Abstract
BackgroundControl of schistosomiasis remains a priority in endemic areas. Local epidemiological data are necessary for a tailored control programme, including data on population behaviour in relation to the disease. The objective of this study was to assess schistosomiasis-related knowledge, attitudes and practices in the general population of Lambaréné, a small city in Gabon, in order to optimise the design and implementation of a local control programme that is tailored to need.MethodsThe study was cross-sectional in nature. Eligible adults and children living in the study area who volunteered (with informed consent) to participate in the study were interviewed using standardised questionnaires, one of which was a simplified version of the primary questionnaire for participants aged 6–13 years. Data on the participants’ knowledge, attitudes and practices that enhance the risk for contracting schistosomiasis were collected.ResultsA total of 602 participants were included. The mean (± standard deviation) age was 21.2 (± 15.0) years, the female:male gender ratio was 1.6 and 289 (48%) participants completed the simplified version the questionnaire. Of the 602 participants, 554 (92%) reported past or current contact with freshwater, 218 (36%) reported a history of a diagnosis of schistosomiasis and 193 (32%) reported past intake of praziquantel medication. The overall levels of knowledge and adequate attitudes toward schistosomiasis among young adults and adults were 68 and 73%, respectively. The proportion of participants pursuing risk-enhancing practices (REP) was 60% among the whole study population. Location was significantly associated with differences in knowledge and REP levels. A history of confirmed schistosomiasis and larger family size were significantly associated with an increase in good knowledge and REP levels. However, the indication of freshwater-associated activities was only associated with a significant increase in the REP level.ConclusionsThe results of this survey reveal a high level of population exposure to schistosomiasis, which is in line with known prevalence of schistosomiasis in Lambaréné and its surroundings. The local population has a reasonable level of knowledge of and adequate attitudes toward schistosomiasis but the level of REP is high, particularly in areas where piped water is absent. In terms of interventions, improving hygiene should have the highest priority, but in a context where provision of safe water is difficult to achieve, the effectiveness of praziquantel treatment and the education of at-risk populations on the need for protective behaviours should be a prominent feature of any local control programme.Graphical abstract
Highlights
Control of schistosomiasis remains a priority in endemic areas
In addition to mass drug administration (MDA) and snail control, the World Health Organization (WHO) strategy for schistosomiasis control is based on the access to safe water (W), improved sanitation (S) and hygiene education (H) of at-risk population groups [2], a strategy known as the WAter Sanitation and Hygiene (WASH) programme [3]
We report here the results of a KAP study that was performed to gain insight into the knowledge, attitudes and practices of local people regarding schistosomiasis, with the goal to facilitate control program optimisation, as the region appears to be one of the areas of the country worst affected by schistosomiasis
Summary
Control of schistosomiasis remains a priority in endemic areas. Local epidemiological data are neces‐ sary for a tailored control programme, including data on population behaviour in relation to the disease. In order to propose the appropriate change in behaviour or better adaptative behaviour, and to implement an adequate approach for prevention, it becomes necessary to assess the knowledge of the local population in each area where the disease is endemic, and to identify the attitudes and practices (KAP) of these local populations toward the disease. To this end, the KAP survey appears to be a relevant tool to explore the local situation, as a pre-requisite for targeting group-tailored intervention strategies. A number of previous KAP studies on schistosomiasis that were conducted in rural and semi-urban areas, where sanitation is usually rudimentary and safe water supply is limited, demonstrated that even when the levels of knowledge and attitude in relation to schistosomiasis are moderate or good [6, 7], disease prevention often remains difficult to practise - mainly in terms of personal and sanitation hygiene, in both children [6, 7] and adults [7] with limited access to adequate toilet facilities and safe water, and possibly in combination with a lack of knowledge of how schistosomiasis is transmitted or could be prevented [8]
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