Community Perceptions on Schistosomiasis in Northeast Brazil

Assessment of Knowledge, Attitude and Practice on Schistosomiasis in Pujini Shehia, Pemba Island, Tanzania: A Blueprint for Planning Community-based Interventions

Background

Lack of insight into the community's knowledge, attitude and practice (KAP) regarding schistosomiasis stands as a significant obstacle in controlling the disease in endemic regions. Understanding communities' KAP is crucial for designing and implementing appropriate disease control measures. The present study was conducted to assess community's KAP on shistosomiasis in Pujini, Pemba.

Methods

A total of 328 respondents aged 7 to 79 years were selected from schools and the general community using systematic random sampling method. Data collection was conducted using questionnaires, face-to-face interviews and Focus Group Discussion (FGD) to capture communities' KAP and personal experiences and participants' demographic characteristics.

Results

Most participants demonstrated awareness of schistosomiasis, including its transmission, symptoms and preventive measures, although they struggled to distinguish between urogenital and intestinal schistosomiasis. The majority displayed positive attitudes toward the disease, yet over half of them (59.1%) believed that the disease could not re-occur after initial treatment. Notably, older people were significantly less knowledgeable than their younger counterparts (ƴ2 = 41.982, df = 5, p = <.05) while farmers were also significantly more knowledgeable than other occupational groups like fishermen, livestock keepers and house wives (ƴ2 = 36.194, df = 4, p = .003).

Conclusion

Community's knowledge about schistosomiasis decreased with increasing age likely due to low levels of education among adults and their poor attendance to health education meetings and campaigns. Despite positive attitudes and awareness toward schistosomiasis, a significant portion of the population continue to be engaged in risky activities such as water contact and poor sanitation practices. Efforts to enhance knowledge, foster positive attitudes, and encourage good practices remains crucial for the successful control and eventual elimination of schistosomiasis.

Teachers as multipliers of knowledge about schistosomiasis: a possible approach for health education programmes

Background

In the past decade, Brazil has significantly reduced the prevalence of schistosomiasis through a combined effort of early treatment of infected people, expansion of basic sanitation infrastructure and educational measures. Despite these efforts, in some areas, prevalence of schistosomiasis exceeds 20% of the school population, who lack knowledge of the risks of the disease. Action can be taken in schools to empower this population about their health condition. This paper describes the role of the teacher as a multiplier of knowledge about schistosomiasis and proposes two different approaches to training these teachers.

Methods

This study used mixed methods to evaluate training of teachers and educational intervention with those teachers’ pupils. Two training courses, each with 40 h of face-to-face activity, were offered to 19 teachers, using two different but complementary approaches, based on theoretical references and specific educational strategies: Critical Pedagogical Approach (Training Course I, held in 2013) and Creative Play Approach (Training Course II, held in 2014).The courses included classroom activities, laboratory and field work. After the training, the teachers conducted activities on schistosomiasis with their pupils. These activities involved constructing educational materials and cultural productions. The pupils’ knowledge about the disease was evaluated before the activities and 12 months later. The teachers’ acceptance and perceptions were assessed through structured interviews and subsequent thematic analysis. The Shistosoma mansoni infection status of teachers and their students was also assessed using the Kato Katz stool test.

Results

The parasitological study showed 31.6% of the teachers and 21.4% of the pupils to be positive for S. mansoni. The teachers’ knowledge of important aspects of schistosomiasis transmission and prevention was fragmented and incorrect prior to the training. The teachers’ knowledge changed significantly after the training and they were strongly accepting of the pedagogical methods used during the training. The level of their pupils’ knowledge about the disease had increased significantly (p < 0.05). However, pupils responded that, even after the educational activities, they still had contact with the city’s contaminated waters (p > 0.05).

Conclusions

The results of this study underline the importance of schools and teachers as partners in controlling and eliminating schistosomiasis. Teacher training on the disease significantly increases their pupils’ knowledge, reflecting empowerment with regard to local health conditions.

Do health risk perceptions motivate water - and health-related behaviour? A systematic literature review

Health-related risk perceptions are important determinants of health behaviours and components of behaviour change theories. What someone thinks or feels will motivate or hinder their intention or hesitancy to implement a certain behaviour. Thus, a perceived potential risk to our health and well-being can influence our health-promoting and/or health-seeking behaviour. We aimed to review and synthesize available peer-reviewed literature to better understand the links between water and health-related risk perceptions and behaviours. We conducted the first systematic review of peer-reviewed literature on risk perceptions and behaviours in the context of water and health, published between 2000 and 2021. A total of 187 publications met the inclusion criteria. We extracted data relating to study characteristics and categorized our results according to the major themes emerging from the literature, namely drinking water, sanitation, hygiene and wasterelated topics, health risk factors, diseases and mental health implications, and preventative measures. Our review shows that the literature has grown over the past twenty years, reporting information from different countries belonging to different income groups around the globe, conducted in various settings and contexts, among different target populations, from various disciplinary angles, using different methods, theories and approaches. Our review provides evidence of health risk perceptions determining behaviour particularly related to drinking water sources and water safety. Evidence on disease prevention, health seeking, variations and changes in perception and behaviour over space, geography, socioeconomic differences and time, and the relevance of cultural context is provided. Our review shows that risk perception studies are vital for WASH governance in terms of policy, raising awareness, education and behaviour change. In order to make risk perception and behaviour studies even more relevant to effective public health planning and health messaging, future research needs to increasingly focus on early culturally sensitive interventions and changes in perceptions and behaviours over time.