Ngetich B Cheruiyot, Sachiyo Nagi, Asena E Chadeka, Rie Takeuchi, Miho Sassa, Bahati Felix, Noriko Kobayashi, Taeko Moriyasu, Janet Masaku, Gordon Okomo, Collins Ouma, Doris Njomo, Sammy M Njenga, Shinjiro Hamano
{"title":"肯尼亚西部 Mbita 县减少肠血吸虫病的障碍和误解。","authors":"Ngetich B Cheruiyot, Sachiyo Nagi, Asena E Chadeka, Rie Takeuchi, Miho Sassa, Bahati Felix, Noriko Kobayashi, Taeko Moriyasu, Janet Masaku, Gordon Okomo, Collins Ouma, Doris Njomo, Sammy M Njenga, Shinjiro Hamano","doi":"10.1186/s41182-024-00602-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Community and individual participation are crucial for the success of schistosomiasis control. The World Health Organization (WHO) has highlighted the importance of enhanced sanitation, health education, and Mass Drug Administration (MDA) in the fight against schistosomiasis. These approaches rely on the knowledge and practices of the community to be successful; however, where the community knowledge is low and inappropriate, it hinders intervention efforts. Hence, it is essential to identify barriers and misconceptions related to awareness of schistosomiasis, sources of infection, mode of transmission, symptoms, and control measures.</p><p><strong>Methods: </strong>This was a mixed-method cross-sectional study involving 1200 pre-school children randomly selected and examined for Schistosoma mansoni infection using the Kato-Katz technique. All parents/guardians of selected children were enrolled for a pre-tested questionnaire survey, while 42 were engaged in focus group discussions (FGDs). The level of knowledge and awareness among parents/guardians about schistosomiasis was evaluated in relation to the infection status of their pre-school children.</p><p><strong>Results: </strong>Among pre-school children, the prevalence of intestinal schistosomiasis was 45.1% (95% CI 41.7-48.5). A majority of parents/guardians (85.5%) had heard about schistosomiasis, and this awareness was associated with the participant's level of education (OR = 0.16, 95% CI 0.08, 0.34). In addition, a positive association was observed between higher educational attainment and knowledge of the causative agent (OR = 0.69, 95% CI 0.49, 0.96). Low education level was significantly associated with limited knowledge of transmission through lake water contact (OR = 0.71, 95% CI 0.52, 0.97) and infection from the lake (OR = 0.33, 95% CI 0.19, 0.57). Notably, parents/guardians who have heard of schistosomiasis could not recognize symptoms of S. mansoni infection, such as abdominal pain (91.8%, 815/888) and blood in the stool (85.1%, 756/888). Surprisingly, 49.8% (442/888) incorrectly identified hematuria (blood in urine), a key sign of S. haematobium, but not S. mansoni, in an endemic area for S. mansoni infection. The majority (82.6%, 734/888) of parents/guardians were unaware that dams are potential infection sites, despite 53.9% (479/888) of their pre-school-aged children testing positive for schistosome infection.</p><p><strong>Conclusions: </strong>Despite the high level of awareness of intestinal schistosomiasis in the study area, we identified a low level of knowledge regarding its causes, modes of transmission, signs and symptoms and potential sites of transmission within the community. This study emphasizes the need for targeted educational interventions to address the misconceptions and knowledge gaps surrounding intestinal schistosomiasis through tailored community-based programs.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":null,"pages":null},"PeriodicalIF":3.6000,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11092127/pdf/","citationCount":"0","resultStr":"{\"title\":\"Barriers and misconceptions hindering reduction of intestinal schistosomiasis in Mbita Sub-County, Western Kenya.\",\"authors\":\"Ngetich B Cheruiyot, Sachiyo Nagi, Asena E Chadeka, Rie Takeuchi, Miho Sassa, Bahati Felix, Noriko Kobayashi, Taeko Moriyasu, Janet Masaku, Gordon Okomo, Collins Ouma, Doris Njomo, Sammy M Njenga, Shinjiro Hamano\",\"doi\":\"10.1186/s41182-024-00602-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Community and individual participation are crucial for the success of schistosomiasis control. 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The level of knowledge and awareness among parents/guardians about schistosomiasis was evaluated in relation to the infection status of their pre-school children.</p><p><strong>Results: </strong>Among pre-school children, the prevalence of intestinal schistosomiasis was 45.1% (95% CI 41.7-48.5). A majority of parents/guardians (85.5%) had heard about schistosomiasis, and this awareness was associated with the participant's level of education (OR = 0.16, 95% CI 0.08, 0.34). In addition, a positive association was observed between higher educational attainment and knowledge of the causative agent (OR = 0.69, 95% CI 0.49, 0.96). Low education level was significantly associated with limited knowledge of transmission through lake water contact (OR = 0.71, 95% CI 0.52, 0.97) and infection from the lake (OR = 0.33, 95% CI 0.19, 0.57). Notably, parents/guardians who have heard of schistosomiasis could not recognize symptoms of S. mansoni infection, such as abdominal pain (91.8%, 815/888) and blood in the stool (85.1%, 756/888). Surprisingly, 49.8% (442/888) incorrectly identified hematuria (blood in urine), a key sign of S. haematobium, but not S. mansoni, in an endemic area for S. mansoni infection. The majority (82.6%, 734/888) of parents/guardians were unaware that dams are potential infection sites, despite 53.9% (479/888) of their pre-school-aged children testing positive for schistosome infection.</p><p><strong>Conclusions: </strong>Despite the high level of awareness of intestinal schistosomiasis in the study area, we identified a low level of knowledge regarding its causes, modes of transmission, signs and symptoms and potential sites of transmission within the community. This study emphasizes the need for targeted educational interventions to address the misconceptions and knowledge gaps surrounding intestinal schistosomiasis through tailored community-based programs.</p>\",\"PeriodicalId\":23311,\"journal\":{\"name\":\"Tropical Medicine and Health\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2024-05-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11092127/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Tropical Medicine and Health\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1186/s41182-024-00602-7\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"TROPICAL MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Tropical Medicine and Health","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s41182-024-00602-7","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"TROPICAL MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
背景:社区和个人的参与对于血吸虫病防治工作的成功至关重要。世界卫生组织(WHO)强调了加强环境卫生、健康教育和大规模药物管理(MDA)在血吸虫病防治中的重要性。这些方法的成功有赖于社区的知识和实践;然而,如果社区的知识水平低且不恰当,就会阻碍干预工作。因此,必须找出与血吸虫病的认识、感染源、传播方式、症状和控制措施有关的障碍和误解:这是一项混合方法横断面研究,随机选取了 1200 名学龄前儿童,采用卡托-卡茨(Kato-Katz)技术对其进行曼氏血吸虫感染检查。所有入选儿童的家长/监护人都参加了预先测试的问卷调查,42 名家长/监护人参加了焦点小组讨论(FGDs)。根据学龄前儿童的感染情况,评估了家长/监护人对血吸虫病的了解和认识水平:结果:在学龄前儿童中,肠血吸虫病的感染率为 45.1%(95% CI 41.7-48.5)。大多数家长/监护人(85.5%)听说过血吸虫病,这种认识与参与者的教育水平有关(OR = 0.16,95% CI 0.08,0.34)。此外,教育程度较高与对病原体的了解程度呈正相关(OR = 0.69,95% CI 0.49,0.96)。教育程度低与对通过湖水接触传播(OR = 0.71,95% CI 0.52,0.97)和从湖水中感染(OR = 0.33,95% CI 0.19,0.57)的了解有限有很大关系。值得注意的是,听说过血吸虫病的父母/监护人无法识别感染曼森氏疟的症状,如腹痛(91.8%,815/888)和便血(85.1%,756/888)。令人惊讶的是,在曼氏沙门氏菌感染流行区,49.8%(442/888)的人错误地识别出了血尿(尿血),而血尿是沙门氏菌感染的一个重要征兆,但并非曼氏沙门氏菌感染的征兆。尽管53.9%(479/888)的学龄前儿童血吸虫感染检测呈阳性,但大多数家长/监护人(82.6%,734/888)并不知道水坝是潜在的感染场所:尽管研究地区对肠道血吸虫病的认知度较高,但我们发现社区居民对血吸虫病的病因、传播方式、体征和症状以及潜在传播地点的了解程度较低。这项研究强调,有必要采取有针对性的教育干预措施,通过量身定制的社区计划来消除人们对肠道血吸虫病的误解和知识差距。
Barriers and misconceptions hindering reduction of intestinal schistosomiasis in Mbita Sub-County, Western Kenya.
Background: Community and individual participation are crucial for the success of schistosomiasis control. The World Health Organization (WHO) has highlighted the importance of enhanced sanitation, health education, and Mass Drug Administration (MDA) in the fight against schistosomiasis. These approaches rely on the knowledge and practices of the community to be successful; however, where the community knowledge is low and inappropriate, it hinders intervention efforts. Hence, it is essential to identify barriers and misconceptions related to awareness of schistosomiasis, sources of infection, mode of transmission, symptoms, and control measures.
Methods: This was a mixed-method cross-sectional study involving 1200 pre-school children randomly selected and examined for Schistosoma mansoni infection using the Kato-Katz technique. All parents/guardians of selected children were enrolled for a pre-tested questionnaire survey, while 42 were engaged in focus group discussions (FGDs). The level of knowledge and awareness among parents/guardians about schistosomiasis was evaluated in relation to the infection status of their pre-school children.
Results: Among pre-school children, the prevalence of intestinal schistosomiasis was 45.1% (95% CI 41.7-48.5). A majority of parents/guardians (85.5%) had heard about schistosomiasis, and this awareness was associated with the participant's level of education (OR = 0.16, 95% CI 0.08, 0.34). In addition, a positive association was observed between higher educational attainment and knowledge of the causative agent (OR = 0.69, 95% CI 0.49, 0.96). Low education level was significantly associated with limited knowledge of transmission through lake water contact (OR = 0.71, 95% CI 0.52, 0.97) and infection from the lake (OR = 0.33, 95% CI 0.19, 0.57). Notably, parents/guardians who have heard of schistosomiasis could not recognize symptoms of S. mansoni infection, such as abdominal pain (91.8%, 815/888) and blood in the stool (85.1%, 756/888). Surprisingly, 49.8% (442/888) incorrectly identified hematuria (blood in urine), a key sign of S. haematobium, but not S. mansoni, in an endemic area for S. mansoni infection. The majority (82.6%, 734/888) of parents/guardians were unaware that dams are potential infection sites, despite 53.9% (479/888) of their pre-school-aged children testing positive for schistosome infection.
Conclusions: Despite the high level of awareness of intestinal schistosomiasis in the study area, we identified a low level of knowledge regarding its causes, modes of transmission, signs and symptoms and potential sites of transmission within the community. This study emphasizes the need for targeted educational interventions to address the misconceptions and knowledge gaps surrounding intestinal schistosomiasis through tailored community-based programs.