Perceptions and assessment of risk factors in Schistosoma haematobium infection in Buruku and Katsina-Ala Local Government Areas of Benue State-Nigeria
R Houmsou, S Kela, M Suleiman, J Ogidi
buruku, factors, katsina-ala, knowledge, risk, schistosomiasis
R Houmsou, S Kela, M Suleiman, J Ogidi. Perceptions and assessment of risk factors in Schistosoma haematobium infection in Buruku and Katsina-Ala Local Government Areas of Benue State-Nigeria. The Internet Journal of Infectious Diseases. 2009 Volume 8 Number 1.
Schistosomiasis is one of the neglected diseases in tropical Africa that continues to plague inhabitants of sub-urban and rural areas where there are little or no safe water outlets. This study investigated urinary schistosomiasis infection in relation to knowledge, attitudes and practices of people in Buruku and Katsina-Ala Local Government Areas of Benue State, Nigeria. Using standard parasitological method (Filtration technique) to examine the urine, 335 (44.66%) were infected with
Schistosomiasis, also known as bilharziasis is the second most common parasitic disease in the world after malaria.
In Benue State, Nigeria and particularly in the Tiv land, the perceptions that communities have of the potentially deadly disease of urinary schistosomiasis could make challenging the implementation of a control programme. Rice farming during wet season, exploitation of river banks for garden purposes during dry season, dependence of the inhabitants on streams and ponds for drinking water, cooking, washing and recreation are such factors that could contribute to the endemicity of the disease in the area. However, this study was conducted with a view to providing relevant information on the intensity of
Materials and Methods
The study area was made of two Local Government Areas ( Buruku and Katsina-Ala) of Benue State, Nigeria. The relative position of these two Local Government Areas in Benue State is about the middle eastern of the state. The area has a monthly temperature between 27, 38ºC and 28, 00ºC and may go up to a maximum temperature of 30, 08ºC and 34, 24ºC. The area receives 900-1000 mm of rain annually. The dry season starts in late October and usually ends by March. The rainy season which lasts from April to early October is the period of intensive agricultural activities when the indigenous people of the areas mainly Tivs and Etulo are engaged in farming of crops like yams, guinea corn, maize, rice, sesame and cassava which are the principal food crop and cash crop.
Samples Collection and Examination
Prior to the commencement of the research, permission was sought from the Chairmen and local education authorities of both Local Government Areas. A total of 750 urine samples were collected from 372 males and 378 females aged 3-70 years. Participants were from communities (250), primary schools (250) and secondary schools (250). The study was conducted between November 2008 and March 2009. Eggs of
Questionnaire Design and Data Analysis
A survey form consisting of twelve (12) questions relevant to urinary schistosomiasis on socio- demographic data, water contact activities and K.A.P (knowledge, attitudes and practices) was administered to each participant. Pre-schools children that participated in the study were excluded for interview and their mothers were asked to provide relevant information on their water contact activities. Using the form, some of the primary school children were interviewed individually and some of the questions were communicated to them in the local language for ease of understanding with the assistance of a local health worker. SPSS version 15.0 for windows and Microsoft Excel 2007 were used for data analysis.
Table 1 shows the prevalence of
Table 2 elucidates the prevalence and intensity of
Table 3 summarizes the subjects’ explanations for the causes of urinary schistosomiasis in relation to infection. Subjects’ knowledge about the role that fresh water snails play in transmission was low. Only 38(5.77%) understood the role of fresh water snails as vectors and among these 17(2.58%) were found infected. Subjects were more likely to link the disease to other causes such as drinking dirty water 195(29.63%) among whose 115(17.47%) were infected, playing in water 67(8.93%) among whose 67 (10.18) were infected, eating unripe fruits 72(10.98%) among whose 30 (4.00%) were infected. 166(25.22%) were screened not having any idea about the cause of the disease and 70 (9.33%) were found having
The effects of water contact activities on the prevalence of urinary schistosomiasis are given in Table 4. Responses from the questionnaires indicated that those involved in playing/bathing recorded an overall infection rate of 243(40.40%), followed by those involved in washing 301(40.13%) and swimming 226(30.13%). Those involved in rice farm activities recorded an infection rate of 213 (28.40%). An infection rate of 106 (14.13%) was observed among those that used to collect edible snails from ponds, streams or river. Significant associations were found between water contact activities and prevalence of infection(r = 0.103, for swimming; r = 0.128, for washing; r = 0.185, for playing/bathing; r = 0.149, for collection of snails. P < 0.01)
The present study reveals a relatively high prevalence of
Parental occupation has influence on the prevalence of infection. Children of farmers had the highest peak of infection, this could be attributable to the constant contact with contaminated water bodies during their recreational activities or when they are taking along with their parents in rice farm. This observation agrees with the results obtained by Okanla (1991) in Ilorin, Nigeria. The relationship between Schistosomiasis has long been known (Edungbola, 1980; Fernwick and Jorgensen, 1972).
Sex prevalence of individuals in the communities fluctuated. Out of the total percentage (12.80%) of people infected, 7.20% of the females were infected with
In this present study, inhabitants perceived that risky behavior such as swimming, bathing/playing, fishing cause urinary schistosomiasis to become manifest, rather than such behaviour increasing the likelihood of infection by an external germ (the scientific understanding); most of the inhabitants usually associate the disease with the drinking of dirty water rather than with playing in water. This perceptions, however agrees with the reports of WARDA (1999) in Ivory Coast. In addition, schistosomiasis is simply not perceived by the inhabitants as a life threatening or debilitating disease. This might be due to the fact that many infected people do not suffer to any great extent. The fact that if the disease is untreated in adolescence could lead to kidney failure at the age of 45-55 years is simply not known or acknowledged. However, the fact that being in contact with infested water through rice farming was completely ignored by the inhabitants as a potential source of transmission.
Conclusion and Recommendations
The present study showed that community perceptions can have a marked effect on the success of scientific interventions. Thus, due to the devastating effects of urinary schistosomiasis on physical and mental conditions of infected people, relief from the burden of
The development of human resources and materials for health education must be ensured to decrease in the frequency of contact with water sources and encourage adherence to preventive measures.
Primary health care staff in the Local Government Areas should be trained in communication skills using local dialect in order to conduct health education programmes at community level.
Support from non-governmental organization should be sought for schistosomiasis control activities, including chemotherapy, training, health education, sanitation and supply of clean water.
We sincerely thank the chairmen and local education authorities of Buruku and Katsina-Ala LGAs of Benue State, Nigeria for their permission to carry out this study. We also appreciate the cooperation of the heads, teachers, school children and communities of the areas visited. Thanks are also due to Prof (Mrs) E.U., Amuta, Department of Biological Sciences, University of Agriculture Makurdi for her advices. This paper constitutes part of a PhD progress report to be submitted to the Biological Sciences Programme, Abubakar Tafawa Balewa University, Bauchi-Nigeria.