Have You Heard of Schistosomiasis? Knowledge, Attitudes and Practices in Nampula Province, Mozambique

Abstract

BackgroundSchistosomiasis is a parasitic disease which affects almost 300 million people worldwide each year. It is highly endemic in Mozambique. Prevention and control of schistosomiasis relies mainly on mass drug administration (MDA), as well as adoption of basic sanitation practices. Individual and community perceptions of schistosomiasis are likely to have a significant effect on prevention and control efforts. In order to establish a baseline to evaluate a community engagement intervention with a focus on schistosomiasis, a survey to determine knowledge, attitudes and practices relating to the disease was conducted.Methodology/Principal FindingsA representative cross-sectional household survey was carried out in four districts of Nampula province, Mozambique. Interviews were conducted in a total of 791 households, using a structured questionnaire. While awareness of schistosomiasis was high (91%), correct knowledge of how it is acquired (18%), transmitted (26%) and prevented (13%) was low among those who had heard of the disease. Misconceptions, such as the belief that schistosomiasis is transmitted through sexual contact (27%), were common. Only about a third of those who were aware of the disease stated that they practiced a protective behaviour and only a minority of those (39%) reported an effective behaviour. Despite several rounds of MDA for schistosomiasis in the recent past, only a small minority of households with children reported that at least one of them had received a drug to treat the disease (9%).Conclusion/SignificancePoor knowledge of the causes of schistosomiasis and how to prevent it, coupled with persisting misconceptions, continue to pose barriers to effective disease prevention and control. To achieve high levels of uptake of MDA and adoption of protective behaviours, it will be essential to engage individuals and communities, improving their understanding of the causes and symptoms of schistosomiasis, recommended prevention mechanisms and the rationale behind MDA.

Mass drug administration and the sustainable control of schistosomiasis: Community health workers are vital for global elimination efforts

“…The study area has also been the site of a schistosomiasis integrated control trial for the past 5 years, thus exposing the residents and health staff to these activities. This finding is similar to those of studies performed in Kenya, Yemen, Mozambique, and Swaziland in which more than 90% of the survey populations were observed to have an awareness of schistosomiasis (Sady et al, 2015;Mwai et al, 2016;Rassi et al, 2016;Maseko et al, 2016). However, awareness is often limited to just being familiar with the name of the disease.…”

“…Although a high level of familiarity with the name of the infection has been shown, this awareness has often been limited to just having heard the name (Sady et al, 2015;Dawaki et al, 2015;Mwai et al, 2016). Poor knowledge of disease transmission, prevention, and treatment has been observed in Nigeria, Mozambique, and Kenya (Dawaki et al, 2015;Mwai et al, 2016;Rassi et al, 2016). The most common misconception is that schistosomiasis is acquired by drinking or eating contaminated food and water (Acka et al, 2010;Kabatereine et al, 2014;Musuva et al, 2014;Odhiambo et al, 2016;Person et al, 2016).…”

“…The most common misconception is that schistosomiasis is acquired by drinking or eating contaminated food and water (Acka et al, 2010;Kabatereine et al, 2014;Musuva et al, 2014;Odhiambo et al, 2016;Person et al, 2016). Others believe it is transmitted through sexual contact (Rassi et al, 2016;Mwanga et al, 2004).…”

“…Unfortunately, insufficiency of such manpower is a problem and may limit the coverage of health education campaigns (Leonardo et al, 2016a). Community members, specifically neighbours, family members, and friends, are other common sources of information in countries such as the Philippines, China, Mozambique, and Nigeria, where more than 70% of respondents to a recent survey identified them as key informants (Dawaki et al, 2015;Rassi et al, 2016;Ferlyn et al, 2015;Zeng et al, 2011). CHWs are generally defined as nonprofessional lay health workers, who are originally from the community, and who are requested to provide promotional, preventive, and sometimes even curative health care services to their own community (Ma et al, 2017).…”

Knowledge and Preventive Practices of Rural Residents against Schistosomiasis in an Endemic Community in Eastern Philippines

“…Specifically, the results on the knowledge of the causes and symptoms of schistosomiasis are similar to previous studies in which more than half of the respondents were knowledgeable [13]. A recent study described that people learned the cause and symptoms because they heard using the local most common term [14]. However, this is only limited to the local term of disease and not the cause and symptoms.…”