Pre- and post-intervention perceptions and water contact behaviour related to schistosomiasis in north-western Tanzania.

Schistosomiasis is a widespread disease of public health importance in Tanzania requiring concerted efforts to control it. A study on schistosomiasis-related perceptions and water contact behaviour was undertaken in one community population of Hamuyebe village in Ukerewe district, north-western Tanzania, where intestinal schistosomiasis is endemic before and 2 years after implementation of a participatory hygiene and sanitation transformation (PHAST) intervention. Data were obtained from baseline and post-intervention knowledge, attitudes and practices (KAP) questionnaire surveys conducted between 2008 and 2010 among 157 individuals aged 15 years and above. The surveys were further complemented by structured observations of human-water contact activities. We found significant increases in respondents' knowledge of the cause, transmission, symptoms and health consequences of schistosomiasis after the intervention. The reported treatment seeking and preventive practices were congruous with the actual (observed) behaviour. Frequency, duration and timing of water contacts also decreased significantly after the intervention and took into consideration the fact that those activities which need larger body surface exposure, for a long period and at an appropriate time when cercarial densities are high (i.e. around noon) are important for the transmission of schistosomiasis. We conclude that PHAST intervention has succeeded in effecting positive changes in peoples' perceptions and attitudes towards water. As a result, knowledge obtained from the said intervention was translated into actions to prevent schistosomiasis. Studies on knowledge, attitudes and practices coupled with structured observations should be part of the integrated approach for the control of schistosomiasis.