TY - JOUR
T1 - Schistosomiasis infection in pre-school aged children in Uganda
T2 - A qualitative descriptive study to identify routes of exposure
AU - Kibira, Simon Peter Sebina
AU - Ssempebwa, John C.
AU - Ssenyonga, Ronald
AU - Radloff, Scott
AU - Makumbi, Fredrick Edward
N1 - Funding Information:
This study was funded by a generous gift from the Maxmind Inc., through the Johns Hopkins University School of Public Health. The funders had no role in design, conduct, analysis and interpretation of the data in this manuscript.
Publisher Copyright:
© 2019 The Author(s).
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/2/14
Y1 - 2019/2/14
N2 - Background: Prevalence of schistosomiasis is high among children under five years in Uganda. Schistosomiasis control efforts over time have included periodic mass treatments in endemic areas for adults and school going children aged 5 years and above. This study explores behaviour practices of children age 2-4 years that increase the risk of schistosomiasis infection in this age group. Methods: A qualitative descriptive study was conducted using in-depth interviews with 30 caregivers of children aged 2-4 years who tested positive for schistosomiasis in a national prevalence survey in 2017. Observations were done at water bodies where young children go with caretakers or other older children. The study was conducted in three Ugandan sub-regions of West Nile and East-central, and South-western with high, and low prevalence of schistosomiasis, respectively. Data were thematically analysed. Anonymised supporting photos from observations are also presented. Results: Knowledge about schistosomiasis transmission was poor among caregivers, who concurrently had mixed right and wrong information. Reported avenues for contracting schistosomiasis included both correct: contact activities with infested water, and incorrect modes: contact with dirty water, sharing bathrooms, witchcraft, polluted air and contaminated food. The children in this study could have contracted schistosomiasis through the contact with infested water during activities such as bathing and playing, while their caregivers washed clothes, collected snail shells for poultry feeds, fetched water at the water bodies. These activities were reported by caregivers and observed in all study areas. Evidence of open defecation and urination in and near water bodies by adults and children was also observed. Conclusions: Pre-school children age 2-4 years are at a high risk of exposure to schistosomiasis while caretakers conduct activities in infested water bodies. There is need for prevention interventions to target children in their early stages of life to control schistosomiasis in this vulnerable population.
AB - Background: Prevalence of schistosomiasis is high among children under five years in Uganda. Schistosomiasis control efforts over time have included periodic mass treatments in endemic areas for adults and school going children aged 5 years and above. This study explores behaviour practices of children age 2-4 years that increase the risk of schistosomiasis infection in this age group. Methods: A qualitative descriptive study was conducted using in-depth interviews with 30 caregivers of children aged 2-4 years who tested positive for schistosomiasis in a national prevalence survey in 2017. Observations were done at water bodies where young children go with caretakers or other older children. The study was conducted in three Ugandan sub-regions of West Nile and East-central, and South-western with high, and low prevalence of schistosomiasis, respectively. Data were thematically analysed. Anonymised supporting photos from observations are also presented. Results: Knowledge about schistosomiasis transmission was poor among caregivers, who concurrently had mixed right and wrong information. Reported avenues for contracting schistosomiasis included both correct: contact activities with infested water, and incorrect modes: contact with dirty water, sharing bathrooms, witchcraft, polluted air and contaminated food. The children in this study could have contracted schistosomiasis through the contact with infested water during activities such as bathing and playing, while their caregivers washed clothes, collected snail shells for poultry feeds, fetched water at the water bodies. These activities were reported by caregivers and observed in all study areas. Evidence of open defecation and urination in and near water bodies by adults and children was also observed. Conclusions: Pre-school children age 2-4 years are at a high risk of exposure to schistosomiasis while caretakers conduct activities in infested water bodies. There is need for prevention interventions to target children in their early stages of life to control schistosomiasis in this vulnerable population.
KW - Bilharzia
KW - Children
KW - Neglected tropical diseases
KW - Qualitative
KW - Sanitation
KW - Schistosomiasis
KW - Uganda
KW - Water
UR - http://www.scopus.com/inward/record.url?scp=85061542349&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85061542349&partnerID=8YFLogxK
U2 - 10.1186/s12879-019-3803-z
DO - 10.1186/s12879-019-3803-z
M3 - Article
C2 - 30764781
AN - SCOPUS:85061542349
VL - 19
JO - BMC Infectious Diseases
JF - BMC Infectious Diseases
SN - 1471-2334
IS - 1
M1 - 165
ER -