Knowledge, attitudes and practices about human African trypanosomiasis and their implications in designing intervention strategies for Yei county, South Sudan.

Salome A Bukachi,Wilson Sebit,Joseph M Ndung'U,Sylvain Biéler,John Rumunu,Ayak C D Alak,Angeline A Mumbo,Philippe Büscher

doi:10.1371/journal.pntd.0006826

Abstract

BackgroundA clear understanding of the knowledge, attitudes and practices (KAP) of a particular community is necessary in order to improve control of human African trypanosomiasis (HAT).New screening and diagnostic tools and strategies were introduced into South Sudan, as part of integrated delivery of primary healthcare. Knowledge and awareness on HAT, its new/improved screening and diagnostic tools, the places and processes of getting a confirmatory diagnosis and treatment are crucial to the success of this strategy.MethodologyA KAP survey was carried out in Yei County, South Sudan, to identify gaps in community KAP and determine the preferred channels and sources of information on the disease. The cross-sectional KAP survey utilized questionnaires, complemented with key informant interviews and a focus group discussion to elicit communal as well as individual KAP on HAT.FindingsMost (90%) of the respondents had general knowledge on HAT. Lower levels of education, gender and geographic locations without a history of HAT interventions were associated with incorrect knowledge and/or negative perceptions about the treatability of HAT. Symptoms appearing in the late stage were best known. A majority (97.2%) would seek treatment for HAT only in a health centre. However, qualitative data indicates that existing myths circulating in the popular imagination could influence people’s practices. Seventy-one percent of the respondents said they would offer social support to patients with HAT but qualitative data highlights that stigma still exists. Misconceptions and stigma can negatively influence the health seeking behaviour of HAT cases. In relation to communication, the top preferred and effective source of communication was radio (24%).ConclusionGaps in relation to KAP on HAT still exist in the community. Perceptions on HAT, specifically myths and stigma, were key gaps that need to be bridged through effective education and communication strategies for HAT control alongside other interventions.

Highlights

Human African trypanosomiasis (HAT), known as sleeping sickness, is a parasitic neglected tropical disease of public health significance that mostly afflicts poor populations in endemic areas of rural Africa [1]
We had envisaged to have more than one focus group discussion (FGD) but it became a challenge to get the category of people we were keen on having discussions with, coupled with the long distances on rough terrain, and we focused more on the key informants who were easier to access
This is similar to findings by [18] in a KAP survey of human African trypanosomiasis (HAT) in the Democratic Republic of the Congo (DRC), who concluded that education among other factors was significant in the acquisition of knowledge

Summary

Introduction

Human African trypanosomiasis (HAT), known as sleeping sickness, is a parasitic neglected tropical disease of public health significance that mostly afflicts poor populations in endemic areas of rural Africa [1]. It is caused by two species of Trypanosoma: T. brucei rhodesiense, mostly found in eastern and southern Africa and causes the acute form of the disease, and T.b. gambiense, found in west and central Africa, and causes the chronic form of the disease. South Sudan is one of the countries that is still reporting cases of HAT [1]. Knowledge and awareness on HAT, its new/improved screening and diagnostic tools, the places and processes of getting a confirmatory diagnosis and treatment are crucial to the success of this strategy

Methods

Results

Discussion

Conclusion