行为干预对坦桑尼亚奔巴学童血吸虫病相关知识、态度和行为的影响：一项为期4年的重复横断面研究

IF 3.4 2区医学 Q1 PARASITOLOGY

PLoS Neglected Tropical Diseases Pub Date : 2025-09-30 eCollection Date: 2025-09-01 DOI:10.1371/journal.pntd.0013462

Naomi Chi Ndum, Lydia Trippler, Ulfat Amour Mohammed, Mohammed Nassor Ali, Jan Hattendorf, Shaali Makame Ame, Fatma Kabole, Jürg Utzinger, Said Mohammed Ali, Stefanie Knopp

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引用次数: 0

摘要

背景：血吸虫病是一种主要影响撒哈拉以南非洲学龄儿童的寄生虫病。预防性化疗是控制的主要手段。建议采取其他干预措施，包括行为改变沟通，以减少传播并最终实现消除。在坦桑尼亚奔巴的4年SchistoBreak项目中，我们确定了BCC干预对暴露于不同BCC干预频率和持续时间的儿童的血吸虫病相关知识、态度和行为（KAP）的影响。方法：从2020年到2024年，对18所小学进行年度调查。对随机选择的3-5年级儿童进行血吸虫病相关KAP评估。BCC干预措施在一个时期（4所学校）、两个无间隔期（3所学校）、两个有1年间隔期（1所学校）或从未实施（10所学校）。采用随机效应的线性和逻辑混合模型来评估2024年BCC暴露类别作为预测因素与知识或态度得分或不安全洗涤习惯作为结果变量之间的关联。主要发现：共有4196名儿童参与了调查。持续或反复接触BCC干预措施后，知识和态度有所改善。2024年，与从未接受过BCC干预的儿童相比，接受过一次BCC干预（差异：1.2,95%置信区间（CI）： 0.6-1.9）或两次BCC干预（差异：2.1,95% CI: 1.4-2.7）的儿童的知识得分显著高于未接受BCC干预的儿童。接受两次BCC干预的儿童（差异：1.2,95% CI: 0.8-1.6）在2024年的态度得分显著较高。无论儿童是否暴露于BCC，洗涤习惯都有所改善。在接受BCC干预的儿童中，有多达一半的儿童知道安装在干预区域的洗涤平台，但其使用率相当低，在7.5%至43.1%之间。结论/意义：我们证明了BCC干预能够改善学童的血吸虫病相关知识和态度。为了产生可持续的长期影响，可能需要重复的BCC干预措施。试验注册：ISRCTN， ISRCTN91431493。2020年2月11日注册，https://www.isrctn.com/ISRCTN91431493。

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Effect of behavioral interventions on schistosomiasis-related knowledge, attitudes, and practices of schoolchildren in Pemba, Tanzania: A 4-year repeated cross-sectional study.

Background: Schistosomiasis is a parasitic disease that mostly affects school-age children in sub-Saharan Africa. Preventive chemotherapy is the mainstay of control. Other interventions, including behavior change communication (BCC), are recommended to reduce transmission and ultimately achieve elimination. We determined the effect of BCC interventions on schistosomiasis-related knowledge, attitudes, and practices (KAP) among children who were exposed to different BCC intervention frequencies and durations within the 4-year SchistoBreak project in Pemba, Tanzania.

Methodology: Annual surveys were carried out from 2020 to 2024 in 18 primary schools. Schistosomiasis-related KAP were assessed in randomly selected children attending grades 3-5. BCC interventions were implemented for one period (4 schools), two periods without gap (3 schools), two periods with a 1-year gap (1 school), or never (10 schools). Linear and logistic mixed-models with random effect were applied to assess associations between BCC exposure categories as predictors and knowledge or attitude scores, or unsafe washing practices as the outcome variable in 2024.

Principal findings: A total of 4196 children participated in the surveys. Knowledge and attitude improved with continuous or repeated exposure to BCC interventions. In 2024, the knowledge scores were significantly higher in children who received BCC intervention once (difference: 1.2, 95% confidence interval (CI): 0.6-1.9) or twice (difference: 2.1, 95% CI: 1.4-2.7), as compared to children who never received BCC interventions. Children who were exposed to BCC interventions twice (difference: 1.2, 95% CI: 0.8-1.6) had significantly higher attitude scores in 2024. Washing practices improved regardless of whether or not children were exposed to BCC. The washing platforms installed in intervention areas were known by up to half of the children exposed to BCC interventions, but their use was considerably lower, varying between 7.5% and 43.1%.

Conclusions/significance: We demonstrated that BCC interventions were able to improve schistosomiasis-related knowledge and attitudes in schoolchildren. Repeated BCC interventions might be required for sustainable long-term impact.

Trial registration: ISRCTN, ISRCTN91431493. Registered 11 February. 2020, https://www.isrctn.com/ISRCTN91431493.

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PLoS Neglected Tropical Diseases PARASITOLOGY-TROPICAL MEDICINE

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10.50%

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723

期刊介绍： PLOS Neglected Tropical Diseases publishes research devoted to the pathology, epidemiology, prevention, treatment and control of the neglected tropical diseases (NTDs), as well as relevant public policy. The NTDs are defined as a group of poverty-promoting chronic infectious diseases, which primarily occur in rural areas and poor urban areas of low-income and middle-income countries. Their impact on child health and development, pregnancy, and worker productivity, as well as their stigmatizing features limit economic stability. All aspects of these diseases are considered, including: Pathogenesis Clinical features Pharmacology and treatment Diagnosis Epidemiology Vector biology Vaccinology and prevention Demographic, ecological and social determinants Public health and policy aspects (including cost-effectiveness analyses).