Knowledge, Attitude and Practices Associated with S. Haematobium Infections among Pregnant Mothers in Kwale County, Kenya

Abstract

BACKGROUND: Schistosomiasis is a disease of global public health importance among populations residing in Schistosoma-infection endemic zones such as the Kenyan coast. Preventive measures and mass treatment of infected populations can reduce or possibly eliminate schistosomiasis. This study investigated the knowledge, attitude and practices associated with S. haematobium infection among pregnant mothers in Kwale County, Kenya.

METHODOLOGY: A mixed methods study with quantitative and qualitative methods was employed in Kwale County, from March through August 2016. Quantitative data was collected using structured questionnaires, in-depth interview guide was used for Key Informant interviews. Clinical investigations were done to detect Schistosoma infection as well and quantification of Schistosoma eggs using the Kato-Katz technique was done. Confirmatory pregnancy tests were carried and STATA version 12.0 was employed in logistic regression analysis. The qualitative data were analysed by NVIVO and presented in themes.

RESULTS: The overall prevalence of S. haematobium infection was 12.2%. Kinango Sub County had the highest prevalence of 14.1% and Mbuguni (site 1) in Matuga Sub County had the highest prevalence of 30% among the 18 sites. Rice farming significantly increased the infection risk. Among the participants, 36.7% utilized river water and 14% used water pans. Among the participants 29% did not use toilets instead went to the bush for open defecation. The participants were knowledgeable about bilharziasis; 96.7% knew what bilharzia was and 84.8% mistakenly identified the causal agent as an insect. Kitchen placement was significantly associated (P=0.024) with infection.

CONCLUSION: The prevalence of S. haematobium among pregnant mothers in Kwale County is 12.7% despite the low intensity. Low literacy levels may augment the risk of infection through practices such as bathing in rivers and the use of untreated water.