Knowledge, attitudes and practices on schistosomiasis and soil-transmitted helminths among caregivers in Ingwavuma area in uMkhanyakude district, South Africa.

Background: Schistosomiasis and soil-transmitted helminth infections are among the most chronic infections worldwide. Based on their demonstrable impact on human health, the WHO recently recommended the implementation of robust strategies aimed at controlling or eliminating schistosomiasis and soil-transmitted helminths by 2020. The implementation of this strategy, however, warrants a clear understanding of the community's knowledge, attitudes and practices in relation to these infections. This study sought to identify sociocultural gaps that should be addressed to ensure the success of cost-effective community-based schistosomiasis-soil-transmitted helminths control and elimination programs.

Methods: This was a cross-sectional mixed methodology study. Quantitative data were collected using a structured questionnaire from 442 caregivers of preschool aged children. In-depth interviews and focus group discussions were conducted among caregivers, preschool teachers, traditional authorities and community caregivers. All interviews were captured using an audio recorder to maximize accuracy. Quantitative data were analysed using bivariate and multivariate techniques while qualitative data were analysed thematically.

Results: Findings reflected inadequate knowledge, attitudes and practices in relation to schistosomiasis and soil-transmitted helminths while awareness of schistosomiasis and soil-transmitted helminths was high (87.1 and 79.2% respectively). Correct knowledge on transmission, prevention, signs and symptoms and life cycle was low (below 50%) for both infections among those who had heard of the disease. From multivariate analysis, being aged at least 35 years increased the odds of reporting good practices on schistosomiasis by 65% (COR 1.652, 95% CI: 1.073-2.543) while receiving health information through community meetings (COR 0.072, 95% CI: 0.010-0.548) significantly reduced the odds of having good knowledge on schistosomiasis.

Conclusions: These findings are valuable in designing behavioural change approaches towards enhancing health outcomes through community-based interventions to ensure effective control and elimination of schistosomiasis and soil-transmitted helminths. There is a critical need for channelling efforts towards making health education the core of schistosomiasis and soil-transmitted helminths programs aimed at achieving intensified control or elimination of these infections by 2020.