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.
Highlights
Schistosomiasis is a parasitic disease acquired when people come into contact with larval forms of the parasite of the Schistosoma (S.) genus, known as cercariae, which are released by freshwater snails acting as intermediate hosts
Correct knowledge of schistosomiasis was low with regard to transmission routes, with just over 10% of those who were generally aware of the disease citing one correct route
Given the high prominence of mass drug administration (MDA) in schistosomiasis prevention and control strategies both internationally and nationally, it was worrying to find that knowledge of MDA and knowledge of praziquantel as a drug that treats schistosomiasis was very low, with only 5% of respondents citing MDA as a prevention mechanism and 61% stating that they did not know whether a drug existed to treat the disease
Summary
Schistosomiasis is a parasitic disease acquired when people come into contact with larval forms of the parasite of the Schistosoma (S.) genus, known as cercariae, which are released by freshwater snails acting as intermediate hosts. Infection typically occurs while wading, bathing or washing in contaminated water, when cercariae emerging from their host snails penetrate a person’s skin and develop into mature worms, which can live within the blood vessels of the human host for several years. The complex life cycle of schistosomiasis continues when an infected person defecates or urinates in or near freshwater, releasing a proportion of the eggs into the water, which hatch and infect their intermediate snail host [1]. Schistosomiasis is a parasitic disease which affects almost 300 million people worldwide each year. 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
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