Schistosomiasis messaging in endemic communities: lessons and implications for interventions from rural Uganda, a rapid ethnographic assessment study

Ssali, A., Pickering, L. , Nalwadda, E., Mujumbusi, L., Seeley, J. and Lamberton, P. H. L. (2021) Schistosomiasis messaging in endemic communities: lessons and implications for interventions from rural Uganda, a rapid ethnographic assessment study. PLoS Neglected Tropical Diseases, 15(10), e0009893. (doi: 10.1371/journal.pntd.0009893) (PMID:34705819) (PMCID:PMC8575311)

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Abstract

Background: Over 240 million people are infected with schistosomiasis, the majority in sub-Saharan Africa. In Uganda, high infection rates exist in communities on the shores of Lake Victoria. Praziquantel mass drug administration (MDA) delivered by village health teams is the mainstay of schistosomiasis control. However, treatment uptake remains suboptimal, with many people unaware of treatment or thinking it is only for children. Furthermore, people are often rapidly reinfected post-treatment due to continued exposure. In three Schistosoma mansoni high endemicity lake-shore communities in Mayuge district, Eastern Uganda, we investigated the sources of schistosomiasis information, remembered content of information, and the perception of information and related practices towards the control of schistosomiasis. Methods and principal findings: Data were collected from September 2017 to March 2018 using a rapid ethnographic assessment that included transect walks, observations, individual in-depth interviews and focus group discussions. Data were analysed thematically using iterative categorisation. We found that the main sources of schistosomiasis information included health workers at government facilities, village health teams, teachers, and radio programmes produced by the Ministry of Health. These messages described the symptoms of schistosomiasis, but did not mention the side effects of praziquantel treatment. Despite this messaging, the main cause of the disease and transmission was unclear to most participants. The translation of schistosomiasis on the radio into the local language ‘ekidada’—meaning swollen stomach—increased, rather than reduced, confusion about the cause(s) of schistosomiasis, due to believed links between ekidada and witchcraft, and prompted a reluctance to engage with treatment or preventative efforts. Conclusion and significance: This study highlights gaps in schistosomiasis messaging. We recommend MDA is complemented by effective, evidence-based messaging on schistosomiasis transmission, prevention, and treatment, that is sensitive to local language and context issues, resulting in clear, concise, and consistent messages, to increase effectiveness.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Mujumbusi, Dr Lazaro and Pickering, Dr Lucy and Nalwadda, Dr Edith and Lamberton, Dr Poppy
Creator Roles:
Pickering, L.Conceptualization, Data curation, Formal analysis, Funding acquisition, Methodology, Project administration, Supervision, Validation, Writing – review and editing
Nalwadda, E.Data curation, Formal analysis, Investigation, Methodology, Project administration, Validation, Writing – review and editing
Mujumbusi, L.Data curation, Formal analysis, Investigation, Methodology, Project administration, Validation, Writing – review and editing
Lamberton, P. H.L.Conceptualization, Data curation, Funding acquisition, Methodology, Project administration, Resources, Supervision, Validation, Visualization, Writing – review and editing
Authors: Ssali, A., Pickering, L., Nalwadda, E., Mujumbusi, L., Seeley, J., and Lamberton, P. H. L.
College/School:College of Medical Veterinary and Life Sciences > Institute of Biodiversity Animal Health and Comparative Medicine
College of Social Sciences > School of Social and Political Sciences > Sociology Anthropology and Applied Social Sciences
Journal Name:PLoS Neglected Tropical Diseases
Publisher:Public Library of Science
ISSN:1935-2735
ISSN (Online):1935-2727
Published Online:27 October 2021
Copyright Holders:Copyright © 2021 Ssali et al.
First Published:First published in PLoS Neglected Tropical Diseases 15(10): e0009893
Publisher Policy:Reproduced under a Creative Commons License

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