildren and their knowledge, attitude and behaviour of STH assessed in both groups at baseline and through two follow-up surveys undertaken immediately prior to the semi-annual national mass administration of albendazole. The outcomes between the study arms were compared using generalized estimating equation models, accounting for clustering at the school level. The trial is registered with Australian New Zealand Clinical Trials Registry number: ACTRN12616000508471. Findings At follow-up assessments, the mean knowledge and behaviour scores in the intervention group were, respectively, 5·3 (95% confidence interval [CI]:4·2-6·5; p=<0.001) and 1·1 (95% CI: 0·4-1·7; p=0.002) percentage points higher than the control group. There was no overall effect on helminth infections (any STH; adjusted odds ratio [aOR]:1·0; 95% CI: 0·8-1·3; p=0·856), Ascaris lumbricoides; aOR:1·0; 95% CI: 0·7-1·6; p=0·894, or Trichuris trichiura; aOR:1·7; 95% CI: 0·9-1·6; p=0·315) but sub-group analysis showed a 60% reduction in the odds of any STH infection resulting from the "Magic Glasses" intervention in schools with a baseline prevalence ≤15% (aOR: 0·4; 95% CI: 0·2-0·7; p=0·001). Interpretation The health-education package demonstrated a modest but statistically significant impact on the students' overall STH knowledge and changes in their behaviour but was only effective in preventing STH infections in intervention schools where the baseline prevalence was ≤15%. Funding National Health and Medical Research Council, Australia, and the UBS-Optimus Foundation, Switzerland.
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Affiliation(s)
- Mary Lorraine S Mationg
- Research School of Population Heath, The Australian National University, Canberra, Australia.,Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines
| | - Gail M Williams
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Veronica L Tallo
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines
| | - Remigio M Olveda
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines
| | - Eindra Aung
- Research School of Population Heath, The Australian National University, Canberra, Australia.,St Vincent's Clinical School, University of New South Wales, Sydney, Australia
| | - Portia Alday
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines
| | - Mark Donald Reñosa
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines
| | - Chona Mae Daga
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines
| | - Jhoys Landicho
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines
| | - Maria Paz Demonteverde
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines
| | - Eunice Diane Santos
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines
| | - Thea Andrea Bravo
- Department of Epidemiology and Biostatistics, Research Institute for Tropical Medicine, Manila, Philippines
| | - Franziska Angly Bieri
- Research School of Population Heath, The Australian National University, Canberra, Australia
| | - Andrew Bedford
- Research School of Population Heath, The Australian National University, Canberra, Australia
| | - Yuesheng Li
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, Australia.,Hunan Institute of Parasitic Diseases, World Health Organization Collaborating Centre for Research and Control on Schistosomiasis in Lake Region, Yueyang, China
| | | | - Peter Steinmann
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Kate Halton
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Donald E Stewart
- Research School of Population Heath, The Australian National University, Canberra, Australia.,School of Medicine, Griffith University, Brisbane, Australia
| | - Donald P McManus
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Darren J Gray
- Research School of Population Heath, The Australian National University, Canberra, Australia
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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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