BackgroundAmong 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.MethodsFrom 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).ResultsThe 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.ConclusionsThis 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 materialThe online version of this article (10.1186/s40249-018-0453-0) contains supplementary material, which is available to authorized users.
People's knowledge, attitudes, practices and beliefs (KAPB) pertaining to malaria are generally well described. However, little is known about population knowledge and awareness of insecticide resistance in malaria vectors. The aim of this study was to investigate KAPB related to insecticide resistance in malaria vectors due to the use of insecticides in agriculture and the prevention against mosquitoes. In mid-2017, we carried out a cross-sectional survey in Elibou, South Côte d'Ivoire, employing a mixed methods approach. Quantitative data were obtained with a questionnaire addressed to household heads. Interviews were conducted with key opinion leaders, including village chiefs, traditional healers, heads of health centres and pesticide sellers. Focus group discussions were conducted with youth and elders. A total of 203 individuals participated in the questionnaire survey (132 males, 65%). We found that people had good knowledge about malaria and mosquitoes transmitting the disease, while they felt that preventing measures were ineffective. Pesticides were intensively used by farmers, mainly during the rainy season. Among the pesticides used, insecticides and herbicides were most commonly used. While there was poor knowledge about resistance, the interviewees stated that insecticides were not killing the mosquitoes anymore. The main reason given was that insecticides were diluted by the manufacturers as a marketing strategy to sell larger quantities. More than a third of the farmers used agricultural pesticides for domestic purposes to kill weeds or mosquitoes. We observed a misuse of pesticides among farmers, explained by the lack of specific training. In the community, long-lasting insecticidal nets were the most common preventive measure against malaria, followed by mosquito coils and insecticide sprays. The interviewees felt that the most effective way of dealing with insecticide resistance was to combine at least two preventive measures. In conclusion, population attitudes and practices related to insecticides used in agriculture and the prevention against mosquitoes could lead to resistance in
Despite efforts at the national and international levels to mitigate adverse effects of climate change on the environment and human health in developing countries, there is still a paucity of data and information concerning stakeholder’s engagement and their level of collaboration, responses and assistance in West Africa. This study aimed at assessing the perception of institutional stakeholders and limitations on coping strategies in flooding risk management in Abidjan (Côte d’Ivoire) and Lomé (Togo). Using a transdisciplinary framework, the methodological approach basically relied on qualitative data collected through desk review and key informant interviews with various stakeholders, covering a range of topics related to flooding risk. Findings show that flooding experiences cause serious environmental and health problems to populations. Poor hygiene practices and contacts with contaminated water are the main causes of risks. Collaboration between stakeholders is limited, reducing the efficiency of planned interventions. Furthermore, health risk prevention strategies are still inadequately developed and implemented. Findings also show limited capacities of affected and displaced people to cope and plan for their activities. Engaging various stakeholders in the health risk prevention plans is likely to improve the efficiency of coping strategies in flooding risk management in West Africa.
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