Control of urinary schistosomiasis on Zanzibar (Unguja Island): a pilot evaluation of the educational impact of the Juma na Kichocho health booklet within primary schools

Abstract

To improve health education within primary schools, the health education booklet Juma na kichocho was evaluated during a study within 5 schools using key-informant questionnaires that recorded children's knowledge and attitude (KA) towards schistosomiasis before and after daily structured-use of booklets. A total of 229 schoolchildren (114 boys : 115 girls) of between 11 and 15 years of age were interviewed and re-assessed after a working school week. Existing and putative booklet-induced changes in KA scores for schistosomiasis were compared directly against equivalent KA scores for malaria. In total 47.4% of children were already aware that schistosomiasis was a water-borne disease while only 10.5% knew of its exact aetiology; after booklet intervention these levels increased to 54.6 and 15.7%, respectively. The majority of children still failed, however, to realise that re-infection could take place soon after treatment. While a positive increase was observed for children's total KA questionnaire scores for both malaria and schistosomiasis after booklet intervention, these were not statistically significant. In the context of control, further educational efforts are needed to promote and guide behavioural change, especially in relation to reduction of environmental water contact. Key words: health education -knowledge and attitude -information education and communication -malaria - Schistosoma haematobiumSchistosomiasis continues to be a scourge of the health of people living in sub-Saharan Africa with a yearly ascribed death rate of over 200,000 (van der Werf et al. 2003). The global burden of the disease is presently under revision (King et al. 2005) and there has been renewed support for control. Several recent initiatives are focused upon provision of chemotherapy with praziquantel, often in conjunction with medications for other diseases (Molyneux et al. 2005), to ensure the prevention and containment of schistosomiasis-induced morbidity (Fenwick 2006). Administration of medications, with focus usually upon treatment of school-aged children, is primarily facilitated through use of school-based resources (Southgate et al. 2005).Urinary schistosomiasis, caused by infection with Schistosoma haematobium, is a major public health problem in Zanzibar and is locally known as kichocho (Stothard et al. 2002a). In contrast to the widespread distribution of the disease on Pemba Island (Albonico et al. 1997, Lwambo et al. 1997, the distribution of urinary schistosomiasis on Unguja is clearly restricted within the distribution of the only suitable local intermediate snail host, Bulinus globosus (Stothard & Rollinson 1997). Prevalence of the disease by school is strongly correlated with proximity to B. globosus habitats and with levels of children's local water contact as ascertained by interrogative questionnaires (Stothard et al. 2002a, b). Earlier questionnaire methods revealed that awareness of kichocho was initially low allowing much room for improvement (Stothard et al. 2002b).In October 2003, the President of...

Schistosomiasis transmission; socio-demographic, knowledge and practices as transmission risk factors in pregnant women

“…The influence of education, occupation and religion on schistosomiasis in pregnant women is similar to that of the general population. A poor level of education appears to be a risk factor for urogenital schistosomiasis in Nigeria in present study, intestinal schistosomiasis in Brazil (Bethony et al 2001) and many other parasitic diseases throughout the developing world (Montresor et al 2001;Asaolu and Ofoezie 2003;Stothard et al 2006;Aagaard-Hansen et al 2009). This association is probably multi-faceted, education affecting attitudes and behavior in different ways in different settings (Ugbomoiko et al 2010).…”

Development and testing of Schisto and Ladders™, an innovative health educational game for control of schistosomiasis in schoolchildren

“…Complimenting health education with deworming program has been suggested as a potential way of breaking parasite’s transmission cycle by preventing contamination of the environment [15]. Complementary interventions such as improvement in water and sanitation [16] and health education have been advocated, as additional efforts essential to sustain the gains of preventive chemotherapy [17, 18]. It is against this background we are reporting a newly developed health educational game Schisto and Ladders™ and its potential to promote behavioural changes for schistosomiasis control by increasing knowledge of schistosomiasis among school children in an endemic community near Abeokuta, Nigeria.…”

Changing Patterns of Soil-Transmitted Helminthiases in Zanzibar in the Context of National Helminth Control Programs

“…11,12 For example, in Chaani and Kinyasini, children received annual treatment with mebendazole and praziquantel from 1995 to 2000 through the national helminth control program and, after a shortage of drug donations, albendazole and praziquantel were again distributed from 2003 onward to school children as part of the "Kick out Kichocho Program." [13][14][15] Starting in 2001, the Global Program to Eliminate Lymphatic Filariasis (GPELF) targeted eligible individuals in Zanzibar (including children ≥ 5 years of age) annually with ivermectin plus albendazole. 13,16,17 Of note, ivermectin (single oral dose of 200 μg/kg) is not only efficacious against filarial worms but also against S. stercoralis and A. lumbricoides .…”