Community perceptions of schistosomiasis transmission, prevalence and control in relation to aquatic habitats in the Lake Victoria basin of Kenya

Background: Intestinal schistosomiasis caused by Schistosoma mansoni and urinary schistosomiasis caused by Schistosoma haematobium are widely distributed parasites in several localities of the Lake Victoria basin of Kenya, the former being more prevalent. In Kenya, transmission of the intestinal form of bilharzia (S. mansoni) tends to be closely confined to narrow zones along the shores of large bodies of water such as Lake Victoria where it is endemic and the intermediate host is found. The prevalence of S. mansoni along the Kenyan Lake Victoria basin ranges between 40% and 80%.Objective: To assess the community’s knowledge and perceptions of schistosomiasis prevalence, transmission and control in relation to aquatic habitats in the Lake Victoria basin of Kenya.Design: Community-based cross-sectional study.Setting: The Kenyan Lake Victoria basin.Subjects: Two hundred and forty three individuals (both women and men residing in the beaches and surrounding areas) were interviewed about their knowledge and perceptions regarding schistosomiasis.Results: The community regarded schistosomiasis as a naturalistic disease not caused by supernatural forces but by an agent of contamination in water. Knowledge on schistosomiasis transmission and control was low, with 42% of the respondents having no idea on how schistosomiasis is contracted, while 22% and 18% of the respondents mentioned contact with contaminated water and drinking / eating dirty water / food, respectively. Most respondents were familiar with the snails’ habitats, but had poor knowledge on aquatic plants harbouring snails, as 57% of the respondents did not know about aquatic plants being associated with schistosomiasis snails. Only 3% of the respondents associated snails with schistosomiasis transmission. Sixty percent (60%) of the respondents mentioned use of tablets and injections as means of treating schistosomiasis, while 38% had no idea how it is treated and 2% mentioned use of local herbs and services of medicine men.Conclusion: Majority of Kenyan Lake Victoria basin inhabitants had little awareness about schistosomiasis despite high prevalence of the disease in the region. There is need to adapt prevention and control strategies to the people’s livelihoods. There is also need to target the less advantaged members of the community such as women, uneducated and subsistence farmers for intense health education strategies aimed at increasing participation in the control of schistosomiasis. Study to elicit divergence between biomedical and local understandings of schistosomiasis/bilharzia is suggested.

Knowledge and Perceptions on Malaria and Its Association with Aquatic Habitats

Background: Malaria remains the major cause of morbidity and mortality among children in Kenya. About 70 percent of the population is at risk of infection, and roughly 34,000 young children die of malaria-related causes annually.Objective: To investigate the knowledge and perceptions of the local people for malaria in relation to aquatic habitats along the Kenyan Lake Victoria basin.Design: Community-based cross-sectional study.Setting: The Kenyan Lake Victoria basin Region.Subjects: Two hundred and fourty three individuals (both women and men residing in the beaches and surrounding areas) were interviewed about their knowledge and perceptions regarding malaria.Results: Mosquitoes were perceived to be the main cause of malaria. Most respondents were familiar with the main signs and symptoms of mild malaria. Majority of the respondents had poor knowledge of mosquito breeding habitats with 45% mentioning the lake and only 18.6 and 8.9% mentioning ponds and dams, respectively. Most female respondents did not know the difference between mosquitoes and lake flies, P=0.03, Fishers exact test. The majority (97.5%) of the respondents reported seeking conventional malaria treatment from health institutions.Conclusion: Mosquitoes are perceived to be the main cause of malaria by both males and females. A significant proportion of the respondents were familiar with the main signs and symptoms of malaria and sought conventional medicine for treatment of the disease. Most of the respondents, however, had poor knowledge on the breeding habitats of mosquitoes. Concerted effort is needed to scale-up health education and improve the knowledge of the community about mosquitoes and their breeding habitats, particularly malaria vectors which do not breed in deep lake waters. Effective anti-malarial drugs should also be available at the grassroots level where the problem of malaria is rampant