Masaku Janet, Mwende Faith, Odhiambo Gladys, Musuva Rosemary, Matey Elizabeth, Kihara Jimmy H, Thuita Isaac G, Njomo Doris W
Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), Nairobi, Kenya.
Centre for Global Health Research (CGHR) Kenya Medical Research Institute (KEMRI), Kisumu, Kenya.
PLoS Negl Trop Dis. 2017 Mar 30;11(3):e0005514. doi: 10.1371/journal.pntd.0005514. eCollection 2017 Mar.
Soil-transmitted helminthes (STHs) are common human parasitic diseases in most of the developing world particularly in Kenya. The ongoing National School-Based Deworming Programme (NSBDP) was launched in 2012 and is currently targeting 28 of the 47 endemic Counties. In an effort to improve treatment intervention strategies among Pre-School Age Children (PSAC) attending Early Childhood Development Centres (ECDC), we sought to assess parents' knowledge, perceptions and practices on worm infection.
We conducted a qualitative cross-sectional study in four endemic sub-counties of two counties of coastal region of Kenya. A total of 20 focus group discussions (FGDs) categorized by gender were conducted among parents of pre-school age children. Participants were purposively selected based on homogenous characteristics with the saturation model determining the number of focus group discussions conducted. The data collected was analyzed manually by study themes.
The majority of the parents had knowledge on worms and modes of transmission of the parasitic infections among the pre-school children. Also, most of the participants knew the causes of worm infection and the pre- disposing factors mentioned included poor hygiene and sanitation practices. Due to poor knowledge of signs and symptoms, misconceptions about the drugs administered during the NSBDP were common with a large majority of the parents indicating that the drugs were ineffective in worm control. The findings also indicated that most of the participants sought medical care on the onset of the signs and symptoms of worm infestation and preferred services provided at public health facilities as opposed to private health facilities or buying drugs from the local market citing mistrust of such services. Cultural beliefs, high cost of building and availability of vast pieces of land for human waste disposal were factors that contributed to low or lack of latrine ownership and usage by a large majority of the respondents.
Our results show that to a large extent the parents of the pre-school age children have information on worm infections. However, some cultural beliefs and practices on the pathology and mode of transmission mentioned could be a hindrance to prevention and control efforts. There is need to implement health promotion campaigns to strengthen the impact of control strategies and reduce infection.
土壤传播的蠕虫病（STHs）是大多数发展中国家常见的人类寄生虫病，在肯尼亚尤为如此。正在进行的全国在校驱虫计划（NSBDP）于2012年启动，目前针对47个流行县中的28个。为了改进对就读于幼儿发展中心（ECDC）的学龄前儿童（PSAC）的治疗干预策略，我们试图评估家长对蠕虫感染的知识、认知和做法。
我们在肯尼亚沿海地区两个县的四个流行次县进行了一项定性横断面研究。在学龄前儿童的家长中，按性别进行了总共20次焦点小组讨论（FGDs）。根据同质特征有目的地选择参与者，饱和模型确定进行焦点小组讨论的数量。收集的数据按研究主题进行人工分析。
大多数家长了解蠕虫以及学龄前儿童寄生虫感染的传播方式。此外，大多数参与者知道蠕虫感染的原因，提到的易感因素包括卫生和环境卫生习惯差。由于对体征和症状了解不足，对全国在校驱虫计划期间服用的药物存在误解很常见，绝大多数家长表示这些药物对控制蠕虫无效。研究结果还表明，大多数参与者在出现蠕虫感染的体征和症状时会寻求医疗护理，并且更喜欢公共卫生设施提供的服务，而不是私人卫生设施或从当地市场购买药物，理由是对这些服务不信任。文化信仰、建造厕所成本高以及有大量土地可用于处理人类粪便，是导致大多数受访者厕所拥有率低或不使用厕所的因素。
我们的结果表明，在很大程度上，学龄前儿童的家长了解蠕虫感染的信息。然而，提到的一些关于病理和传播方式的文化信仰和做法可能会阻碍预防和控制工作。有必要开展健康促进活动，以加强控制策略的影响并减少感染。
