Community Knowledge, Perceptions, and Practices Associated with Urogenital Schistosomiasis among School-Aged Children in Zanzibar, United Republic of Tanzania
Identifieur interne : 000B05 ( Pmc/Checkpoint ); précédent : 000B04; suivant : 000B06Community Knowledge, Perceptions, and Practices Associated with Urogenital Schistosomiasis among School-Aged Children in Zanzibar, United Republic of Tanzania
Auteurs : Bobbie Person [États-Unis] ; Said M. Ali ; Faiza M. A Adir ; Jamal N. Ali ; Ulfat A. Mohammed ; Khalfan A. Mohammed ; David Rollinson [Royaume-Uni] ; Stefanie Knopp [Royaume-Uni, Suisse]Source :
- PLoS Neglected Tropical Diseases [ 1935-2727 ] ; 2016.
Abstract
On the Zanzibar islands, United Republic of Tanzania, elimination of urogenital schistosomiasis is strived for in the coming years. This qualitative study aimed to better understand community knowledge, perceptions, and practices associated with schistosomiasis among school-aged children on Unguja and Pemba islands, in order to inform the development of behavior change interventions contributing to eliminate urogenital schistosomiasis.
In 2011, we conducted 35 children’s discussion groups, 41 in-depth interviews with parents and teachers, and 5 focus group discussions with community members in Zanzibar. Using a modified-grounded theory approach, we transcribed and coded the narrative data followed by thematic analysis of the emergent themes.
Urogenital schistosomiasis is a common experience among children in Zanzibar and typically considered a boys’ disease. Children engage in multiple high-risk behaviors for acquiring schistosomiasis because of poor knowledge on disease transmission, lack of understanding on severity of disease-associated consequences, and lack of alternative options for water related activities of daily living and recreational play. Local primary school teachers had little to no training about the disease and no teaching tools or materials for students.
Conducting activities in open natural freshwater contaminated by
Url:
DOI: 10.1371/journal.pntd.0004814
PubMed: 27399310
PubMed Central: 4939940
Affiliations:
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PMC:4939940Le document en format XML
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<front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Background</title>
<p>On the Zanzibar islands, United Republic of Tanzania, elimination of urogenital schistosomiasis is strived for in the coming years. This qualitative study aimed to better understand community knowledge, perceptions, and practices associated with schistosomiasis among school-aged children on Unguja and Pemba islands, in order to inform the development of behavior change interventions contributing to eliminate urogenital schistosomiasis.</p>
</sec>
<sec id="sec002"><title>Methodology</title>
<p>In 2011, we conducted 35 children’s discussion groups, 41 in-depth interviews with parents and teachers, and 5 focus group discussions with community members in Zanzibar. Using a modified-grounded theory approach, we transcribed and coded the narrative data followed by thematic analysis of the emergent themes.</p>
</sec>
<sec id="sec003"><title>Principal Findings</title>
<p>Urogenital schistosomiasis is a common experience among children in Zanzibar and typically considered a boys’ disease. Children engage in multiple high-risk behaviors for acquiring schistosomiasis because of poor knowledge on disease transmission, lack of understanding on severity of disease-associated consequences, and lack of alternative options for water related activities of daily living and recreational play. Local primary school teachers had little to no training about the disease and no teaching tools or materials for students.</p>
</sec>
<sec id="sec004"><title>Conclusions/Significance</title>
<p>Conducting activities in open natural freshwater contaminated by <italic>S</italic>
. <italic>haematobium</italic>
larvae compromises the health of school-aged children in Zanzibar. The perception of urogenital schistosomiasis as a minor illness rather than a serious threat to a child’s well-being contributes to the spread of disease. Understanding community perceptions of disease along with the barriers and facilitators to risk reduction behaviors among children can inform health promotion activities, campaigns, and programs for the prevention, control, and elimination of urogenital schistosomiasis in Zanzibar.</p>
</sec>
</div>
</front>
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<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS Negl Trop Dis</journal-id>
<journal-id journal-id-type="iso-abbrev">PLoS Negl Trop Dis</journal-id>
<journal-id journal-id-type="publisher-id">plos</journal-id>
<journal-id journal-id-type="pmc">plosntds</journal-id>
<journal-title-group><journal-title>PLoS Neglected Tropical Diseases</journal-title>
</journal-title-group>
<issn pub-type="ppub">1935-2727</issn>
<issn pub-type="epub">1935-2735</issn>
<publisher><publisher-name>Public Library of Science</publisher-name>
<publisher-loc>San Francisco, CA USA</publisher-loc>
</publisher>
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<article-meta><article-id pub-id-type="pmid">27399310</article-id>
<article-id pub-id-type="pmc">4939940</article-id>
<article-id pub-id-type="doi">10.1371/journal.pntd.0004814</article-id>
<article-id pub-id-type="publisher-id">PNTD-D-15-02039</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>People and Places</subject>
<subj-group><subject>Population Groupings</subject>
<subj-group><subject>Age Groups</subject>
<subj-group><subject>Children</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>People and Places</subject>
<subj-group><subject>Population Groupings</subject>
<subj-group><subject>Families</subject>
<subj-group><subject>Children</subject>
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<subj-group><subject>Behavior</subject>
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<subj-group><subject>Population Groupings</subject>
<subj-group><subject>Professions</subject>
<subj-group><subject>Teachers</subject>
</subj-group>
</subj-group>
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</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Earth Sciences</subject>
<subj-group><subject>Marine and Aquatic Sciences</subject>
<subj-group><subject>Bodies of Water</subject>
<subj-group><subject>Rivers</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Ecology and Environmental Sciences</subject>
<subj-group><subject>Aquatic Environments</subject>
<subj-group><subject>Freshwater Environments</subject>
<subj-group><subject>Rivers</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Earth Sciences</subject>
<subj-group><subject>Marine and Aquatic Sciences</subject>
<subj-group><subject>Aquatic Environments</subject>
<subj-group><subject>Freshwater Environments</subject>
<subj-group><subject>Rivers</subject>
</subj-group>
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</subj-group>
</subj-group>
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<subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject>
<subj-group><subject>Parasitic Diseases</subject>
<subj-group><subject>Helminth Infections</subject>
<subj-group><subject>Schistosomiasis</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject>
<subj-group><subject>Tropical Diseases</subject>
<subj-group><subject>Neglected Tropical Diseases</subject>
<subj-group><subject>Schistosomiasis</subject>
</subj-group>
</subj-group>
</subj-group>
</subj-group>
<subj-group subj-group-type="Discipline-v3"><subject>People and Places</subject>
<subj-group><subject>Geographical Locations</subject>
<subj-group><subject>Africa</subject>
<subj-group><subject>Tanzania</subject>
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<subj-group><subject>Urination</subject>
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<subj-group><subject>Urination</subject>
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<title-group><article-title>Community Knowledge, Perceptions, and Practices Associated with Urogenital Schistosomiasis among School-Aged Children in Zanzibar, United Republic of Tanzania</article-title>
<alt-title alt-title-type="running-head">Community Perceptions about Schistosomiasis in Zanzibar</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Person</surname>
<given-names>Bobbie</given-names>
</name>
<xref ref-type="aff" rid="aff001"><sup>1</sup>
</xref>
<xref ref-type="corresp" rid="cor001">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ali</surname>
<given-names>Said M.</given-names>
</name>
<xref ref-type="aff" rid="aff002"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>A’Kadir</surname>
<given-names>Faiza M.</given-names>
</name>
<xref ref-type="aff" rid="aff003"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ali</surname>
<given-names>Jamal N.</given-names>
</name>
<xref ref-type="aff" rid="aff003"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mohammed</surname>
<given-names>Ulfat A.</given-names>
</name>
<xref ref-type="aff" rid="aff002"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mohammed</surname>
<given-names>Khalfan A.</given-names>
</name>
<xref ref-type="aff" rid="aff003"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Rollinson</surname>
<given-names>David</given-names>
</name>
<xref ref-type="aff" rid="aff004"><sup>4</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Knopp</surname>
<given-names>Stefanie</given-names>
</name>
<xref ref-type="aff" rid="aff004"><sup>4</sup>
</xref>
<xref ref-type="aff" rid="aff005"><sup>5</sup>
</xref>
<xref ref-type="aff" rid="aff006"><sup>6</sup>
</xref>
</contrib>
</contrib-group>
<aff id="aff001"><label>1</label>
<addr-line>The Schistosomiasis Consortium for Operational Research and Evaluation, University of Georgia, Atlanta, Georgia, United States of America</addr-line>
</aff>
<aff id="aff002"><label>2</label>
<addr-line>Public Health Laboratory—Ivo de Carneri, Chake Chake, Pemba, United Republic of Tanzania</addr-line>
</aff>
<aff id="aff003"><label>3</label>
<addr-line>Zanzibar Neglected Tropical Diseases Control Program, Ministry of Health, Zanzibar Town, Unguja, United Republic of Tanzania</addr-line>
</aff>
<aff id="aff004"><label>4</label>
<addr-line>Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom</addr-line>
</aff>
<aff id="aff005"><label>5</label>
<addr-line>Swiss Tropical and Public Health Institute, Basel, Switzerland</addr-line>
</aff>
<aff id="aff006"><label>6</label>
<addr-line>University of Basel, Basel, Switzerland</addr-line>
</aff>
<contrib-group><contrib contrib-type="editor"><name><surname>Pullan</surname>
<given-names>Rachel L</given-names>
</name>
<role>Editor</role>
<xref ref-type="aff" rid="edit1"></xref>
</contrib>
</contrib-group>
<aff id="edit1"><addr-line>London School of Hygiene and Tropical Medicine, UNITED KINGDOM</addr-line>
</aff>
<author-notes><fn fn-type="conflict" id="coi001"><p>The authors have declared that no competing interests exist.</p>
</fn>
<fn fn-type="con" id="contrib001"><p>Conceived and designed the experiments: BP SMA KAM DR SK. Performed the experiments: BP SMA FMA JNA UAM. Analyzed the data: BP. Contributed reagents/materials/analysis tools: BP SMA KAM DR. Wrote the paper: BP SMA FMA JNA UAM KAM DR SK.</p>
</fn>
<corresp id="cor001">* E-mail: <email>bobbieperson@gmail.com</email>
</corresp>
</author-notes>
<pub-date pub-type="epub"><day>11</day>
<month>7</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="collection"><month>7</month>
<year>2016</year>
</pub-date>
<volume>10</volume>
<issue>7</issue>
<elocation-id>e0004814</elocation-id>
<history><date date-type="received"><day>7</day>
<month>12</month>
<year>2015</year>
</date>
<date date-type="accepted"><day>8</day>
<month>6</month>
<year>2016</year>
</date>
</history>
<permissions><copyright-statement>© 2016 Person et al</copyright-statement>
<copyright-year>2016</copyright-year>
<copyright-holder>Person et al</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>
, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p>
</license>
</permissions>
<self-uri content-type="pdf" xlink:href="pntd.0004814.pdf"></self-uri>
<abstract><sec id="sec001"><title>Background</title>
<p>On the Zanzibar islands, United Republic of Tanzania, elimination of urogenital schistosomiasis is strived for in the coming years. This qualitative study aimed to better understand community knowledge, perceptions, and practices associated with schistosomiasis among school-aged children on Unguja and Pemba islands, in order to inform the development of behavior change interventions contributing to eliminate urogenital schistosomiasis.</p>
</sec>
<sec id="sec002"><title>Methodology</title>
<p>In 2011, we conducted 35 children’s discussion groups, 41 in-depth interviews with parents and teachers, and 5 focus group discussions with community members in Zanzibar. Using a modified-grounded theory approach, we transcribed and coded the narrative data followed by thematic analysis of the emergent themes.</p>
</sec>
<sec id="sec003"><title>Principal Findings</title>
<p>Urogenital schistosomiasis is a common experience among children in Zanzibar and typically considered a boys’ disease. Children engage in multiple high-risk behaviors for acquiring schistosomiasis because of poor knowledge on disease transmission, lack of understanding on severity of disease-associated consequences, and lack of alternative options for water related activities of daily living and recreational play. Local primary school teachers had little to no training about the disease and no teaching tools or materials for students.</p>
</sec>
<sec id="sec004"><title>Conclusions/Significance</title>
<p>Conducting activities in open natural freshwater contaminated by <italic>S</italic>
. <italic>haematobium</italic>
larvae compromises the health of school-aged children in Zanzibar. The perception of urogenital schistosomiasis as a minor illness rather than a serious threat to a child’s well-being contributes to the spread of disease. Understanding community perceptions of disease along with the barriers and facilitators to risk reduction behaviors among children can inform health promotion activities, campaigns, and programs for the prevention, control, and elimination of urogenital schistosomiasis in Zanzibar.</p>
</sec>
</abstract>
<abstract abstract-type="summary"><title>Author Summary</title>
<p>On the Zanzibar islands, United Republic of Tanzania, elimination of urogenital schistosomiasis, a disease caused by infection with a blood fluke (<italic>Schistosoma haematobium</italic>
), locally known as kichocho, is strived for in the coming years. This study used qualitative research methods of focus groups and in-depth interviews with adults, and group discussions with school-aged children to explore (i) knowledge and perceptions of kichocho transmission, (ii) specific behaviors among children in Zanzibar that put them at risk for acquiring infections with the kichocho parasite, (iii) symptoms of kichocho along with personal health-seeking behaviors and treatment strategies, and finally (iv) ideas for preventing kichocho in children. We found that there was little available formal education about disease transmission, which contributed to myths and misperceptions about routes of transmissions, causes, and treatment of kichocho. School-aged children regularly exposed themselves to contaminated natural, open freshwater bodies through recreational and domestic activities of daily life. Kichocho was often wrongly viewed as an infection with an intestinal worm of little significance, rarely associated with severe health consequences, and with little to no disease stigma. Local primary school teachers had little to no training about the disease and no teaching tools or materials for students. The findings add valuable insights into how current knowledge, perceptions, and practices impede optimal disease prevention and control and highlight the necessity for a community tailored behavioral intervention to interrupt transmission of urogenital schistosomiasis.</p>
</abstract>
<funding-group><award-group id="award001"><funding-source><institution>Schistosomiasis Consortium for Operational Research and Evaluation</institution>
</funding-source>
<award-id>RR374-053/4893206</award-id>
<principal-award-recipient><name><surname>Rollinson</surname>
<given-names>David</given-names>
</name>
</principal-award-recipient>
</award-group>
<award-group id="award002"><funding-source><institution>Schistosomiasis Consortium for Operational Research and Evaluation</institution>
</funding-source>
<award-id>RR374-053/4893196</award-id>
<principal-award-recipient><name><surname>Knopp</surname>
<given-names>Stefanie</given-names>
</name>
</principal-award-recipient>
</award-group>
<funding-statement>This study received financial support from the University of Georgia Research Foundation Inc., which is funded by the Bill & Melinda Gates Foundation for these Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) projects (prime award no. 50816, sub-award nos. RR374-053/4893206). SK is financially supported by sub-award no. RR374-053/4893196. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.</funding-statement>
</funding-group>
<counts><fig-count count="1"></fig-count>
<table-count count="2"></table-count>
<page-count count="19"></page-count>
</counts>
<custom-meta-group><custom-meta id="data-availability"><meta-name>Data Availability</meta-name>
<meta-value>Our study analyzes qualitative data and the participants did not consent to have their full transcripts made publicly available. The data policy exception related to privacy concerns pertains in this case. Excerpts of the transcripts relevant to the study are available on request from the corresponding author Bobbie Person at <email>bobbieperson@gmail.com</email>
.</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
<notes><title>Data Availability</title>
<p>Our study analyzes qualitative data and the participants did not consent to have their full transcripts made publicly available. The data policy exception related to privacy concerns pertains in this case. Excerpts of the transcripts relevant to the study are available on request from the corresponding author Bobbie Person at <email>bobbieperson@gmail.com</email>
.</p>
</notes>
</front>
</pmc>
<affiliations><list><country><li>Royaume-Uni</li>
<li>Suisse</li>
<li>États-Unis</li>
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<li>Grand Londres</li>
<li>Géorgie (États-Unis)</li>
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<name sortKey="Ali, Said M" sort="Ali, Said M" uniqKey="Ali S" first="Said M." last="Ali">Said M. Ali</name>
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<name sortKey="Knopp, Stefanie" sort="Knopp, Stefanie" uniqKey="Knopp S" first="Stefanie" last="Knopp">Stefanie Knopp</name>
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<country name="Suisse"><noRegion><name sortKey="Knopp, Stefanie" sort="Knopp, Stefanie" uniqKey="Knopp S" first="Stefanie" last="Knopp">Stefanie Knopp</name>
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<name sortKey="Knopp, Stefanie" sort="Knopp, Stefanie" uniqKey="Knopp S" first="Stefanie" last="Knopp">Stefanie Knopp</name>
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