[Healthcare in Low-resource Settings 2017; 5:6108] [page 1]
Factors associated with
Schistosomiasis control
measures in Mwaluphamba
Location, Kwale County, Kenya
Ahmad Juma,
1
Arthur K.S. Ng’etich,
1
Violet Naanyu,
2
Ann Mwangi,
2
Ruth C. Kirinyet
1
1
Department of Epidemiology &
Biostatistics, School of Public Health,
Moi University, Eldoret;
2
Department of
Behavioral Sciences-School of Medicine,
Moi University, Eldoret, Kenya
Abstract
The study set out to investigate the fac-
tors associated with Schistosomiasis control
measures in Mwaluphamba location of
Kwale County. A descriptive cross-sectional
study design was used. Mwaluphamba loca-
tion was purposely sampled and simple ran-
dom sampling was used to select 338
respondents in villages in each location.
Structured questionnaires were used to col-
lect data. A majority of the respondents
were males (60%), Muslim affiliated
(85%), aged 41 years and over (39%) and
most (56%) of them had achieved at least a
primary level of education. Results showed
that 40% of the respondents were knowl-
edgeable of health education as a service
offered by health care providers to control
Schistosomiasis. Male respondents and
those of Islamic affiliation were five times
(OR: 4.686) and three times (OR: 3.13)
more likely to seek health education in
comparison to their female counterparts
respectively. Respondents’ who had
achieved at least a primary level of educa-
tion and those that earned an income of
above one thousand shillings significantly
utilized mass treatment. Respondents with
income levels below a thousand shillings
were less likely to seek both health educa-
tion and mass treatment compared to those
with a higher income. In conclusion, there
was a statistically significant association
between respondents’ socio-demographic
factors and control measures for the infec-
tion. There is need for equal implementa-
tion of all control measures to overcome the
socio-demographic barriers and to ensure
effective control of Schistosomiasis infec-
tion.
Introduction
Schistosomiasis is considered one of the
Neglected Tropical Diseases (NTD) and it
is second only to malaria as the most devas-
tating parasitic disease. In Kenya, schisto-
somiasis is endemic with an estimated
prevalence of between 5% to 65 % affecting
over six million people.
1
Both Schistosoma
mansoni and Schistosoma haematobium
exist and are unequally distributed in sever-
al parts of the country. Schistosoma haemo-
tobium is high in most parts of the coastal
belt as well as the lake basin. It is prevalent
in scattered foci and sometimes mixed with
Schistosoma mansoni in Eastern, Central
and Nyanza provinces with mixed infec-
tions existing on the shores of Lake
Victoria. The vectors for Schistosoma man-
soni and Schistosoma haemotobium in
Kenya belong to species of snails of the
genus Biomphalaria and Bolinus respec-
tively.
2
Schistosomiasis may not be a major
cause of mortality but it ranks highly as a
cause of morbidity as assessed in hospital
attendances as well as research that has
been carried out in different parts of
Kenya.
2
The prevalence of infection is
increasing as a result of the water develop-
ment programmes such as agriculture and
recreational activities which encourage the
establishment of snail vectors exposing
communities to infected water.
3
While the socio-economic impact
including poor school attendance and per-
formance is known, Schistosomiasis has not
been given the attention it deserves and
continues to be a health problem for many
developing countries.
2
Treatment of
Schistosomiasis infection has been increas-
ing from 12.4 million in 2006 to 33.5 mil-
lion in 2010 depicting an upward trend in its
prevalence since the year 2002 when uni-
versal declaration to control the disease was
made.
4
The universal control measure of
using chemotherapy to treat school-aged
children and populations at risk of the infec-
tion in endemic areas of Kenya has not bore
much fruits compared to other parts of the
world. This is attributed to lack of consis-
tent access to vulnerable populations, late
detection of infections and inconsistent sup-
ply of the praziquantel drugs for consistent
treatment.
2
The coastal area of Kenya is a
Schistosoma haemotobium endemic area
causing Urinary Schistosomiasis which is a
major public health problem in Kwale
County of the coastal region.
4
Kwale
County had a prevalence rate of 70%
amongst school-going children despite the
tireless campaign efforts by Kenyan gov-
ernment and other Non Governmental
Organizations (NGOs) towards prevention
and control of Schistosomiasis.
5
Current
research shows that Urinary
Schistosomiasis has a prevalence rate of
45% in Tsimba location and above 80%
among school-aged children and an average
prevalence of 18.2% among adults in
Mwaluphamba location of Kwale County.
3,6
Kenya Medical Research Institute
(KEMRI) and the Kenyan government
through concerted efforts have been imple-
menting a mass treatment programme to
control Schistosomiasis over a long period
of time but the prevalence of the infection
still remains high in Kwale County. The
programme is focused on treatment of
school-going children who are diagnosed
with Schistosomiasis.
3
It is probable that the
programme has not been fully effective in
achieving a significant reduction in the
prevalence of the infection given lack of
attention to the specific factors associated
Healthcare in Low-resource Settings 2017; volume 5:6108
Correspondence: Arthur Kipkemoi Saitabau
Ng’etich, Moi University, P.O. Box 7470-
30100, Eldoret, Kenya.
Tel.: +254710 890 400.
Email: arthursaitabau@yahoo.com
Key words: Schistosomiasis, Control
Measures, Kwale County.
Contributions: AJ, research idea conception,
study designing, data collection, analysis, and
interpretation of data; AKSN, drafting and
revising the manuscript and final review and
approval of final version of manuscript for
publication; VN, study design, interpretation
of manuscript, revising manuscript and final
approval of version to be published; AM, data
analysis review, revising of manuscript and
approval of the final version for publication;
RCK, references check, revising of manu-
script and approval of the final version for
publication
Conflict of interest: the authors declare no
potential conflict of interest.
Acknowledgements: We would like to express
our sincere appreciation to the entire Moi
University School of Public Health academic
fraternity for their guidance and more impor-
tantly their extensive knowledge in this area of
research which informed the study. A special
thank you to the people of Mwaluphamba
location for their participation in the study.
Received for publication: 23 June 2016.
Revision received: 2 December 2016
Accepted for publication: 21 December 2016.
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Licensee PAGEPress, Italy
Healthcare in Low-resource Settings 2017; 5:6108
doi:10.4081/hls.2017.6108
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