Abstract:

Background: Schistosoma. mansoni is a major public health problem in sub-Saharan Africa, including Tanzania. Schistosoma. mansoni mostly affects people living in areas where water and sanitation services are poor, inadequate, or unavailable. In Tanzania, under-five children have often been left out in Schistosomiasis prevention and control programs. Hence, little information is available about the prevalence and the transmission route. The study intended to determine the prevalence of Schistosoma. mansoni among under-five children and their caregivers and the activities that put these groups at risk of Schistosoma. mansoni infection.

Methodology: A cross-sectional, mixed methods study was conducted involving a pair of 427 caregivers and under-five children from Musozi and Nebuye villages in Ukerewe district, North-western Tanzania. This was essentially a knowledge, attitudes and practices (KAP) study. Structured questionnaire were used to collect information on the knowledge, attitudes and practice of caregivers, whereas In-depth interviews were used to collect data on caregiver’s knowledge and water contact practices. Points-of-care-circulating cathodic antigen (POC-CCA) and Kato-Katz thick smears technique were used to diagnose Schistosoma. mansoni. Quantitative data were analyzed using STATA version 13 while qualitative data were analyzed with the help of the NVivo software version 12.

Findings: Based on Kato-Katz and POC-CCA, 72/213 (33.8%) under-five children and 89/214 (41.12%) caregivers were infected with Schistosoma. mansoni. The majority of the respondent 207 (96.7%) stated having heard about schistosoma. Among 143 (69.08%) agreed that under-five children are at risk of contracting intestinal schistosomiasis (S.mansoni) while 123(59.42%) reported that caregivers expose under-five children to Schistosoma. mansoni infection by taking them to the lake. However, misconceptions regarding intestinal schistosomiasis cause risk factors and transmission were widespread. The common misconception reported was that intestinal schistosomiasis is transmitted via drinking dirty water. Under-five children in this study could have contracted schistosomiasis through contact with infested lake water during activities such as swimming and bathing, while their caregivers engaged in various recreational, agricultural, and domestic activities in or near the lake. These activities were reported by caregivers.

Conclusion: The prevalence of S. mansoni infection in both parents and children using Kato-Katz and POC-CCA was moderate. These results emphasize the need for comprehensive health education to improve the knowledge and practices of caregivers regarding the prevention and control of intestinal schistosomiasis. The findings also highlight the importance of including under-five children and caregivers in the MDA programs (that is, treatment with praziquantel).