Knowledge, attitudes, and practices regarding schistosomiasis infection and prevention: A mixed-methods study among endemic communities of western Uganda

Abstract

Introduction In Uganda, schistosomiasis (re)infections have continued to remain high despite the implementation of mass drug administration and sensitization campaigns aimed at controlling the disease. This could imply that there are some barriers to the implemented preventive measures. We conducted a mixed-methods study in Kagadi and Ntoroko districts around Lake Albert to assess knowledge, attitudes, and practices regarding schistosomiasis and to explore and understand perspectives regarding the disease. Materials and methods Semi-structured survey questionnaires were administered to 337 household adults selected through systematic random sampling. We also interviewed 12 participants and held 28 focus-group discussion sessions with 251 individuals respectively. Quantitative data was analysed using frequencies, percentages, and chi-square tests for associations, while themes and sub-themes were used to analyse qualitative data respectively. Findings A total of 98.5%, 81.3%, and 78.5% had heard about schistosomiasis, and knew the main transmission modes and symptoms, respectively. The majority (75.8%) said avoiding contact with water was a preventative way, while 67.5% said observing signs and symptoms was a form of diagnosis. Furthermore, 98.4% and 73.4% said it was important to defecate in latrines and to avoid contact with contaminated water respectively. However, it is difficult to avoid contact with lake water because it is the only source of livelihood, especially for fisher communities. Open defecation is commonly practiced along the lake due to insufficient space and difficulties in the construction of latrines. Myths and misconceptions reported include; lake water is safe, gassing in water causes transmission, fetching water early in the morning and from deep water is safe, and feces in the lake water act as a bait for catching fish. Conclusions and recommendations Despite adequate knowledge of schistosomiasis and a positive attitude towards its prevention, existing myths and misconceptions, coupled with persistent risky water, sanitation, and hygiene practices still pose a challenge. A more robust community-based awareness intervention using bottom-up participatory approaches, accompanied by the provision of clean and safe water sources and increasing latrine coverage, could provide lasting solutions to these barriers.

Health-Seeking Behavior Regarding Schistosomiasis Treatment in the Absence of a Regular Mass Drug Administration (MDA) Program: The Case of Endemic Communities Along Lake Albert in Western Uganda

“…However, our research contrasts with a study in Ghana that found no signi cant association between proper diagnosis and health service utilization [5]. This could be because of variations in the level of knowledge about the disease reported by studies which reveal inadequate knowledge about the diagnosis of schistosomiasis by communities in Uganda [30], and health seeking [42]. Re ning knowledge of MDA and addressing issues of side effects could improve health seeking from modern sources [28].…”

“…Although the PZQ uptake has been increasing steadily over the years, the inconsistency attributed to funding gaps is likely to affect the achievement of the WHO target [29]. Moreover, endemic communities continue to engage in risky water, sanitation, and hygiene (WASH) practices [30,31]. This also implies that such communities must receive constant treatment to contain the spread of the disease and control morbidity levels.…”

The Role of Knowledge and Practices in Schistosomiasis Transmission Among Primary School Children in Osun State, Nigeria

“…Thus, whoever has acquired sufficient knowledge on schistosomiasis transmission would take cognisance of This study is, however, in contrast with a study carried out in Uganda [25] to assess knowledge, attitudes, and practices regarding schistosomiasis infection and prevention, where a total of 98.5%, 81.3%, and 78.5% had heard about schistosomiasis and knew the main transmission modes and symptoms respectively. The good knowledge recorded in the study was attributed to countrywide health education campaigns organized by the Ministry of Health between 2017 and 2018.…”

Understanding perceptions of schistosomiasis and its control among highly endemic lakeshore communities in Mayuge, Uganda

“…Even though some people do not drink from the lake, they depend on lake water for all other water activities. Research in Western Uganda also shows that schistosomiasis was considered hard to prevent because the lake is the only source of free water [63] and many other Ugandan studies highlight a lack of safe water in fishing communities [49,[63][64][65]. The taps available in Musubi and Bugoto villages were unreliable, they frequently broke down, some were faulty or locked and on cloudy or rainy days the taps run out of water because they used a solar pump.…”