Effects of ‘The Vicious Worm’ educational tool on Taenia solium knowledge retention in Zambian primary school students after one year

Abstract

Background Taenia solium is a neglected zoonotic parasite endemic throughout many low-income countries worldwide, including Zambia, where it causes human and pig diseases with high health and socioeconomic burdens. Lack of knowledge is a recognized risk factor, and consequently targeted health educational programs can decrease parasite transmission and disease occurrence in endemic areas. Preliminary assessment of the computer-based education program ‘The Vicious Worm’ in rural areas of eastern Zambia indicated that it was effective at increasing knowledge of T . solium in primary school students. The aim of this study was to evaluate the impact of ‘The Vicious Worm’ on knowledge retention by re-assessing the same primary school students one year after the initial education workshops. Methodology/Principal findings Follow-up questionnaires were administered in the original three primary schools in eastern Zambia in 2017, 12 months after the original workshops. In total, 86 pupils participated in the follow-up sessions, representing 87% of the initial workshop respondents. Knowledge of T . solium at ‘follow-up’ was significantly higher than at the initial ‘pre’ questionnaire administered during the Vicious Worm workshop that took place one year earlier. While some specifics of the parasite’s life cycle were not completely understood, the key messages for disease prevention, such as the importance of hand washing and properly cooking pork, remained well understood by the students, even one year later. Conclusions/Significance Results of this study indicate that ‘The Vicious Worm’ may be an effective tool for both short- and long-term T . solium education of rural primary school students in Zambia. Inclusion of educational workshops using ‘The Vicious Worm’ could be recommended for integrated cysticercosis control/elimination programs in sub-Saharan Africa, particularly if the content is simplified to focus on the key messages for prevention of disease transmission.

Effects of ‘The Vicious Worm’ educational software on Taenia solium knowledge among key pork supply chain workers in Zambia

“…Previous T . solium health education interventions in India [ 22 ], Kenya [ 23 ], Mexico [ 24 ], Tanzania [ 20 , 25 – 29 ] and Zambia [ 30 , 31 ] led to significant increases in knowledge among targeted stakeholders. Moreover, attitudinal and behavioral change were reported in different T .…”

“…Moreover, attitudinal and behavioral change were reported in different T . solium health education studies; including increased condemnation of infected meat, better confinement of pigs and improved sanitary/hygienic practices [ 20 , 22 – 25 , 27 – 30 , 32 ]. More importantly, health education proved able to reduce PCC [ 20 , 24 , 25 ] and HCC [ 32 ] incidence.…”

“…Different health education approaches have been tested; including the use of informational movies, street plays, songs, interactive discussions, leaflets, posters, banners, trained teachers and software programs [ 22 – 28 , 30 , 31 ]. ‘The Vicious Worm’ (TVW, https://theviciousworm.be/ ) is a free educational software program that provides evidence-based information on T .…”

“…Previous studies found that health education with TVW provided significant short- and long-term knowledge uptake in Zambian primary school students [ 30 , 31 ] and Tanzanian medical and agricultural professionals [ 26 , 28 ]. Furthermore, TVW was well-received by study participants and exposure to the program was reported to lead to positive behavioral changes and effective knowledge dissemination [ 20 , 26 , 28 , 30 ]. Our study aimed to assess the effects of TVW health education on key actors in the Zambian pork supply chain.…”

Modelling for Taenia solium control strategies beyond 2020

“…Studies have demonstrated a statistically significant increase in knowledge and attitudes scores in both the United Republic of Tanzania and Zambia. 10,11 In Peru, mechanisms for transferring intervention strategies to local communities, such as community-based reporting of pig cysticercosis to inform ring strategies, have also been explored. 12 While this study did not identify a significant change in the seroincidence of cysticercosis in the intervention group, efforts to develop locally sustainable interventions, for example, by transferring ownership of interventions, is important.…”