Knowledge attitudes and practices of grade three primary schoolchildren in relation to schistosomiasis, soil transmitted helminthiasis and malaria in Zimbabwe

BMC Infectious Diseases

Takafira Mduluza⁷  Nirbhay Kumar¹  Francisca Mutapi²  Kimberly C Brouwer³  Vivian Chadukura⁶  Godfrey Makware⁴  Farisai Tongogara⁶  Masceline J Mutsaka⁶  Gibson Hlerema⁶  Davison Sangweme¹  Noah H Paul⁷  Munyaradzi P Mapingure⁷  Sekesai Mtapuri-Zinyowera⁵  Nicholas Midzi⁶ 

[1] Johns Hopkins Bloomberg School of Public Health, Department of Molecular Microbiology and Immunology, Baltimore, Maryland, USA;University of Edinburgh, Institute for Immunology and Infection Research, Edinburgh, UK;University of California, San Diego, Division of Global Public Health, Department of Medicine, San Diego, California USA;Zimbabwe National Statistics Agency PO Box CY 342, Causeway, Harare, Zimbabwe;College of Health Sciences, Department of Medical Microbiology, P.0 Box A178, Avondale, Harare, Zimbabwe;National Institute of Health Research, Box CY 573, Causeway Harare, Zimbabwe;University of Zimbabwe, Department of Biochemistry, P.O Box MP167, Mount Pleasant, Harare, Zimbabwe

关键词: malaria;    soil transmitted helminthiasis;    schistosomiasis;    practices;    attitudes;    Knowledge;   

Others  :  1175680
DOI  :  10.1186/1471-2334-11-169

 received in 2010-07-28, accepted in 2011-06-13,  发布年份 2011

【 摘 要 】

Background

Helminth infection rates in grade three children are used as proxy indicators of community infection status and to guide treatment strategies in endemic areas. However knowledge, attitudes and practices (KAP) of this target age group (8-10 years) in relation to schistosomiasis, soil transmitted helminthiasis (STHs) and malaria is not known at a time when integrated plasmodium - helminth control strategies are being advocated. This study sought to assess KAP of grade 3 children in relation to schistosomiasis, STHs and malaria in order to establish an effective school based health education for disease transmission control.

Methods

Grade 3 children (n = 172) attending four randomly selected primary schools (one in rural and 3 in the commercial farming areas) in Zimbabwe were interviewed using a pre-tested interviewer administered questionnaire. The urine filtration technique was used to determine S. haematobium infection status. Infection with S. mansoni and STHs was determined using a combination of results from the Kato Katz and formol ether concentration techniques. P. falciparum was diagnosed by examination of Giemsa stained thick blood smears.

Results

It was observed that 32.0%, 19.2% and 4.1% of the respondents had correct knowledge about the causes of schistosomiasis, malaria and STHs, respectively, whilst 22.1%, 19.2% and 5.8% knew correct measures to control schistosomiasis, malaria and STHs. Sixty-two percent and 44.8% did not use soap to wash hands after toilet and before eating food respectively, whilst 33.1% never wore shoes. There were no functional water points and soap for hand washing after toilet at all schools. There was a high prevalence distribution of all parasites investigated in this study at Msapa primary school - S. haematobium (77.8%), S. mansoni (33.3%) hookworms (29.6%) and P. falciparum (48.1%). Reports that participant had suffered from schistosomiasis and malaria before were significant predictors of these diseases (p = 0.001 and p = 0.042, respectively). Report that participant had blood in urine on the day of examination was a significant predictor of schistosomiasis (p = 0.045).

Conclusion

There is a critical need for targeting health messages through schools in order to reach the most susceptible schoolchildren. This will empower the schoolchildren with the basic knowledge and skills ultimately protecting them from acquiring schistosomiasis, STHs and malaria.

【 授权许可】

   
2011 Midzi et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Crompton DWT: How much human helminthiasis is there in the world? JParasitol 1999, (3):397-403.
• [2]Montresor A, Crompton DWT, Gyorkos TW, Savioli L: Helminths control in school age children: a guide for managers of control programmes. Geneva, World Health Organization; 2002.
• [3]World Health Organization (WHO): The prevention and control of schistosomiasis and soil transmitted helminthiasis. Report of a WHO Expert Committee. Geneva, World Health Organization; 2002. WHO Technical Report Series No.912
• [4]Snow RW, Guerra CA, Abdisalan M, Myint HY, Hay SI: The global distribution of clinical episodes of Plasmodium falciparum malaria. Nature 2005, 343:214-217.
• [5]Bundy DAP, Lwin S, Osika JS, McLaughline J, Pannenborg CO: "What Should Schools Do about Malaria?". Parasitol Today 2000, 16:181-82.
• [6]Brooker S, Guyatt H, Omumbo J, Shretta R, Drake L, Ouma J: "Situation Analysis of Malaria in School-Aged Children in Kenya: What Can Be Done?". Parasitol Today 2000, 16:183-86.
• [7]National Health Profile 2002 Ministry of Health and Child Welfare, Harare, Zimbabwe;
• [8]Taylor P, Makura O: Prevalence and distribution of Schistosomiasis in Zimbabwe. Ann Trop Med Parasitol 1985, 79(3):287-299.
• [9]Chandiwana SK, Taylor P, De Clarke V: Prevalence and intensity of schistosomiasis in two rural areas in Zimbabwe and their relationship to village location and snail infection rates. Ann Trop Med Parasitol 1988, 82(2):163-173.
• [10]Chandiwana SK, Woolhouse MEJ: Heterogeneities in water contact patterns and the epidemiology of Schistosoma haematobium. Parasitol 1991, 103:363-370.
• [11]Chandiwana SK, Makaza D: Some epidemiological aspects of intestinal helminth infections in a farm worker community in Burma Valley. Cent Afr J Med 1983, 29:173-177.
• [12]Chandiwana SK, Bradley M, Chombo F: Hookworm and roundworm infections in farm-worker communities in the large-scale agricultural sector in Zimbabwe. J Trop Med Hyg 1989, 92(5):338-44.
• [13]Bradley M, Chandiwana SK: Age-dependency in predisposition to hookworm infection in the Burma valley area of Zimbabwe. Tans R Soc Trop Med Hyg 1990, 84(6):826-8.
• [14]Bradley M, Chandiwana SK, Bundy DA, Medley GF: The epidemiology and population biology of Necator americanus infection in a rural community in Zimbabwe. Trans R Soc Trop Med Hyg 1992, 86(1):73-6.
• [15]Bradley M, Chandiwana SK, Bundy DA: The epidemiology and control of hookworm infection in the Burma Valley area of Zimbabwe. Trans R Soc Trop Med Hyg 1993, 87(2):145-7.
• [16]Taylor P, Mutambu SL: A review of the malaria situation in Zimbabwe with special reference to the period 1972-1981. Trans R Soc Trop Med Hyg 1984, 87(supl.2):25-30.
• [17]Midzi N, Sangweme D, Zinyowera S, Mapingure MP, Brouwer KC, Munatsi A, Mutapi F, Mudzori J, Kumar N, Woelk G, Mduluza T: The burden of polyparasitism among primary schoolchildren in rural and farming areas in Zimbabwe. Trans R Soc Trop Med Hyg 2008, 102(10):1039-45.
• [18]Montresor A, Gyokos TW, Crompton DWT, Bundy DAP, Savioli A: Monitoring helminths control programmes: Guideline for monitoring the impact of control programmes aimed at reducing the morbidity of caused by soil transmitted helminths and schistosomes, with particular reference to school age children. WHO; 1999. WHO/CDS/CPC/SIP/99.3
• [19]World Health Organization: Preventive Chemotherapy in human helminthiasis. Coordinated use of antihelminthic drugs in control interventions: A manual for Health Professionals and programme managers. In WHO. Geneva; 2006.
• [20]Mutapi F, Ndhlovu PD, Hagan P, Woolhouse ME: Anti-schistosome antibody responses in children co-infected with malaria. Parasite Immunol 2000, 22:341-348.
• [21]Taylor P, Chandiwana SK, Govere JM, Chombo F: Knowledge attitudes and practices in relation to schistosomiasis in a rural community. Soc Sci Med 1987, 24(7):607-611.
• [22]Yeneneh H, Gyokos TW, Joseph L, Pickering J, Tedla S: Antimalarial drug utilization at by women in Ethiopia: a knowledge attitude practice study. Bull World Health Organ 1993, 71(6):763-772.
• [23]Vundule C, Mharakurwa S: Knowledge, practice and perceptions about malaria in rural communities of Zimbabwe: Relevance to malaria control. Bull World Health Organ 1996, 74(1):55-60.
• [24]Areetey ME, Aholu C, Wagatsuma Y, Bentil G, Nkurummah FK, Kojima S: Health education and community participation in the control of urinary schistosomiasis in Ghana. East Afr Med J 1999, 76(6):324-9.
• [25]Kyawt-Kyawt-Swe , Alan Pearson: Knowledge, attitudes and practices with regard to malaria control in an endemic rural area of Myanmar. Southeast Asian J Trop Med Pub Health 2004, 35(1):53-62.
• [26]Ibidapo CA: Perception of causes of malaria and treatment-seeking behaviour of nursing mothers in a rural community. Aust J Rural Health 2005, 13:214-218.
• [27]Brooker S, Clements ACA, Hotez PJ, Hay SI, Tatem AJ, Bundy DAP, Snow R: The co-distribution of Plasmodium falciparum and hookworm among African school children. Mal J 2006, 5:99. BioMed Central Full Text
• [28]Brooker S, Akhwales W, Pullan R, Estambale B, Clarke SE, Snow RW, Hotez PZ: Epidemiology of Plasmodium-Helminth Co-infection in Africa: Populations at risk, potential impact on anaemia and prospects for combining control. Am J Trop Med Hyg 2007, 77(suppl. 6):88-98.
• [29]Barish G, Maude GH, Bockarie MJ, Eggele TA, Greenwood BM, Ceesay S: Malaria in a rural area of Sierra Leone. I. Initial results. Ann Trop Med Parasitol 1993, 87:125-136.
• [30]Montresor A, Crompton DW, Hall A, Bundy DAP, Savioli L: Guidelines for the evaluation of soiltransmitted helminthiasis and schistosomiasis at community level. Geneva: World Health Organ 1998. WHO/CTD/SIP/98.1
• [31]Lukwa N, Nyazema NZ, Curtis CF, Mwaiko GL, Chandiwana SK: People's perceptions about malaria transmission and control using mosquito repellent plants in a locality in Zimbabwe. Central Afr J M 1999, 45(3):64-68.
• [32]Tomono N, Anantaphruti MT, Jongsuksuntigul P, Thongthien P, Leerapan P, Silapharatsamee Y, Kojima S, Looareesuwan S: Risk factors of helminthiasis among schoolchildren in Southern Thailand. Southeast Asian J Trop Med Pub Health 2003, 34(2):264-268.
• [33]Makura O, Kristensen TK: National freshwater snail survey of Zimbabwe. Proc Tenth Intern Malacol Congr 1991, 227-231.
• [34]Kloos H, Higashi GI, Cattani JA, Schinski VD, Mansour NS, Murrell KD: Water contact behavior and schistosomiasis in an Upper Egyptian village. Soc Sci Med 1983, 17:545-562.
• [35]Brito LL, Barreto M, Silva RCR, Assis AMO, Reis MG, Parraga IM, Blanton RE: Moderate and low-intensity co-infections by intestinal helminths and Schistosoma mansoni, dietary iron intake and anaemia in Brazilian children. Am J Trop Med Hyg 2006, 75(5):939-944.
• [36]Ezeamama AE, Friedman JF, Olveda RM, Acosta LP, Kurtis JD, Mor V, Mcgarvey ST: Functional significance of low-intensity polyparasite helminths infections in anaemia. J Infect Dis 2005, 192(12):2 160-2 170.
• [37]Midzi N, Mtapuri-Zinyowera S, Sangwemec D, Chirehwa MT, Mapingure MP, Mudzori J, Hlerema G, Mutapi F, Kumar N, Mduluza T: Consequences of polyparasitism on anaemia among primary school children in Zimbabwe. Acta Trop 2010, (115):103-111.
• [38]Hotez PJ, Molyneux DH, Fenwick A, Ottesen E, Ehrrlich Sachs S, Sachs JD: Incorporating a rapid-impact package for neglected tropical diseases with programs for HIV/AIDS, tuberculosis, and malaria. PLoS Med 2006, 3(5):e102.
• [39]Mwangi TW, Bethony J, Brooker S: Malaria and helminth interactions in humans: an epidemiological viewpoint. Ann Trop Med Parasitol 2006, 100(7):551-570.