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Knowledge, attitudes and practices toward female genital schistosomiasis among community women and healthcare professionals in Kimpese region, Democratic Republic of Congo
(PLOS Neglected Tropical Diseases, 2024) Anyolitho, Maxson Kenneth; Wambui, Cecilia Wangari; Madinga, Joule; Ashepet, Mercy Gloria; Mitash, Patricki; Huyse, Tine
Background Chronic infection with Schistosoma haematobium causes female genital schistosomiasis (FGS), which leads to diverse lesions in the female genital tract and several complications, including infertility and a higher risk for HIV transmission. This study aims to understand the knowledge, attitudes, and practices (KAP) toward FGS and associated factors among women and health professionals in the schistosomiasis endemic focus of Kimpese, western Democratic Republic of Congo (DRC). Methods In January 2022, two semi-quantitative questionnaires were administered to 201 randomly selected community women in Kifua II village, and to purposely selected health professionals (20 nurses and 41 doctors) from Kimpese Health Zone. KAP statements were coded using Likert scale, summarized as frequencies and percentages, and assessed for internal reliability using Cronbach’s alpha. Associations between the socio-demographic characteristics of respondents and the KAP variables were assessed using Pearson chi-square (χ2) test, Cramer’s V (φ) and gamma (γ) coefficients. Results Overall, respondents had high knowledge of schistosomiasis in general but low FGS-specific knowledge (91% versus 45%). Misconceptions concerned the disease transmission, with 30.3% of women and 25% of the nurses believing that FGS is transmitted by drinking untreated water, while 26.8% of the doctors mentioned sexual contact as a mode of FGS transmission. Negative attitudes included considering FGS not a very serious disease (34.8%), feeling uncomfortable during gynaecological examination (35.3%), difficulties avoiding risky water contact (72.1%) and open defecation/urination (41.3%), not intending to share FGS status with their husbands (38.3%) and loved ones (63.6%), and believing that husbands would leave them if they were infertile (31.8%). Regarding practices, 77.6% of women engaged daily in activities involving contact with water. Practices of health professionals were hampered by the lack of equipment and specialized knowledge for FGS diagnosis with only 57% of healthcare workers having a microscope in their facilities. Women’s KAPs varied by age, education, marital status, occupation and monthly income. Conclusion This study highlights insufficient knowledge, existing negative attitudes, at risk practices towards FGS by women, and limitations of FGS management by health professionals. These findings can help for tailored health education and WASH strategies, and call for health professional’s capacities reinforcement.
Socio-cultural and structural barriers influencing parents’ knowledge and access to information on schistosomiasis in children around Ugandan Lakes
(PLoS neglected tropical diseases, 2025) Anyolitho, Maxson Kenneth; Reigl, Lisa Sophie; Neema, Stella; Amuyunzu-Nyamongo, Mary; Buhl, Andrea; Burrill, Jennifer; Frese, Marie; Gnahore, Djouquou Alexise; Hürlimann, Eveline; Lobohon, Suzanne Lavry Épouse Yao; Masaku, Janet; Monnier, Nora; Preston, Ashley; Sinkeet, Alice Sereti; Steinmann, Peter; Toh, Alain; Okan, Orkan; Winkler, Andrea S.; Lange, Isabelle L.
In Uganda, the national prevalence of schistosomiasis is 36.1% among the two-to-four-year age group. Knowledge about schistosomiasis and socio-cultural factors have been reported to influence adult participation in mass drug administrations of praziquantel, the standard medication used to treat the disease. In advance and support of the (pilot) introduction of the recently developed paediatric praziquantel formulation (arpraziquantel), we conducted research on parent and other community members’ knowledge about paediatric schistosomiasis, their information sources, and potential perceived barriers that influence knowledge and access to information on schistosomiasis. Methods This cross-sectional qualitative study consisted of 65 in-depth interviews and ten focus group discussions with parents/guardians of preschool-aged children (PSAC), Village Health Teams (VHTs), health professionals, community leading persons and district officials, in addition to direct observations. We collected data concurrently in Hoima District at Lake Albert and Bugiri at Lake Victoria, Uganda, in 2022. The analy¬sis followed both an inductive and a deductive thematic approach. Results Despite high parental awareness of the disease and knowledge of signs and symp¬toms, we identified less familiarity with its transmission and prevention. With limited communication channels, VHTs emerged as the primary information sources but reflected varied local understandings of schistosomiasis. Parents expressed a desire to be informed about the new paediatric treatment through VHTs, health profes¬sionals, and community leaders, and partly through the radio. Other mentioned socio-cultural and structural barriers to information flow included language barriers, illiteracy, high population movement, fears, and resentment from restrictive govern¬ment fishing laws. Conclusions Carefully designed information campaigns tailored to local circumstances and health literacy needs should be carried out by trained VHTs and preferably supported by health professionals and the local leadership structure. These components are essential to inform parents/guardians of PSAC, enabling them to make well-informed decisions for their children’s health.
Insufficient Water, Sanitation, and Healthcare Facilities Hinder Schistosomiasis Control in Endemic Areas: A Mixed Methods Study
(medRxiv, 2024) Mudavanhu, Aspire; Weeda, Rachelle; Anyolitho, Maxson Kenneth; Mlangeni, Linda; Brendonck, Luc; Manyangadze, Tawanda; Huyse, Tine
Abstract Introduction Schistosomiasis remains a significant public health issue in sub-Saharan Africa, particularly in resource-limited settings. This mixed-methods study assesses the knowledge, attitudes, and practices (KAP) related to schistosomiasis in two communities in Zimbabwe’s Chiredzi district: Hippo Valley Estate (HVE) and Chipimbi. Methodology In August 2022, a total of 279 household adults were surveyed using semi-structured questionnaires, selected through systematic random sampling. Additionally, four key informants were interviewed, and eight focus group discussions (FGDs) were conducted. Cramer’s V (φ) and Gamma (γ) coefficients were used to determine associations between sociodemographic factors and KAP variables, with a p-value of 0.05 indicating statistical significance. Quantitative data were analyzed using frequencies, percentages, and chi-square tests, while qualitative data were analyzed by identifying themes and sub-themes. Results Awareness of schistosomiasis was high, with 87.5% of respondents having heard of the disease and 86% knowing its transmission modes and symptoms. However, misconceptions persist, such as the belief that walking barefoot or eating unwashed fruits are major risk factors. Only 7% recognized the importance of avoiding unsafe water, a challenge further amplified in both communities due to their reliance on water for irrigation in HVE and as a primary water source in Chipimbi, especially when stored water is depleted. Although 98% emphasized the importance of latrine use, open defecation remains prevalent due to insufficient latrine coverage in Chipimbi (14%) and occasional water shortages for flushing in HVE. Both communities showed positive attitudes toward treatment, but access to healthcare facilities remains a significant barrier due to selective treatment, long distances, and inadequate facilities. Conclusion Despite high awareness and positive attitudes, inadequate water, sanitation, and healthcare facilities hinder effective schistosomiasis control. Enhancing community-based awareness, improving access to clean water, and increasing latrine coverage are crucial steps toward sustainable schistosomiasis management
Behavioral Biases and Uptake of Life Insurance Policy in Lira City.
(Lira University, 2024) Abwot, Ursula; Opio, Charles Bonny
This study investigated the effect of behavioral biases of policyholders on the uptake of life insurance policies in Lira City. Motivated by persistently low life insurance policy uptake despite its importance for financial security, the research focused on four behavioral biases: Framing Bias, Overconfidence, Loss Aversion, and Regret Aversion as independent variables, with the uptake of life insurance policy (measured by the amount spent on life insurance policy and the number of policies acquired) as the dependent variable. The objectives were to examine the effects of framing bias, overconfidence, loss aversion, and regret aversion on life insurance policy uptake, with the hypotheses that each bias has no significant effect on uptake. Grounded in Prospect Theory and Expected Utility Theory, the research employed a cross-sectional and correlational design. The population comprised 100 life insurance policyholders, from which a sample of 93 respondents was selected. Data were collected using structured questionnaires that were pretested for reliability, encompassing demographic information and measures of the four behavioral biases. Analysis was conducted using SPSS version 23 and Ordinary Least Squares (OLS) regression models. The findings revealed that loss aversion has a statistically significant positive effect on life insurance policy uptake (ẞ= 0.561, p = 0.000), while framing bias (B = 0.016, p = 0.866), overconfidence (B = 0.051, p = 0.585), and regret aversion (B = -0.069, p = 0.458) were not significant. The study concludes that loss aversion significantly influences life insurance policy uptake decisions, whereas other biases have limited effects. It recommends that insurance companies leverage loss aversion in their marketing strategies by emphasizing the risks of being uninsured, and suggests that simplifying insurance products and enhancing financial literacy programs can further promote life insurance policy adoption, supporting national financial inclusion goals.
The Functionality of Farmers' Stores in Local Economic Development Initiatives of Oyam District: A Case of Aber Sub-County
(Lira University, 2024) Otim, Clement Emmanuel; Mwesigwa, David
Local Economic Development (LED) emerged as a strategy for enhancing development in different parts of the World and was adapted by Uganda as a tool for enhancing development. Consequently, this study examined the relationship between the functionality of farmers' stores and LED initiatives. Specifically, the study determined the effect of farmers' stores functionality on resource mobilization; assessed the contribution of farmers' stores functionality on resource management; and assessed the effect of farmers' stores functionality on resource utilization. The study adopted a cross-sectional study design, which employed a mixed methods approach of both quantitative and qualitative methods. The study population consisted of 322 respondents, which involved both political leaders and civil servants of Aber Sub County in addition to members of the farmers' groups. Both the Simple random sampling technique and purposive sampling technique were used to select a sample of 177 participants. The researcher adopted Self- Administered Questionnaires to collect quantitative data and an interview guide to collect qualitative data. Both descriptive statistics (mean, and standard deviation), and inferential statistics (correlation and regression) were used to analyse numerical data. Thematic analysis was used to analyse qualitative data. The findings revealed a statistically significant positive relationship between functionality of farmers' stores and LED initiatives. The functionality of farmers' stores yielded a significant effect on resource mobilisation, resource management and resource utilisation. It was concluded that the functionality of farmers' stores significantly affects LED initiatives in Aber Sub County, Oyam district. This study contributes an original and empirical-evidence of the functionality of farmers' store on LED initiatives. It is recommended that the production and agricultural department of Oyam district local government strengthens the capacity of farmer groups by training them on activities such as value addition and financial management so that they can be in position to mobilise more financial resources.