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Wambui CW, Madinga J, Ashepet MG, Anyolitho MK, Mitashi P, Huyse T. Knowledge, attitudes and practices toward female genital schistosomiasis among community women and healthcare professionals in Kimpese region, Democratic Republic of Congo. PLoS Negl Trop Dis 2024; 18:e0011530. [PMID: 38995976 PMCID: PMC11268635 DOI: 10.1371/journal.pntd.0011530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 07/24/2024] [Accepted: 06/11/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND Chronic infection with Schistosoma haematobium causes female genital schistosomiasis (FGS), which leads to diverse lesions in the female genital tract and several complications, including infertility and a higher risk for HIV transmission. This study aims to understand the knowledge, attitudes, and practices (KAP) toward FGS and associated factors among women and health professionals in the schistosomiasis endemic focus of Kimpese, western Democratic Republic of Congo (DRC). METHODS In January 2022, two semi-quantitative questionnaires were administered to 201 randomly selected community women in Kifua II village, and to purposely selected health professionals (20 nurses and 41 doctors) from Kimpese Health Zone. KAP statements were coded using Likert scale, summarized as frequencies and percentages, and assessed for internal reliability using Cronbach's alpha. Associations between the socio-demographic characteristics of respondents and the KAP variables were assessed using Pearson chi-square (χ2) test, Cramer's V (φ) and gamma (γ) coefficients. RESULTS Overall, respondents had high knowledge of schistosomiasis in general but low FGS-specific knowledge (91% versus 45%). Misconceptions concerned the disease transmission, with 30.3% of women and 25% of the nurses believing that FGS is transmitted by drinking untreated water, while 26.8% of the doctors mentioned sexual contact as a mode of FGS transmission. Negative attitudes included considering FGS not a very serious disease (34.8%), feeling uncomfortable during gynaecological examination (35.3%), difficulties avoiding risky water contact (72.1%) and open defecation/urination (41.3%), not intending to share FGS status with their husbands (38.3%) and loved ones (63.6%), and believing that husbands would leave them if they were infertile (31.8%). Regarding practices, 77.6% of women engaged daily in activities involving contact with water. Practices of health professionals were hampered by the lack of equipment and specialized knowledge for FGS diagnosis with only 57% of healthcare workers having a microscope in their facilities. Women's KAPs varied by age, education, marital status, occupation and monthly income. CONCLUSION This study highlights insufficient knowledge, existing negative attitudes, at risk practices towards FGS by women, and limitations of FGS management by health professionals. These findings can help for tailored health education and WASH strategies, and call for health professional's capacities reinforcement.
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Affiliation(s)
- Cecilia Wangari Wambui
- Department of Biology, Royal Museum for Central Africa,Tervuren, Belgium
- Department of Biology, KU Leuven, Leuven
| | - Joule Madinga
- Institute National de Recherche Biomedicale (INRB), Kinshasa, DR Congo
| | - Mercy Gloria Ashepet
- Department of Biology, Royal Museum for Central Africa,Tervuren, Belgium
- Department of Earth Science, Royal Museum for Central Africa, Tervuren, Belgium
- Division of Bioeconomics, Department of earth and environment science, KU Leuven, Leuven, Belgium
| | - Maxson Kenneth Anyolitho
- Department of Human Development and Relational Sciences, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Community Health, Faculty of Public Health, Lira University, Lira, Uganda
- Department of Sociology, Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium
| | - Patrick Mitashi
- Department of Tropical Medicine, University of Kinshasa, Kinshasa, DR Congo
| | - Tine Huyse
- Department of Biology, Royal Museum for Central Africa,Tervuren, Belgium
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Azanu WK, Osarfo J, Appiah G, Godonu YS, Ampofo GD, Orish V, Amoh M, Agbeno EK, Morhe ESK, Gyapong M. Knowledge of female genital schistosomiasis and urinary schistosomiasis among final-year midwifery students in the Volta Region of Ghana. PLoS One 2024; 19:e0302554. [PMID: 38696499 PMCID: PMC11065279 DOI: 10.1371/journal.pone.0302554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 04/07/2024] [Indexed: 05/04/2024] Open
Abstract
BACKGROUND Female genital schistosomiasis (FGS) is a gynaecological complication of urinary schistosomiasis (US) with an estimated burden of 20-120 million cases in endemic areas. A neglected sexual and reproductive health disease in sub-Saharan Africa, FGS increases susceptibility to sexually transmitted infections including cervical cancer and infertility among other morbidities. However, there appears to be limited FGS knowledge among practicing and pre-service health providers with implications for control. We assessed FGS awareness among final-year midwifery students who would soon be delivering primary maternal and reproductive health care. METHODS A cross-sectional study was conducted among 193 randomly selected final-year students from all three midwifery training institutions in the Volta region of Ghana in August/September, 2022. Data on participants' demographics and knowledge of the transmission, signs and symptoms, complications, treatment and prevention of both FGS and US were collected using structured questionnaires. Summary statistics were presented as frequencies, proportions and percentages. RESULTS Only 23.3% (44/189) of participants had heard about FGS compared to 64% (123/192) for US. Of the former, 42 (95%), 40 (91%) and 36 (81.8%) respectively identified genital itching/burning sensation, bloody vaginal discharge and pelvic pain/pain during intercourse as part of the symptoms of FGS. Less than a third (13/44) and about half (25/44) of those who indicated hearing about FGS knew it can be a risk for ectopic pregnancies and infertility respectively. Majority of these participants, 40 (91%), wrongly selected antibiotics as treatment for FGS while 9 indicated it is prevented by sleeping in insecticide-treated nets. CONCLUSION Awareness of FGS was limited among the study participants. The high prevalence of knowledge of some FGS symptoms related to the genitalia needs cautious interpretation. Health care training institutions must make deliberate efforts to highlight FGS in the training of midwives as the condition has diagnostic and management implications for some sexual and reproductive health conditions.
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Affiliation(s)
- Wisdom Klutse Azanu
- Department of Obstetrics and Gynaecology, School of Medicine, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Joseph Osarfo
- Department of Community Health, School of Medicine, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Gideon Appiah
- Physician Assistantship Training Programme, School of Medicine, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | | | - Gifty Dufie Ampofo
- Department of Community Health, School of Medicine, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Verner Orish
- Department of Microbiology and Immunology, School of Medicine, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Michael Amoh
- Department of Obstetrics and Gynaecology, School of Medicine, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Evans Kofi Agbeno
- Department of Obstetrics and Gynaecology, School of Medical Sciences, University of Cape Coast, Cape Coast, Central Region, Ghana
| | - Emmanuel Senanu Komla Morhe
- Department of Obstetrics and Gynaecology, School of Medicine, University of Health and Allied Sciences, Ho, Volta Region, Ghana
| | - Margaret Gyapong
- Institute of Health Research, University of Health and Allied Sciences, Ho, Volta Region, Ghana
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Alemu G, Nibret E, Amor A, Munshea A, Anegagrie M. Knowledge, attitude and practice towards intestinal schistosomiasis among school-aged children and adults in Amhara Regional State, northwest Ethiopia. A cross-sectional study. Trop Med Health 2024; 52:23. [PMID: 38462634 PMCID: PMC10926617 DOI: 10.1186/s41182-024-00584-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/26/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Schistosoma mansoni causes intestinal schistosomiasis (SCH) in all regions of Ethiopia. Despite many years of mass treatment, the prevalence has not dropped significantly. The reduction of SCH transmission demands the integration of deworming with safe water, sanitation, and hygiene (WASH) activities. Adequate knowledge and a positive attitude towards SCH are critical to practicing those interventions. However, data on the knowledge, attitude, and practice (KAP) level in school and community settings is limited in Ethiopia. METHODS School and community-based cross-sectional studies were conducted from February to June 2023 among 634 school-aged children (SAC) and 558 adults. A pre-tested questionnaire was used to collect socio-demographic and KAP data. Records were entered and analyzed using SPSS software version 21. Correct responses for each of the KAP questions were scored as one, while incorrect or 'I don't know' responses were scored as zero. Good knowledge, a positive attitude and good practice were declared if percentage scores were ≥ 80%, ≥ 90% and ≥ 75%, respectively. RESULTS Only 229 (19.2%) respondents, comprising 91 (14.4%) SAC and 138 (24.7%) adults, had ever heard of SCH. Adults, males, and urban residents had higher awareness level compared to their respective counterparts (p < 0.05). Only 28.4% of aware respondents knew that swimming or bathing in freshwater is a risk factor for schistosoma infection; 10.9% knew the etiologic agent; and 14.4% mentioned at least one sign and symptom associated with SCH. The majority (97.8%) of the respondents were willing to take therapeutic drugs, but only 37.6% believed that SCH is a serious disease. Regarding risky practices, 89.5% practiced swimming or bathing in freshwater, and 25.3% had no access to piped water. Among the aware respondents, only 18 (7.9%) had good knowledge, while 30 (13.1%) had a positive attitude towards SCH. Ninety-nine (43.2%) respondents had good Schistosoma infection prevention practices. CONCLUSIONS The knowledge, attitude, and preventive practice level towards schistosomiasis are low in the study area. Therefore, strengthening school and community-based health education, along with mass drug administration (MDA), WASH, and a vector control program, is recommended for preventing SCH.
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Affiliation(s)
- Getaneh Alemu
- Department of Medical Laboratory Science, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Endalkachew Nibret
- Biology Department, Science College, Bahir Dar University, Bahir Dar, Ethiopia
- Health Biotechnology Division, Institute of Biotechnology (IoB), Bahir Dar University, Bahir Dar, Ethiopia
| | - Arancha Amor
- Mundo Sano Foundation and Institute of Health Carlos III, Madrid, Spain
| | - Abaineh Munshea
- Biology Department, Science College, Bahir Dar University, Bahir Dar, Ethiopia
- Health Biotechnology Division, Institute of Biotechnology (IoB), Bahir Dar University, Bahir Dar, Ethiopia
| | - Melaku Anegagrie
- Mundo Sano Foundation and Institute of Health Carlos III, Madrid, Spain
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Mohammed T, Degarege A, Aemero M, Animut A, Negash Y, Erko B. Assessment of Urogenital Schistosomiasis Knowledge, Attitudes and Practices Among Abobo Communities in Gambella Regional State, Southwestern Ethiopia. ENVIRONMENTAL HEALTH INSIGHTS 2024; 18:11786302241234731. [PMID: 38414577 PMCID: PMC10898313 DOI: 10.1177/11786302241234731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/06/2024] [Indexed: 02/29/2024]
Abstract
Background Knowledge about community awareness and practices related to a disease, among other things, helps to plan relevant control strategies. This study assessed the knowledge, attitude, and practices (KAPs) of the community in Abobo district of Gambella Regional State in Southwestern Ethiopia about urogenital schistosomiasis (UGS), which is endemic to the region. Methods A community-based cross-sectional study was conducted in 2022. A pretested structured questionnaire was administered. Multivariable logistic regression was used to examine factors associated with KAPs variables. Results Most study participants (90.6%) responded they have previously heard of UGS. Over 95% of the participants knew at least 1 symptom of UGS and 30% knew the transmission cycle. About 15.9% and 26.8% knew keeping environmental hygiene and refraining from using cercariae infested water, as preventive methods, respectively. Over half of the participants (50.1%) disagreed or did not know that urinating close to the river/dam water contributes to transmission, and almost all participants had contact with the dam/river water in one way or another. Education status and history of having the infection were the key significant correlates of most KAPs variables. Conclusion Most of the community members had poor knowledge and attitudes about the mode of transmission and preventive measures of UGS. Thus, besides school-based mass drug administration (MDA), UGS control efforts in the region should incorporate health education in conjunction with safe water supplies, and provision of sanitary facilities to effectively reduce the transmission of the disease.
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Affiliation(s)
- Tigist Mohammed
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- Ethiopian Catholic University, Addis Ababa, Ethiopia
| | - Abraham Degarege
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Mulugeta Aemero
- Department of Medical Parasitology, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abebe Animut
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yohannes Negash
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Berhanu Erko
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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Essien-Baidoo S, Essuman MA, Adarkwa-Yiadom B, Adarkwa D, Owusu AA, Amponsah SB. Urinogenital schistosomiasis knowledge, attitude, practices, and its clinical correlates among communities along water bodies in the Kwahu Afram Plains North District, Ghana. PLoS Negl Trop Dis 2023; 17:e0011513. [PMID: 37585379 PMCID: PMC10431615 DOI: 10.1371/journal.pntd.0011513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 07/07/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Adequate knowledge and proper practices coupled with knowledge of the burden of disease are necessary for the eradication of Schistosoma infection. This study assessed knowledge, attitude, and practice (KAP) as well as health outcomes related to Schistosoma haematobium infection at Kwahu Afram Plains North District (KAPND). METHODS A cross-sectional survey using a structured questionnaire was carried out among 140 participants from four local communities in KAPND in August 2021. From these participants, 10ml of urine was collected for determination of the presence of S. haematobium and urine routine examination. In addition, 4ml of blood was collected and used for haematological examination. Descriptive statistics and logistic regression analysis using IBM SPSS were used to describe and represent the data collected. RESULTS The study reports a gap in knowledge about schistosomiasis in the study area with the majority indicating that they have not heard of schistosomiasis (60.7%), do not know the mode of transmission (49.3%), and do not know how the disease could be spread (51.5%). The overall prevalence of urinary schistosomiasis was 52.9%. This was associated with age, occupation, perceived mode of Schistosoma transmission, knowledge of Schistosoma prevention, awareness that schistosomiasis can be treated, frequency of visits to water bodies, and water usage patterns. In multivariate analysis, factors that remained significantly associated with S. haematobium infection were age 21-40 (OR = 0.21, 95% CI: 0.06-0.76), 41-60 (OR = 0.01, 95% CI: 0.01-0.52) and ≥ 60 (OR = 0.02, 95% CI: 0.02-0.87), informal employment (OR = 0.01, 95% CI: 0.01-0.69) and awareness of transmission by drinking water from river body (OR = 0.03, 95% CI: 0.03-0.92). In Schistosoma infection, reduced haemoglobin, haematocrit, mean corpuscular volume, mean corpuscular haemoglobin, lymphocytes and eosinophils were observed. White blood cells, neutrophils, and monocytes were significantly elevated in infected states. Urine analysis revealed high pus cells and red blood cells counts among Schistosoma-positive participants. CONCLUSION Schistosoma infection is endemic among inhabitants in KAPND, and is associated with a gap in knowledge, awareness, and practice possibly due to inadequate education in the area. Poor clinical outcomes associated with Schistosoma infection have been demonstrated in the area. A well-structured public education, nutritional intervention, and mass drug administration will be necessary to eradicate this menace.
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Affiliation(s)
- Samuel Essien-Baidoo
- Department of Medical Laboratory Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Mainprice Akuoko Essuman
- Department of Medical Laboratory Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Bernard Adarkwa-Yiadom
- Department of Medical Laboratory Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
- Laboratory Department, Akomaa Memorial Adventist Hospital, Kortwia, Bekwai, Ghana
| | - Dominic Adarkwa
- Department of Medical Laboratory Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
- Laboratory Department, Onwe Government Hospital, Ejisu-Onwe, Ghana
| | - Anita Akua Owusu
- Department of Medical Laboratory Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
- Laboratory Department, Agona Nkwanta Health Centre, Agona Nkwanta, Ghana
| | - Seth Boakye Amponsah
- Department of Medical Laboratory Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
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Torres-Vitolas CA, Trienekens SCM, Zaadnoordijk W, Gouvras AN. Behaviour change interventions for the control and elimination of schistosomiasis: A systematic review of evidence from low- and middle-income countries. PLoS Negl Trop Dis 2023; 17:e0011315. [PMID: 37163556 DOI: 10.1371/journal.pntd.0011315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 05/22/2023] [Accepted: 04/16/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND For the last two decades, schistosomiasis control efforts have focussed on preventive treatment. The disease, however, still affects over 200 million people worldwide. Behaviour change (BC) interventions can strengthen control by interrupting transmission through modifying exposure behaviour (water contact) or transmission practices (open urination/defaecation); or through fostering treatment seeking or acceptance. This review examines these interventions to assess their effectiveness in modifying risk practices and affecting epidemiological trends. METHODOLOGY/PRINCIPAL FINDINGS A systematic multi-database literature search (PROSPERO CRD42021252368) was conducted for peer-reviewed publications released at any time before June 2021 assessing BC interventions for schistosomiasis control in low- and middle-income countries. 2,593 unique abstracts were identified, 66 were assigned to full text review, and 32 met all inclusion criteria. A typology of intervention models was outlined according to their use of behaviour change techniques and overarching rationale: health education (HEIs), social-environmental (SEIs), physical-environmental (PEIs), and incentives-centred interventions (ICIs). Available evidence does not allow to identify which BC approach is most effective in controlling risk behaviour to prevent schistosomiasis transmission. HEIs' impacts were observed to be limited by structural considerations, like infrastructure underdevelopment, economic obligations, socio-cultural traditions, and the natural environment. SEIs may address those challenges through participatory planning and implementation activities, which enable social structures, like governance and norms, to support BC. Their effects, however, appear context-sensitive. The importance of infrastructure investments was highlighted by intervention models. To adequately support BC, however, they require users' inputs and complementary services. Whilst ICIs reported positive impacts on treatment uptake, there are cost-effectiveness and sustainability concerns. Evaluation studies yielded limited evidence of independent epidemiological impacts from BC, due to limited use of suitable indicators and comparators. There was indicative evidence, however, that BC projects could sustain gains through treatment campaigns. CONCLUSIONS/SIGNIFICANCE There is a need for integrated interventions combining information provision, community-based planning, and infrastructure investments to support BC for schistosomiasis control. Programmes should carefully assess local conditions before implementation and consider that long-term support is likely needed. Available evidence indicates that BC interventions may contribute towards schistosomiasis control when accompanied by treatment activities. Further methodologically robust evidence is needed to ascertain the direct epidemiological benefits of BC.
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Affiliation(s)
- Carlos A Torres-Vitolas
- Unlimit Health, London, United Kingdom
- School of Public Health, Imperial College London, London, United Kingdom
| | - Suzan C M Trienekens
- School of Biodiversity, One Health and Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
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dos Santos AJ, Lima SVMA, de Sousa AFL, Vasconcelos dos Santos A, Santos IGDA, Bezerra Santos M, Feitosa VLC, dos Santos AD, Primão JCM, de Andrade D, Silva JRS. Knowledge, Attitude and Practices towards the Prevention of Schistosomiasis Mansoni in an Endemic Area of Alagoas, Northeast Brazil. Trop Med Infect Dis 2023; 8:tropicalmed8010034. [PMID: 36668941 PMCID: PMC9864828 DOI: 10.3390/tropicalmed8010034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/13/2022] [Accepted: 12/27/2022] [Indexed: 01/06/2023] Open
Abstract
We analyzed the knowledge, attitudes and practices (KAP) of schistosomiasis mansoni prevention in an endemic area of Brazil. This cross-sectional study was conducted between March and May 2021, with 412 participants living in the municipality of Feira Grande, Alagoas, Brazil. Data collection occurred through visits to the Health Center Urbano II and Massapê, through an interview with a structured questionnaire to identify the levels of KAP regarding schistosomiasis prevention. Of all respondents, 70.87% lived in rural areas, 22.66% reported a history of past schistosomiasis and 52.71% never participated in schistosomiasis control program actions. Factors associated with better KAP scores were being part of an older age group, not using rainwater and having no history of past schistosomiasis. Specifically, among the domains, attitude was the highest score and knowledge was the lowest. Participation in a health intervention program, knowing someone who had schistosomiasis and having been informed through a public health program seemed to have an important impact on the population's KAP. Our results contributed to broadening perceptions about schistosomiasis prevention, highlighting the positive impacts that health programs and interventions have on disease control.
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Affiliation(s)
- Adriano José dos Santos
- Post-Graduation Programme in Parasitic Biology, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil
| | - Shirley Verônica Melo Almeida Lima
- Post-Graduation Programme in Nursing, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil
- Collective Health Research Center, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil
| | - Alvaro Francisco Lopes de Sousa
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, 1349-008 Lisbon, Portugal
- Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo 01308-060, SP, Brazil
| | - Aytana Vasconcelos dos Santos
- Post-Graduation Programme in Pharmaceutical Sciences, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil
| | | | - Márcio Bezerra Santos
- Medical and Nursing Science Center, Federal University of Alagoas, Campus Arapiraca 57309-005, AL, Brazil
- Post-Graduation Programme in Health Sciences, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil
| | - Vera Lucia Corrêa Feitosa
- Post-Graduation Programme in Parasitic Biology, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil
- Department of Morphology, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil
| | - Allan Dantas dos Santos
- Post-Graduation Programme in Nursing, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil
- Collective Health Research Center, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil
| | - Juliana Cristina Magnani Primão
- Human Exposome and Infectious Diseases Network (HEID), Ribeirão Preto College of Nursing, University of São Paulo, Ribeirao Preto 14040-902, SP, Brazil
| | - Denise de Andrade
- Human Exposome and Infectious Diseases Network (HEID), Ribeirão Preto College of Nursing, University of São Paulo, Ribeirao Preto 14040-902, SP, Brazil
| | - José Rodrigo Santos Silva
- Post-Graduation Programme in Parasitic Biology, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil
- Department of Statistics and Actuarial Sciences, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil
- Correspondence:
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Gabaake KP, Phaladze NA, Lucero-Prisno Iii DE, Thakadu OT. Assessment of awareness and knowledge of schistosomiasis among school-aged children (6-13 years) in the Okavango Delta, Botswana. Glob Health Res Policy 2022; 7:36. [PMID: 36175987 PMCID: PMC9524007 DOI: 10.1186/s41256-022-00267-x] [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: 07/05/2022] [Accepted: 09/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Schistosomiasis is a global health problem affecting 250 million people, with 90% in Sub-Saharan Africa. In Botswana, the burden is high in the Okavango delta because of the water channels. WHO recommends integrated measures, including access to clean water, sanitation, health education, and drugs to control and eliminate schistosomiasis. Gauging knowledge and awareness of schistosomiasis for School-Aged Children (SAC) is crucial. Our study aimed at assessing knowledge and awareness of schistosomiasis among SAC in the Okavango Delta. METHODS A cross-sectional survey assessing awareness and knowledge of schistosomiasis in schools was conducted. 480 questionnaires were administered to gather demographic profiles, awareness, and knowledge of risky behaviors. Chi-square and descriptive analysis determined the differences in SAC`s awareness and knowledge levels based on localities, gender, age, and health education. RESULTS The results showed a low awareness level, with only (42%) of respondents having heard about the disease and (52%) knowing its local name. Younger children from Sekondomboro (83%) and Samochima lacked awareness, while children from Mohembo (77%) and those who had health education (70%) demonstrated significant awareness levels (P ≤ 0.001). Seventy-two percent (72%) lacked knowledge of the cause and (95%) did not know the disease life-cycle. Children from Xakao (91%), (85%) Sepopa, and (75%) of younger children did not know haematuria is a symptom of the disease. Older and SAC with health education were more likely to know that swimming is a risk factor (P ≤ 0.001) and (P ≤ 0.05) respectively. CONCLUSIONS Although respondents from four schools demonstrated some level of awareness of the disease, and knowledge of risky behaviors, the study showed a lack of in-depth knowledge on the life-cycle and cause of the diseases. We, therefore, recommend the implementation of an integrated approach to health education and improvement in access to clean water and sanitation in all study areas.
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Affiliation(s)
- Kebabonye P Gabaake
- School of Allied Health Professions, University of Botswana, Gaborone, Botswana.
| | | | - Don Eliseo Lucero-Prisno Iii
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.,Faculty of Management and Development Studies, University of the Philippines Open University, Los Baños, Laguna, Philippines
| | - Olekae T Thakadu
- Okavango Research Institute, University of Botswana, Maun, Botswana
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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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10
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Evaluating the feasibility and acceptability of a community dialogue intervention in the prevention and control of schistosomiasis in Nampula province, Mozambique. PLoS One 2021; 16:e0255647. [PMID: 34351982 PMCID: PMC8341517 DOI: 10.1371/journal.pone.0255647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 07/21/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Schistosomiasis is a parasitic neglected tropical disease that ranks second only to malaria in terms of human suffering in the tropics and subtropics. Biomedical disease control interventions need to be complemented with effective prevention and health education strategies, that address the social and environmental determinants of disease. Malaria Consortium conducted an implementation research study between May 2014 and February 2016, in four districts of Nampula province, Mozambique, to test a Community Dialogue (CD) intervention to enhance schistosomiasis prevention and control. The study aimed to evaluate the acceptability and feasibility of using CD to improve communities' level of knowledge, attitudes and practices, and engagement in wider schistosomiasis prevention and control efforts. METHODS The feasibility and acceptability of the CD intervention was evaluated using qualitative and process evaluation data collected throughout the development and implementation phases. Qualitative data sets included key informant interviews (N = 4) with health system personnel, focus group discussions (N = 22) with Community Dialogue facilitators and participants, field observation visits (N = 11), training reports (N = 7), feedback meeting reports (N = 5), CD monitoring sheets (N = 1,458) and CD planning sheets (N = 152). FINDINGS The CD intervention was found highly acceptable and feasible, particularly well-suited to resource poor settings. Non-specialist community volunteers were able to deliver participatory CDs which resulted in increased knowledge among participants and triggered individual and communal actions for improved disease prevention and control. The visual flipchart was a key aid for learning; the use of participatory communication techniques allowed the correction of misconceptions and positioned correct prevention and control practices as the community recommendations, through consensus building. CONCLUSION The Community Dialogue Approach should be embedded within neglected tropical disease control programmes and the health system to create long-lasting synergies between the community and health system for increased effectiveness. However, for behavioural change to be feasible, community engagement strategies need to be supported by improved access to treatment services, safer water and sanitation.
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Low awareness and common misconceptions about schistosomiasis in endemic lowland areas in Western Ethiopia: a mixed-methods study. BMC Public Health 2021; 21:1064. [PMID: 34088297 PMCID: PMC8178865 DOI: 10.1186/s12889-021-11106-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/17/2021] [Indexed: 11/28/2022] Open
Abstract
Background Understanding the health behavior of the target population is crucial for sustainable schistosomiasis control. The aim of this study was to assess schistosomiasis related levels of knowledge, attitude, and practices of communities in lowland areas of western Ethiopia, where schistosomiasis is endemic. Methods A community-based multilevel triangulation mixed-methods design was conducted in three schistosomiasis endemic villages in the Abbey and Didessa valleys of the Benishangul Gumuz Region of Western Ethiopia, where mass drug administration (MDA) was done 30 years back and again the last 5 years. A structured survey questionnaire, in-depth interviews, focused group discussions, and observation was conducted to assess levels of knowledge, attitude, and practices related to schistosomiasis in the communities. Results Among the survey participants, 13% reported having heard of schistosomiasis, locally called Pecka (meaning worm). The majority of this 13% believe that schistosomiasis is caused by the biting of the worm Pecka, while others say drinking dirty water is the cause of infection, or they didn’t know what the cause is. A majority of respondents answered “I don’t know” to most of the questions about established knowledge of schistosomiasis. Male participants and students were more aware of schistosomiasis than their counterparts, and awareness increased with the educational level. Only one participant perceived that schistosomiasis was a serious disease. There were negative attitudes and misconceptions about the drug used in the mass treatment and many complaints were raised related to the size of the tablet and its side effects. There was no local budget and specific plan to prevent and control the disease. Local health personnel had insufficient knowledge about schistosomiasis, and the diagnosis and treatment capacities of local health institutions were poor. Conclusion In the current research area, schistosomiasis prevention and control recommendations should be redesigned to change the knowledge, attitudes, and practices of the community and local health workers. It is also necessary to have the local budget and trained manpower in order to diagnose and treat schistosomiasis locally. There is a great need to have a safer Praziquantel pediatric formulation. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11106-y.
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12
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Parisi S, Mazigo HD, Kreibich S, Puchner K, Kasang C, Mueller A. Factors associated with relevant knowledge of intestinal schistosomiasis and intention to participate in treatment campaigns: a cross sectional survey among school children at Ijinga Island on Lake Victoria, North-Western Tanzania. BMC Public Health 2019; 19:1762. [PMID: 31888548 PMCID: PMC6937638 DOI: 10.1186/s12889-019-8091-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 12/16/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Annual Mass Drug Administration (MDA) using praziquantel targeting primary school children is the main control strategy against schistosomiasis in Tanzania. However, there are concerns about decreasing participation in mass drug administration among primary school children for unknown reasons. Therefore, the aim of this study was to identify factors related to relevant knowledge about schistosomiasis and the intention to participate in mass drug administration among primary school children in order to give recommendations for future projects. METHODS A cross sectional, extended knowledge, attitudes and practices (KAP) survey was conducted among 356 primary school children aged 5-17 years in February-March 2016 using a pre-tested questionnaire. This survey was part of a baseline assessment for an integrated proof of concept study aiming towards schistosomiasis elimination on Ijinga Island. Outcomes of interest in logistic regression analysis were relevant knowledge and high intention to participate in treatment campaigns. Explanatory variables were sociodemographic information sources and elements aligned to Protection Motivation Theory (PMT). RESULTS Only 17% of the children had relevant intestinal schistosomiasis related knowledge and very few of them knew any of the S. mansoni manifestations and complications. Factors associated with relevant schistosomiasis knowledge were previous diagnosis of schistosomiasis (aOR = 2.43, 95%CI: 1.1-5.6), having heard about schistosomiasis at school (aOR = 9.94, 95%CI: 5.0-19.7) and being enrolled in 6th or 7th grade (aOR = 3.94, 95%CI: 1.3-11.8). Only 40% of the children demonstrated high intention to participate in treatment campaigns. Factors associated with high intention to participate in MDA were previous diagnosis (aOR = 2.23, 95%CI: 1.1-4.7), perceived general risk of disease transmission by lake water (aOR = 1.79, 95%CI: 1.0-3.1), perceived own vulnerability of getting infected (aOR = 5.10, 95%CI: 2.1-12.6), perceived danger of the disease (aOR = 2.47, 95%CI: 1.3-4.8) and the perceived effectiveness of medicaments to cure the disease (aOR = 2.86, 95%CI: 1.4-5.7). CONCLUSIONS The minority of the school children had high level of theoretical knowledge about schistosomiasis and a small proportion of the children demonstrated high intention to participate in mass drug administration. In general, practical knowledge on preventive measures such as taking anti-schistosomiasis drug during MDA need to be impacted in school children to increase their participation in the control program.
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Affiliation(s)
- Sandra Parisi
- DAHW - German Leprosy and Tuberculosis Relief Association, Raiffeisenstrasse 3, 97080 Würzburg, Germany
| | - Humphrey D. Mazigo
- School of Medicine, Department of Medical Parasitology, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Saskia Kreibich
- DAHW - German Leprosy and Tuberculosis Relief Association, Raiffeisenstrasse 3, 97080 Würzburg, Germany
| | - Karl Puchner
- DAHW - German Leprosy and Tuberculosis Relief Association, Raiffeisenstrasse 3, 97080 Würzburg, Germany
| | - Christa Kasang
- DAHW - German Leprosy and Tuberculosis Relief Association, Raiffeisenstrasse 3, 97080 Würzburg, Germany
- Medical Mission Institute, Salvatorstrasse 7, 97067 Würzburg, Germany
| | - Andreas Mueller
- Medical Mission Institute, Salvatorstrasse 7, 97067 Würzburg, Germany
- Department of Tropical Medicine, Medical Mission Hospital, Salvatorstrasse 7, 97074 Würzburg, Germany
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Mekete K, Ower A, Dunn J, Sime H, Tadesse G, Abate E, Nigussu N, Seife F, McNaughton E, Anderson RM, Phillips AE. The Geshiyaro Project: a study protocol for developing a scalable model of interventions for moving towards the interruption of the transmission of soil-transmitted helminths and schistosome infections in the Wolaita zone of Ethiopia. Parasit Vectors 2019; 12:503. [PMID: 31665080 PMCID: PMC6820996 DOI: 10.1186/s13071-019-3757-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 10/22/2019] [Indexed: 12/21/2022] Open
Abstract
Background National deworming programmes rely almost exclusively on mass drug administration (MDA) to children to control morbidity caused by these parasitic infections. The provision of other interventions, consisting of preventive chemotherapy at high population level coverage together with water, sanitation and hygiene (WaSH) and changes in risk behaviour, should enable sustainable control of soil-transmitted helminths (STH) and schistosomiasis and ultimately interrupt transmission. Methods/Design Two interventions will be implemented by the project: (i) community-wide biannual albendazole and annual praziquantel treatment with a target of 80–90% treatment coverage (“expanded MDA”); and (ii) provision of WaSH with behaviour change communication (BCC), within the Wolaita zone, Ethiopia. The project has three study arms: (i) expanded community-wide MDA, WaSH and BCC; (ii) expanded community-wide MDA only; and (iii) annual school-based MDA (the current National STH/schistosomiasis Control Programme). The impact of these interventions will be evaluated through prevalence mapping at baseline and endline (after four rounds of MDA), combined with annual longitudinal parasitological surveillance in defined cohorts of people to monitor trends in prevalence and reinfection throughout the project. Treatment coverage and individual compliance to treatment will be monitored by employing fingerprint biometric technology and barcoded identification cards at treatment. WaSH utilisation will be evaluated through school and household level observations and annual WaSH assessment survey. Complementary qualitative surveys will explore practices, cultural and social drivers of risk behaviours, uptake of WaSH and treatment, and assessing the impact of the BCC. Discussion The study has the potential to define an ‘End Game’ for STH and schistosomiasis programmes through provision of multiple interventions. Interrupting transmission of these infections would eliminate the need for long-term repeated MDA, lead to sustained health improvements in children and adults, thereby allowing health systems to focus on other disease control priorities.
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Affiliation(s)
| | - Alison Ower
- London Centre for Neglected Tropical Disease Research, Department of Infectious Diseases Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, W2 1PG, UK
| | - Julia Dunn
- London Centre for Neglected Tropical Disease Research, Department of Infectious Diseases Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, W2 1PG, UK
| | - Heven Sime
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Ebba Abate
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | - Emily McNaughton
- London Centre for Neglected Tropical Disease Research, Department of Infectious Diseases Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, W2 1PG, UK
| | - Roy Malcolm Anderson
- London Centre for Neglected Tropical Disease Research, Department of Infectious Diseases Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, W2 1PG, UK
| | - Anna Elizabeth Phillips
- London Centre for Neglected Tropical Disease Research, Department of Infectious Diseases Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, W2 1PG, UK.
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Sacolo-Gwebu H, Kabuyaya M, Chimbari M. Knowledge, attitudes and practices on schistosomiasis and soil-transmitted helminths among caregivers in Ingwavuma area in uMkhanyakude district, South Africa. BMC Infect Dis 2019; 19:734. [PMID: 31438865 PMCID: PMC6704662 DOI: 10.1186/s12879-019-4253-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 07/03/2019] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Schistosomiasis and soil-transmitted helminth infections are among the most chronic infections worldwide. Based on their demonstrable impact on human health, the WHO recently recommended the implementation of robust strategies aimed at controlling or eliminating schistosomiasis and soil-transmitted helminths by 2020. The implementation of this strategy, however, warrants a clear understanding of the community's knowledge, attitudes and practices in relation to these infections. This study sought to identify sociocultural gaps that should be addressed to ensure the success of cost-effective community-based schistosomiasis-soil-transmitted helminths control and elimination programs. METHODS This was a cross-sectional mixed methodology study. Quantitative data were collected using a structured questionnaire from 442 caregivers of preschool aged children. In-depth interviews and focus group discussions were conducted among caregivers, preschool teachers, traditional authorities and community caregivers. All interviews were captured using an audio recorder to maximize accuracy. Quantitative data were analysed using bivariate and multivariate techniques while qualitative data were analysed thematically. RESULTS Findings reflected inadequate knowledge, attitudes and practices in relation to schistosomiasis and soil-transmitted helminths while awareness of schistosomiasis and soil-transmitted helminths was high (87.1 and 79.2% respectively). Correct knowledge on transmission, prevention, signs and symptoms and life cycle was low (below 50%) for both infections among those who had heard of the disease. From multivariate analysis, being aged at least 35 years increased the odds of reporting good practices on schistosomiasis by 65% (COR 1.652, 95% CI: 1.073-2.543) while receiving health information through community meetings (COR 0.072, 95% CI: 0.010-0.548) significantly reduced the odds of having good knowledge on schistosomiasis. CONCLUSIONS These findings are valuable in designing behavioural change approaches towards enhancing health outcomes through community-based interventions to ensure effective control and elimination of schistosomiasis and soil-transmitted helminths. There is a critical need for channelling efforts towards making health education the core of schistosomiasis and soil-transmitted helminths programs aimed at achieving intensified control or elimination of these infections by 2020.
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Affiliation(s)
- Hlengiwe Sacolo-Gwebu
- School of Nursing and Public Health, College of Health Sciences, Howard College Campus, University of KwaZulu-Natal, Durban, South Africa
| | - Muhubiri Kabuyaya
- School of Nursing and Public Health, College of Health Sciences, Howard College Campus, University of KwaZulu-Natal, Durban, South Africa
| | - Moses Chimbari
- School of Nursing and Public Health, College of Health Sciences, Howard College Campus, University of KwaZulu-Natal, Durban, South Africa
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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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Angelo T, Kinung’hi SM, Buza J, Mwanga JR, Kariuki HC, Wilson S. Community knowledge, perceptions and water contact practices associated with transmission of urinary schistosomiasis in an endemic region: a qualitative cross-sectional study. BMC Public Health 2019; 19:703. [PMID: 31174505 PMCID: PMC6554870 DOI: 10.1186/s12889-019-7041-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 05/23/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In an effort to complement the current chemotherapy based schistosomiasis control interventions in Shinyanga district, community knowledge, perceptions and water contact practices were qualitatively assessed using focus group discussions and semi structured interviews involving 271 participants in one S. haematobium prevalent community of Ikingwamanoti village, Shinyanga district, Northwestern, Tanzania. METHODS In October, 2016 we conducted 29 parent semi structured interviews and 16 focus group discussions with a total of 168 parent informants. Adult participants were conveniently selected from three sub-villages of Butini, Miyu, and Bomani of Ikingwamanoti village, Shinyanga district. In March, 2017, a total of 103 children informants participated in 10 focus group discussions and 20 semi structured interviews, administered to children from standard four, five, six and seven attending Ikingwamanoti Primary School. Note taking and digital recorders were used to collect narrative data for thematic analysis of emergent themes. RESULTS Among participants, 75% parents and 50% children considered urinary schistosomiasis as a low priority health problem. Of the informants, 70% children and 48.3% parents had misconceptions about the cause, modes of transmission and control of schistosomiasis demonstrating gaps in their biomedical knowledge of the disease. Assessment of treatment seeking behavior for urinary schistosomiasis revealed a combination of traditional and modern health care sectors. However, modern medicines were considered effective in the treatment of urinary schistosomiasis. Lack of alternative sources of water for domestic and recreational activities and unhygienic water use habits exposed community members to high risk of acquiring urinary schistosomiasis. CONCLUSION Use of Schistosoma haematobium contaminated water sources for daily domestic and recreational use facilitated contraction of urinary schistosomiasis among community members in Shinyanga district. People's perceptions of urinary schistosomiasis as a less priority health problem promoted persistence of the disease. Future efforts to control urinary schistosomiasis should take into account integrated approaches combining water, sanitation and hygiene, health education, alternative sources of clean and safe water to facilitate behavior change.
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Affiliation(s)
- Teckla Angelo
- Department of Global Health and Bio-Medical Sciences, School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology (NM-AIST), P. O. Box 447, Arusha, Tanzania
- National Institute for Medical Research (NIMR), Mwanza Centre, P. O. Box 1462, Mwanza, Tanzania
| | - Safari M. Kinung’hi
- National Institute for Medical Research (NIMR), Mwanza Centre, P. O. Box 1462, Mwanza, Tanzania
| | - Jorum Buza
- Department of Global Health and Bio-Medical Sciences, School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology (NM-AIST), P. O. Box 447, Arusha, Tanzania
| | - Joseph R. Mwanga
- National Institute for Medical Research (NIMR), Mwanza Centre, P. O. Box 1462, Mwanza, Tanzania
| | - Henry Curtis Kariuki
- Kenya Methodist University, School of Medicine and Health Sciences, P. O. Box 267, Meru, Kenya
| | - Shona Wilson
- Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge, CB2 1QP UK
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Gyasi SF, Boateng AA, Awuah E, Antwi EO. Ellucidating the incidence and the prevalence of Schistosomiasis spp infection in riparian communities of the Bui dam. J Parasit Dis 2019; 43:276-288. [PMID: 31263334 DOI: 10.1007/s12639-019-01089-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 01/23/2019] [Indexed: 11/26/2022] Open
Abstract
The flow rate of rivers are affected when modifications are made for the benefit of mankind. Some man-made alterations carried out include dam construction. The aim of this study was to investigate the health impact of the Bui dam with respect to the prevalence and awareness level of schistosomiasis in a typical damming environment. The study was conducted in 4 riparian communities within the dam catchment area. A cross-sectional study design was employed to interview 350 individuals. Urine and stool samples were also collected from 386 participants. Results of the study showed that, knowledge of schistosomiasis was significantly greater in close communities (99.47%) than their far counterparts (50.29%) (p > 0.001; OR = 172). Schistosomiasis infection rate in the close communities (32.57%) were significantly greater in far communities (7.23%; p ≤ 0.0001). The overall prevalence of 82 (21.1%) was recorded for Schistosoma haematobium and 64 (16.1%) for Schistosoma mansoni. A significantly high prevalence of S. haematobium (43.3%) was found in the age group 15-24 with no prevalence reported for age group 5-9 (Close communities) (p = 0.012). When the same age group was further examined for S. mansonii, group 5-9 recorded a prevalence of 0% with age group 10-14 showing a high prevalence of 26.1% (p = 0.047). From the study, it was concluded that, though awareness level of Schistosomiasis knowledge on the cause, mode of transmission and symptoms were high, they were ignorant on personal preventive strategies. In addition, the study also revealed that, S. haematobium was more prevalent among inhabitants living closer to the Bui dam with children less than 14 years of age being the worst affected.
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Affiliation(s)
- Samuel Fosu Gyasi
- 1Department of Basic and Applied Biology, School of Sciences, University of Energy and Natural Resources (UENR), Sunyani, Ghana
| | - Abigail Antwiwaa Boateng
- 2Department of Energy and Environmental Engineering, School of Engineering, University of Energy and Natural Resources (UENR), Sunyani, Ghana
| | - Esi Awuah
- 3Department of Civil Engineering, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Eric Ofosu Antwi
- 2Department of Energy and Environmental Engineering, School of Engineering, University of Energy and Natural Resources (UENR), Sunyani, Ghana
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Rassi C, Martin S, Graham K, de Cola MA, Christiansen-Jucht C, Smith LE, Jive E, Phillips AE, Newell JN, Massangaie M. Knowledge, attitudes and practices with regard to schistosomiasis prevention and control: Two cross-sectional household surveys before and after a Community Dialogue intervention in Nampula province, Mozambique. PLoS Negl Trop Dis 2019; 13:e0007138. [PMID: 30730881 PMCID: PMC6382216 DOI: 10.1371/journal.pntd.0007138] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 02/20/2019] [Accepted: 01/07/2019] [Indexed: 11/29/2022] Open
Abstract
Background The Community Dialogue Approach is a promising social and behaviour change intervention, which has shown potential for improving health seeking behaviour. To test if this approach can strengthen prevention and control of schistosomiasis at community level, Malaria Consortium implemented a Community Dialogue intervention in four districts of Nampula province, Mozambique, between August 2014 and September 2015. Methodology/Principal findings Cross-sectional household surveys were conducted before (N = 791) and after (N = 792) implementation of the intervention to assess its impact on knowledge, attitudes and practices at population level. At both baseline and endline, awareness of schistosomiasis was high at over 90%. After the intervention, respondents were almost twice as likely to correctly name a risk behaviour associated with schistosomiasis (baseline: 18.02%; endline: 30.11%; adjusted odds ratio: 1.91; 95% confidence interval: 1.14–2.58). Increases were also seen in the proportion of people who knew that schistosomiasis can be spread by infected persons and who could name at least one correct transmission route (baseline: 25.74%; endline: 32.20%; adjusted odds ratio: 1.36; 95% confidence interval: 1.01–1.84), those who knew that there is a drug that treats the disease (baseline: 29.20%, endline: 47.55%; adjusted odds ratio: 2.19; 95% confidence interval: 1.67–2.87) and those who stated that they actively protect themselves from the disease and cited an effective behaviour (baseline: 40.09%, endline: 59.30%; adjusted odds ratio: 2.14; 95% confidence interval: 1.40–3.28). The intervention did not appear to lead to a reduction in misconceptions. In particular, the belief that the disease is sexually transmitted continued to be widespread. Conclusions/Significance Given its overall positive impact on knowledge and behaviour at population level, Community Dialogue can play an important role in schistosomiasis prevention and control. The intervention could be further strengthened by better enabling communities to take suitable action and linking more closely with community governance structures and health system programmes. Schistosomiasis is a parasitic neglected tropical disease that affects around 190 million people worldwide, causing chronic ill health and disability. Central to its prevention and control are the acceptance of health interventions such as the distribution of drugs on a mass scale and the adoption of good hygiene and sanitation practices in communities where the disease thrives. One promising method for promoting such behaviours is the Community Dialogue Approach, which involves training volunteers to host regular community meetings, where local health concerns are discussed and culturally appropriate solutions are agreed upon. In 2014/15, Malaria Consortium implemented a Community Dialogue intervention in four districts of Nampula province, Mozambique, to improve knowledge, attitudes and practices with regard to schistosomiasis prevention and control. To assess the effectiveness of the approach, two household surveys were conducted. Results show that before the intervention, knowledge of how schistosomiasis is acquired, transmitted, prevented and treated was low. After the intervention, knowledge and self-reported adoption of positive behaviours had improved substantially, demonstrating that Community Dialogue can play a central role in strengthening disease prevention and control. The approach could be strengthened by further empowering communities to take action and reducing deeply-held misconceptions.
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Affiliation(s)
| | | | | | | | | | | | - Ercílio Jive
- Direcção Provincial de Saúde, Nampula, Mozambique
| | - Anna E. Phillips
- Schistosomiasis Control Initiative, Imperial College, London, United Kingdom
| | - James N. Newell
- The Nuffield Centre for International Health & Development, University of Leeds, Leeds, United Kingdom
| | - Marilia Massangaie
- Departamento das Doenças Tropicais Negligenciadas, Ministério de Saúde, Maputo, Mozambique
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Mohammed J, Weldegebreal F, Teklemariam Z, Mitiku H. Clinico-epidemiology, malacology and community awareness of Schistosoma mansoni in Haradenaba and Dertoramis kebeles in Bedeno district, eastern Ethiopia. SAGE Open Med 2018; 6:2050312118786748. [PMID: 30034806 PMCID: PMC6048690 DOI: 10.1177/2050312118786748] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 06/12/2018] [Indexed: 11/30/2022] Open
Abstract
Background: Schistosoma mansoni is a major public health problem.
Different studies reported unidentified sites in Ethiopia with variable
prevalence and intensity, but there is no report from this study area. Objective: To assess the clinico-epidemiology, malacology, risk factors, and community
awareness of S. mansoni in Haradenaba and Dertoramis
kebeles in the Bedeno district, eastern Ethiopia. Methods: A cross-sectional study was conducted among 1011 study participants in 413
systematically selected households from Haradenaba and Dertoramis kebeles
from 30 June 2016 to 30 July 2017. Data were collected by using pretested,
structured questionnaires, clinical examinations, and stool examinations.
Stool samples were processed by the Kato-Katz method and examined
microscopically. Snails were collected by scooping from water contact
points. Data were analyzed using SPSS, version 16 statistical software. Result: The overall prevalence of S. mansoni was 35.7%.
Heavy-intensity infection was detected in 8.9% of the study participants.
Results included: participants who were unaware about the possible source of
infection (adjusted odds ratio: 2.95; 95% confidence interval: 1.25, 7.95),
modes of transmission (adjusted odds ratio: 5.51; 95% confidence interval:
3.52, 12.51), prevention (adjusted odds ratio: 4.01; 95% confidence
interval: 2.00, 8.75) about schistosomiasis/bilharziasis were more likely
infected with S. mansoni than those who were aware.
Participants who swim or bathe in the river were more likely infected with
S. mansoni than those who do not (adjusted odds ratio:
6.41; 95% confidence interval: 3.15, 11.25). Biomphalaria
pfeifferi snails were collected from all water bodies in
Haradenaba and Dertoramis, but they did not shed schistosome cercaria in the
laboratory. Conclusion: S. mansoni infection is found in high magnitude in these
study areas, despite not being previously reported. A majority of the study
participants had low awareness about the source of infection, mode of
transmission, and prevention methods of schistosomiasis. Efforts should be
made to improve community awareness about transmission and prevention of
schistosomiasis.
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Affiliation(s)
- Jemal Mohammed
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Fitsum Weldegebreal
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Zelalem Teklemariam
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Habtamu Mitiku
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Koffi AJD, Doumbia M, Fokou G, Keita M, Koné B, Abé NN. Community knowledge, attitudes and practices related to schistosomiasis and associated healthcare-seeking behaviours in northern Côte d'Ivoire and southern Mauritania. Infect Dis Poverty 2018; 7:70. [PMID: 29986766 PMCID: PMC6038328 DOI: 10.1186/s40249-018-0453-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 06/15/2018] [Indexed: 01/01/2023] Open
Abstract
Background Among parasitic infections, schistosomiasis ranks second after malaria in terms of worldwide morbidity. Despite efforts to contain transmission, more than 230 million people are infected, of which 85% live in Sub-Saharan Africa. While the epidemiologic characteristics of schistosomiasis have been extensively studied across endemic settings, social factors have been paid less attention. The current study assesses community knowledge of schistosomiasis causes, transmission, signs, symptoms and prevention, as well as healthcare-seeking behaviours in two West African settings, with the aim of strengthening schistosomiasis control interventions. Methods From August 2014 to June 2015, we conducted two cross-sectional surveys in Korhogo, Côte d’Ivoire and Kaédi, Mauritania. We applied a questionnaire to collect quantitative data at the household level in Korhogo (n = 1456) and Kaédi (n = 1453). Focus group discussions (Korhogo: n = 32, Kaédi: n = 32) and participatory photography (photovoice) (Korhogo: n = 16, Kaédi: n = 16) were conducted within the communities to gather qualitative data. In addition, semi-structured interviews were used to discuss with key informants from control programmes, non-governmental organizations and health districts (Korhogo: n = 8, Kaédi: n = 7). Results The study demonstrated that schistosomiasis is not well known by the communities; 64.1% claimed to know the causes of the disease, but the reality is different. This knowledge is more from cultural than biomedical source. It was observed that social construction of the disease is different from the biomedical definition. In Korhogo, schistosomiasis was often associated with several other diseases, notably stomach ulcer and gonorrhoea. The populations believe that schistosomiasis is caused by exposure to goat or dog urine in the environment. In Kaédi, schistosomiasis is considered as a disease transmitted by environmenal elements such as sunshine and dirty water. In both settings, the care-seeking pathways were found to be strongly influenced by local customs and self-medication acquired from the informal sector. Conclusions This study revealed that knowledge about the aetiology, transmission, symptoms, prevention and treatment of schistosomiasis among the populations in Korhogo and Kaédi is based on their local culture. Deep-rooted habits could therefore pose a significant obstacle to the elimination of schistosomiasis. Electronic supplementary material The online version of this article (10.1186/s40249-018-0453-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Amoin Jeanne d'Arc Koffi
- Department of Research and Development, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Environment and Communication Training Unit, University Alassane Ouattara, Bouaké, Côte d'Ivoire
| | - Mohamed Doumbia
- Department of Research and Development, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire. .,Ethno-Sociology Institute, University Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire.
| | - Gilbert Fokou
- Department of Research and Development, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Moussa Keita
- Faculty of Letters and Social Sciences, University of Nouakchott, Nouakchott, Mauritania
| | - Brama Koné
- Department of Research and Development, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.,University Péléforo-Gbon-Coulibaly, Korhogo, Côte d'Ivoire
| | - N'doumy Noel Abé
- Environment and Communication Training Unit, University Alassane Ouattara, Bouaké, Côte d'Ivoire
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Sacolo H, Chimbari M, Kalinda C. Knowledge, attitudes and practices on Schistosomiasis in sub-Saharan Africa: a systematic review. BMC Infect Dis 2018; 18:46. [PMID: 29347919 PMCID: PMC5773048 DOI: 10.1186/s12879-017-2923-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 12/14/2017] [Indexed: 12/22/2022] Open
Abstract
Background Schistosomiasis remains a global health problem with an estimated 250 million people in 78 countries infected, of whom 85% live in Sub-Saharan Africa. Preventive chemotherapy remains the key public health strategy to combat schistosomiasis worldwide. Recently the WHO emphasized on the use of integrative approaches in the control and elimination of schistosomiasis. However, a detailed understanding of sociocultural factors that may influence the uptake of the intended health activities and services is vital. Thus, our study sought to understand the knowledge, attitudes, perceptions, beliefs and practices about schistosomiasis in various communities in Sub-Saharan Africa. Methods A systematic search of literature for the period 2006–2016 was done on Medline, PubMed, CINAHL, Psych info and Google Scholar using the following key words “Schistosomiasis, S. mansoni, S. haematobium, knowledge, attitudes, perceptions, beliefs and practices in Sub-Saharan Africa” in combination with Bolean operators (OR, AND). In this context, we reviewed studies conducted among school children, community members and caregivers of preschool children. Thematic analysis was utilised for the overall synthesis of the selected studies. This was done after reading the articles in depth. Themes were identified and examined for similarities, differences and contradictions. Results Gaps in schistosomiasis related knowledge and sociocultural barriers towards the uptake of preventive and treatment services among communities in Sub-Saharan Africa were identified. In addition to limited knowledge and negative attitudes, risky water related practices among community members, school children and caregivers of preschool children were identified as key factors promoting transmission of the disease. Conclusion The study concluded that a comprehensive health education programme using contextual and standardised training tools may improve peoples’ knowledge, attitudes and practices in relation to schistosomiasis prevention and control. Findings also highlight the significance of including caregivers in the planning and implementation schistosomiasis control programs targeting pre-school children. Electronic supplementary material The online version of this article (10.1186/s12879-017-2923-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hlengiwe Sacolo
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Howard Campus, Durban, South Africa.
| | - Moses Chimbari
- College of Health Sciences, University of KwaZulu-Natal, Howard Campus, Durban, South Africa
| | - Chester Kalinda
- School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Howard Campus, Durban, South Africa
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Phillips AE, Gazzinelli-Guimarães PH, Aurelio HO, Dhanani N, Ferro J, Nala R, Deol A, Fenwick A. Urogenital schistosomiasis in Cabo Delgado, northern Mozambique: baseline findings from the SCORE study. Parasit Vectors 2018; 11:30. [PMID: 29316983 PMCID: PMC5761122 DOI: 10.1186/s13071-017-2592-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 12/13/2017] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The results presented here are part of a five-year cluster-randomised intervention trial that was implemented to understand how best to gain and sustain control of schistosomiasis through different preventive chemotherapy strategies. This paper presents baseline data that were collected in ten districts of Cabo Delgado province, northern Mozambique, before treatment. METHODS A cross-sectional study of 19,039 individuals was sampled from 144 villages from May to September 2011. In each village prevalence and intensity of S. haematobium were investigated in 100 children first-year students (aged 5-8 years), 100 school children aged 9-12 years (from classes 2 to 7) and 50 adults (20-55 years). Prevalence and intensity of S. haematobium infection were evaluated microscopically by two filtrations, each of 10 ml, from a single urine specimen. Given that individual and community perceptions of schistosomiasis influence control efforts, community knowledge and environmental risk factors were collected using a face-to-face interview. Data were entered onto mobile phones using EpiCollect. Data summary was made using descriptive statistics. Chi-square and logistic regression were used to determine the association between dependent and independent variables. RESULTS The overall prevalence of urogenital schistosomiasis was 60.4% with an arithmetic mean intensity of infection of 55.8 eggs/10 ml of urine. Heavy infections were detected in 17.7%, of which 235 individuals (6.97%) had an egg count of 1000 eggs/10 ml or more. There was a significantly higher likelihood of males being infected than females across all ages (62% vs 58%; P < 0.0005). Adolescents aged 9-12 years had a higher prevalence (66.6%) and mean infection intensity (71.9 eggs/10 ml) than first-year students (63.1%; 58.2 eggs/10 ml). This is the first study in Mozambique looking at infection rates among adults. Although children had higher levels of infection, it was found here that adults had a high average prevalence and intensity of infection (44.5%; 23.9 eggs/10 ml). Awareness of schistosomiasis was relatively high (68.6%); however, correct knowledge of how schistosomiasis is acquired was low (23.2%) among those who had heard of the disease. Schistosomiasis risk behaviour such as washing (91.3%) and bathing (86.7%) in open water sources likely to be infested with host snails was high. CONCLUSIONS Urogenital schistosomiasis is widespread in Cabo Delgado. In addition, poor community knowledge about the causes of schistosomiasis and how to prevent it increases the significant public health challenge for the national control program. This was the first study in Mozambique that examined infection levels among adults, where results showed that S. haematobium infection was also extremely high. Given that this controlled trial aims to understand the impact of different combinations of schistosomiasis control through treatment of communities, schools, and treatment holidays over a five-year period, these findings highlight the importance of examining the impact of different treatment approaches also in adults. TRIAL REGISTRATION The trials have been registered with the International Standard Randomised Controlled Trial registry under ISRCT 14117624 Mozambique (14 December 2015).
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Affiliation(s)
- Anna E. Phillips
- Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Imperial College London, W2 1PG, London, UK
| | - Pedro H. Gazzinelli-Guimarães
- Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Imperial College London, W2 1PG, London, UK
| | - Herminio O. Aurelio
- Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Imperial College London, W2 1PG, London, UK
- Faculdade of Health Sciences, Universidade Católica de Moçambique (UCM), Beira, Mozambique
| | - Neerav Dhanani
- Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Imperial College London, W2 1PG, London, UK
| | - Josefo Ferro
- Faculdade of Health Sciences, Universidade Católica de Moçambique (UCM), Beira, Mozambique
| | | | - Arminder Deol
- Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Imperial College London, W2 1PG, London, UK
| | - Alan Fenwick
- Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Imperial College London, W2 1PG, London, UK
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Mass drug administration and the global control of schistosomiasis: successes, limitations and clinical outcomes. Curr Opin Infect Dis 2018; 29:595-608. [PMID: 27584590 DOI: 10.1097/qco.0000000000000312] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE OF REVIEW Preventive chemotherapy is advocated for the global control and elimination of schistosomiasis. Despite the well known short-term benefits of treating patients for schistosomiasis, the impact of mass drug administration (MDA) campaigns to control the disease in the long term remains unresolved. RECENT FINDINGS Many studies have advocated the success of MDA programs in order to attract donor funds for elimination efforts but such successes are often short-lived given the drug does not alter the life cycle of the organism or prevent reinfection. Within a matter of months to years after halting treatment, the prevalence, intensity of infection and morbidity of disease return to baseline levels. Other mitigating factors contribute to the failings of MDA campaigns namely: poverty, poor drug coverage, poor drug compliance, and, in the case of Asiatic schistosomiasis, zoonotic transmission. Genetic and innate and acquired immunologic mechanisms complicate the epidemiologic picture of schistosomiasis globally, and may contribute indirectly to MDA shortcomings. The possibility of drug resistance is an ever present concern because of the sole reliance on one drug, praziquantel. SUMMARY Preventive chemotherapy is advocated for the global control and elimination of schistosomiasis. The short-term benefits of MDA campaigns are well documented but the long-term benefits are questionable.
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Mass drug administration and the sustainable control of schistosomiasis: Community health workers are vital for global elimination efforts. Int J Infect Dis 2017; 66:14-21. [PMID: 29128644 DOI: 10.1016/j.ijid.2017.10.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 10/26/2017] [Accepted: 10/30/2017] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Schistosomiasis control is centred on preventive chemotherapy through mass drug administration (MDA). However, endemic countries continue to struggle to attain target coverage rates and patient compliance. In the Philippines, barangay health workers (BHWs) play a vital role in the coordination of MDA, acting as advocates, implementers, and educators. The aim of this study was to determine whether BHW knowledge and attitudes towards schistosomiasis and MDA is sufficient and correlated with resident knowledge and drug compliance. METHODS A cross-sectional survey was conducted in 2015 among 2186 residents and 224 BHWs in the province of Northern Samar, the Philippines using a structured survey questionnaire. RESULTS BHWs showed good familiarity on how schistosomiasis is acquired and diagnosed. Nevertheless, both BHWs and residents had poor awareness of the signs and symptoms of schistosomiasis, disease prevention, and treatment options. There was no correlation between the knowledge scores of the BHWs and the residents (r=0.080, p=0.722). Kruskal-Wallis analysis revealed significant differences in BHW knowledge scores between the low (3.29, 95% confidence interval 3.16-3.36), moderate (3.61, 95% confidence interval 3.49-3.69), and high (4.05, 95% confidence interval 3.77-4.13) compliance village groups (p=0.002), with the high compliance areas having the highest mean knowledge scores. CONCLUSIONS This study highlights the importance of community health workers in obtaining the World Health Organization drug coverage rate of 75% and improving compliance with MDA in the community. Investing in the education of community health workers with appropriate disease-specific training is crucial if disease elimination is ultimately to be achieved.
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