Knowledge, attitudes, and practices regarding schistosomiasis infection and prevention: A mixed-methods study among endemic communities of western Uganda

Abstract

Schistosomiasis is one of the leading neglected tropical diseases, second to malaria in prevalence. In Uganda, more than 10 million people (25.6%) are currently infected, with prevalence in some areas as high as 90%, and more than 55% of the population is at risk. The most at-risk populations are the fishing communities and school-aged children. Despite the government’s prevention and control programs such as mass drug administration (MDA) and sensitization, infections and re-infections have continued to occur, even in areas where MDA has been implemented. Previous studies have linked this with risky behavior. However, information from western Uganda is inadequate. We conducted a mixed-methods study to assess community knowledge, attitudes, and practices, and to understand their opinions and perspectives regarding the disease. The study found that, whereas there is adequate knowledge of schistosomiasis and although there is a positive attitude toward avoiding water contact and the use of latrines, it is difficult to do so, something that could explain the persistent risky practices. The risky practices could also be compounded by myths and misconceptions surrounding the disease. These findings shall form the basis for the design and implementation of contextualized, community-based, participatory communication tools for behavior change. Community involvement in schistosomiasis prevention programs could lead to increased awareness about disease prevention and could debunk existing myths and misconceptions, thereby improving behaviors, practices, and habits, ultimately lowering infection.