Edward Irene Yunzu, Maritim Patricia, Jacobs Choolwe, Silumbwe Adam, Mohamed Hussein, Zulu Joseph Mumba, Halwiindi Hikabasa
Department of Medical Sciences and Technology, College of Science and Technical Education, Mbeya University of Science and Technology, Mbeya, Tanzania.
Department of Epidemiology and Biostatistics, School of Public Health, University of Zambia, Lusaka, Zambia.
PLoS One. 2025 Jul 18;20(7):e0327737. doi: 10.1371/journal.pone.0327737. eCollection 2025.
Schistosomiasis is endemic in Tanzania, with a prevalence ranging between 12.7% to 87.6%. Mass drug administration (MDA) with praziquantel is the main recommended choice of preventive treatment for the disease. Low treatment coverage rates (46.6%) in Busega District, Northwestern Tanzania which are far less than the recommended effective coverage rates of ≥ 75% could indicate low acceptability and poor uptake of MDA. This study sought to establish factors associated with acceptability of schistosomiasis mass drug administration among primary school children in Busega District.
A cross-sectional study was conducted among primary school children, randomly selected from six primary schools between 6th March and 29th May 2023. A validated generic questionnaire guided by the Theoretical Framework of Acceptability was used for data collection. The outcome of the study was acceptability of MDA, and the explanatory variables were socio-demographic factors and the seven constructs of the framework such as perceived moral about taking praziquantel, understanding of intervention purpose and affective attitude. Descriptive statistics and logistic regression with robust standard errors were conducted to identify factors associated with acceptability of MDA using STATA version 15.
The study sample comprised 615 primary school children, 60.16% girls and 39.84% boys. Age distribution ranged from 10 to 17 years with a median age of 13 years. About 55.28% were found to have high acceptability of MDA. Factors significantly associated with acceptability of MDA were; perceived effectiveness (AOR = 2.52; 95%CI = 1.31-4.85; p-value = 0.006), understanding of intervention purpose (AOR = 5.51; 95%CI = 3.16-9.59; p-value<0.0001), self-efficacy (AOR = 2.04; 95% CI = 1.08-3.85; p-value = 0.029), affective attitude (AOR = 5.10; 95% CI = 2.77-9.59; p-value<0.0001), and gender (AOR = 0.59; 95% CI = 0.38-0.94; p-value = 0.027).
Slightly more than half of primary school children recorded high acceptability of MDA. However, perceived effectiveness, understanding of intervention purpose, self-efficacy, affective attitude, and gender strongly influence acceptability. This underscores the need for tailored, gender-sensitive community sensitization efforts regarding the benefits of MDA. Targeted educational campaigns and peer-led initiatives should be prioritized to increase awareness and acceptance, ultimately improving the effectiveness of the MDA program.
血吸虫病在坦桑尼亚呈地方性流行，患病率在12.7%至87.6%之间。使用吡喹酮进行群体药物给药（MDA）是该疾病预防性治疗的主要推荐选择。坦桑尼亚西北部布塞加区的治疗覆盖率较低（46.6%），远低于建议的有效覆盖率≥75%，这可能表明MDA的可接受性较低且使用率不佳。本研究旨在确定与布塞加区小学生血吸虫病群体药物给药可接受性相关的因素。
于2023年3月6日至5月29日期间，在从六所小学随机抽取的小学生中开展了一项横断面研究。采用以可接受性理论框架为指导的经过验证的通用问卷进行数据收集。研究结果是MDA的可接受性，解释变量是社会人口学因素以及该框架的七个构成要素，如对服用吡喹酮的道德认知、对干预目的的理解和情感态度。使用STATA 15版进行描述性统计和带有稳健标准误的逻辑回归分析以确定与MDA可接受性相关的因素。
研究样本包括615名小学生，其中女生占60.16%，男生占39.84%。年龄分布在10至17岁之间，中位年龄为13岁。约55.28%的人对MDA具有较高的可接受性。与MDA可接受性显著相关的因素有：感知有效性（比值比[AOR]=2.52；95%置信区间[CI]=1.31 - 4.85；p值=0.006）、对干预目的的理解（AOR=5.51；95% CI=3.16 - 9.59；p值<0.0001）、自我效能感（AOR=2.04；95% CI=1.08 - 3.85；p值=0.029）、情感态度（AOR=5.10；95% CI=2.77 - 9.59；p值<0.0001）以及性别（AOR=0.59；95% CI=0.38 - 0.94；p值=0.027）。
略多于一半的小学生对MDA具有较高的可接受性。然而，感知有效性、对干预目的的理解、自我效能感、情感态度和性别对可接受性有强烈影响。这突出了针对MDA益处开展量身定制的、对性别敏感的社区宣传工作的必要性。应优先开展有针对性的教育活动和由同龄人主导的倡议，以提高认识和接受度，最终提高MDA项目的有效性。
