Perceptions about interventions to control schistosomiasis among the Lake Victoria island communities of Koome, Uganda

Abstract

BackgroundPraziquantel-based mass treatment is the main approach to controlling schistosomiasis mansoni in endemic areas. Interventions such as provision and use of safe water, minimising contact with infested water, disposal of stool in latrines and snail control provide key avenues to break the transmission cycle and can sustain the benefits of mass treatment in the long term. Efforts are also being made to develop a schistosomiasis vaccine which, if effective, might reduce the incidence of re-infection after treatment. However, any interventions deployed need to be acceptable to, and sustainable by, the target communities.MethodsIn this qualitative study, we investigated the perceptions of six Lake Victoria island communities of Koome, Uganda, about interventions to control Schistosoma mansoni infection and their willingness to participate in Schistosoma vaccine trials. Thirty-two in-depth interviews, 12 key informant interviews and 10 focus group discussions were conducted. Data were analysed using a thematic content approach.FindingsIntestinal schistosomiasis was not regarded as a serious health problem because a mass treatment programme is in place. However, the communities lack safe water sources and latrines. Mass treatment with praziquantel, safe water supplies and use of toilets were deemed the most acceptable interventions by the participants. The communities are willing to participate in Schistosoma vaccine trials.Conclusion/SignificanceKnowledge of a community’s perception about interventions to control schistosomiasis can be valuable to policy makers and programme implementers intending to set up interventions co-managed by the community members. In this study, the views of the Lake Victoria island communities of Koome are presented. This study also provides data to guide further work on alternative interventions such as Schistosoma vaccine trials in these communities.

Factors affecting the uptake of preventive chemotherapy treatment for schistosomiasis in Sub-Saharan Africa: A systematic review

“…Beneficiaries’ livelihoods, in turn, were found to condition adults' participation mainly in community-based MDAs [ 19 , 41 – 43 , 56 , 57 , 59 , 61 , 62 , 64 ]. Fishing was the most singled out occupation to put people at risk of missing out on treatment [ 19 , 41 , 56 , 59 , 62 , 64 ]. This happened because fisherfolk regularly spent long hours either fishing or travelling to remote catchment areas or markets, hence remaining uninformed of MDA activities or being absent during treatment days.…”

“…Fear of side effects was the most salient barrier to treatment uptake identified, mentioned by two thirds of all selected publications [ 16 , 19 , 20 , 36 , 41 , 42 , 44 – 46 , 48 , 53 , 54 , 56 – 59 , 62 ]. The extent and manner in which it affected participation, however, varied according to context.…”

Is there a gap between health education content and practice toward schistosomiasis prevention among schoolchildren along the shores of Lake Victoria in Kenya?

“…The study also found that more than half of the pupils went to swim in the lake sometimes or every day. Thus, even if safe water will be provided, they might continue to go to the lake for recreation because of the hot weather in the area [43]. Moreover, fishing is the main source of income of residents in this area; hence fishermen are also at risk of schistosomiasis.…”

Anthelminthic treatment receipt and its predictors in Lake Victoria fishing communities, Uganda: Intervention coverage results from the LaVIISWA cluster randomised trial

“…Women were more likely to refuse praziquantel treatment than men. Reasons for this are unclear, but could be due to concerns about taking during pregnancy or a belief that they are less likely to have schistosomiasis due to less frequent or obvious lake contact [ 26 ]. Our results contrast with studies from other settings that have found little difference in treatment receipt by age and, or gender [ 16 , 17 ], instead finding that factors such as socio-economic status and sanitation had greater predictive utility; unfortunately we did not collect information on these variables on the treatment registers in our study so could not investigate them further.…”