High risk behaviours and schistosomiasis infection in Kumba, South-West Province, Cameroon.

Kumba, a town with a population of mixed background and socio-economic status, is a new and intense focus of schistosomiasis. Although fountains provide clean water, the population still uses the river and streams which cross the town for most of its bathing, laundry and swimming activities. A multivariate analysis indicated that a local subject's age, ethnic group, knowledge about schistomiasis and the intensity of his or her contact with the river and/or stream were all significantly associated with schistosome infection. Surprisingly, a high level of knowledge about schistosomiasis was positively associated with the infection. The potential risk of schistosome infection from water contact shows that; the younger age groups are at relatively high risk and male are at more risk than females. In terms of knowledge about schistosomiasis those aged 15-19 years had the highest means score and those aged >44 years the lowest, with males having a significantly higher knowledge than females. Age, as expected and as observed in most schistosomiasis surveys, was a major determinant of schistosomiasis infection. At similar level of exposure children are more susceptible to schistosomiasis probably because they lack the immunity built up in the adults as a result of previous infections. Most surface-water contact by the children, the group most affected by schistosomiasis, occurs during playing and swimming. It is unlikely that health education will have a significant impact on this recreational high-risk behaviour.