EFFECT OF INTERVENTIONS ON KNOWLEDGE, RISK PERCEPTION AND PREVALENCE OF SCHISTOSOMIASIS INFECTION AMONG SCHOOL PUPILS OF TWO RURAL COMMUNITIES IN OSUN STATE PROJECT
Since the construction of a dam across Erinle River at Igbokiti in Osogbo Local Government Area of Osun State in the year 1981, schistosomiasis has emerged as a major health burden in the five villages located along the river. The comprehensive health centre in Ilie has recorded a large number of cases within the past two decade. The study was conducted to compare the prevalence of schistosomiasis infection among primary school pupils in two of the villages, and to determine the effect of chemotherapy and health education intervention on the prevalence, knowledge and risk perception of schistosomiasis infection among primary school pupils in Ilie the study village, while Ore serves as the control village. One primary school each was randomly selected out of the two primary schools in each village using the ballot method. A total of 452 pupils aged between 6 – 15years were selected, 230 from the study group in Ilie and 222 from the control group Ore. A semi-structured questionnaire was administered on the pupils on the control and study groups, their urine samples were examined for haematuria using the uristrip and also microscopically for eggs of S. haematobium. Praziquantel was administered on symptomatic subjects among the study group. Also two health education sessions were conducted for the study group at the school assembly within an interval of one week. After a period of three months, the same questionnaire was re-administered to the study and control groups, urine examination for haematuria using the uristrip and microscopic examination for eggs of S. haematobium were also repeated for both groups.
At the pre-intervention stage, overall prevalence in Ilie the study group was 80.9% while that of Ore the control group was 81.1%. High rate of terminal haematuria was observed among subject in both groups. Post interventions, in the study group there was a reduction in the prevalence of schistosomiasis to 7.8%, and also reduction in terminal
haematuria. However, the prevalence of 75.7% was observed in the control group in Ore, and also there was an increase in the number of patients that developed haematuria during the interval. At pre-intervention, majority 90.4% of subjects in the study group and 71.6% in the control group were aware of schistosomiasis as a disease in their community. Majority of respondents 87.0% in the study group and above half 57.7% in the control group have knowledge of signs and symptoms of schistosomiasis, however there was a significant reduction in the number of those who mentioned the correct answer in both groups post intervention and three months later more respondents mentioned dysuria and this was statistically significant (p = 0.00). Majority of respondent claim that the disease is transmitted through water 84.4% in the study group and 71.1 % in the control group at pre intervention. At post intervention, there is no significant difference in response in the study group (p = 0.06). In the control group however there was a significant increase in the level of knowledge on mode of transmission (p = 0.03). Majority of pupils in both groups know that wading lead to disease 84.4% in the study group and 83.8% in the control group there is a numerical increase in positive response in the study group and a significant increase in the control group. The was also high level of knowledge that urinating and defecating in the river can transmit disease to other water users 92.2% in the study group and 89.2% in control group, there was a significant increase in both groups post intervention and three months later of Despite the prior knowledge and health education intervention, there was no appreciable change in water contact activities because there was no alternative water supply. Only water contact activities for entertainment like swimming were significantly reduced in both groups. Many of them74.8% in the study group and 57.5% in control group had noticed terminal haematuria in their urine and majority of them know some other members of the communities who passed blood in urine.
This study concludes that schistosomiasis infection is highly endemic in these two communities and that high level of awareness and knowledge about signs and symptomatologies of the infection do not translate to the pupils not contacting the disease. However, praziquantel was found to be a very effective drug in the treatment of schistosomiasis in the study area. The major tools for the control of schistosomiasis should be (1) human behavioral change through continuous and sustained health education, communication participation (2) mass- chemotherapy and (3) clean water supply and adequate sanitation.