The influence of poverty and culture on the transmission of parasitic infections in rural nicaraguan villages.

Intestinal parasitic infections cause one of the largest global burdens of disease. To identify possible areas for interventions, a structured questionnaire addressing knowledge, attitude, and practice regarding parasitic infections as well as the less studied role of culture and resource availability was presented to mothers of school-age children in rural communities around San Juan del Sur, Nicaragua. We determined that access to resources influenced knowledge, attitude, and behaviors that may be relevant to transmission of parasitic infections. For example, having access to a clinic and prior knowledge about parasites was positively correlated with the practice of having fencing for animals, having fewer barefoot children, and treating children for parasites. We also found that cultural beliefs may contribute to parasitic transmission. Manifestations of machismo culture and faith in traditional medicines conflicted with healthy practices. We identified significant cultural myths that prevented healthy behaviors, including the beliefs that cutting a child's nails can cause tetanus and that showering after a hot day caused sickness. The use of traditional medicine was positively correlated with the belief in these cultural myths. Our study demonstrates that the traditional knowledge, attitude, and practice model could benefit from including components that examine resource availability and culture.