Journal of Practical & Professional Nursing Category: Clinical Type: Research Article
Knowledge and Preventive Practices of Rural Residents against Schistosomiasis in an Endemic Community in Eastern Philippines
- Joseph U Almazan1*, Jhunlie E Escala2, Ma Azyl Verdeflor Merida3, Dorothy R Permelona2, Jonas P Cruz4
- 1 Nursing Department, College Of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
- 2 Nursing Department, Samar Provincial Hospital, Catbalogan, Samar, Philippines
- 3 Nursing Department, Samar Provincial Hospital, Coll, Catbalogan, Samar, Philippines
- 4 Nursing Department, College Of Applied Medical Sciences, Shaqra University, Saudi Arabia
*Corresponding Author:Joseph U Almazan
Nursing Department, College Of Applied Medical Sciences, Majmaah University, Majmaah, Saudi Arabia
Received Date: Aug 07, 2017 Accepted Date: Oct 05, 2017 Published Date: Oct 23, 2017
Aim: To assess the health knowledge and preventive practices of rural residents against schistosomiasis in an endemic rural community in Eastern Philippines.
Design: A Cross-sectional study was conducted to 140 conveniently selected rural residents.
Methods: The data was gathered through the use of standardized questionnaire developed by HD Mazigo et al. The researchers utilized random sampling technique in the endemic schistosomiasis community.
Results: Knowledge of the respondents towards schistosomiasis was associated with their age and income. Preventive practices towards schistosomiasis have significant relationships with toilet facility.
Conclusion: There was still lack of understanding concerning transmission schistosomiasis. Consequently, modifying their knowledge and behavioral practices related to schistosomiasis transmission is highly recommended.
The occurrence of this disease in the country is still very high. There were 10 among the 16 regions have reported cases of clinical schistosomiasis, with 6.7 million people living in the endemic areas [4-6]. In addition, within these endemic areas, millions of people were exposed, risk for infection through their daily lifestyle and contact with water including farming, fishing, domestic activities (bathing and washing) and recreation [4-6].
In Samar, a high incidence of this disease was reported [4,5]. Although there was mass treatment in the province, increase household access to toilet and safe water facilities, conduct sentinel surveillance through stool examination, still, the prevalence rate was very high . In order to halt transmission of the parasite in such community, treatment regimen, as well as other control programs such as community awareness, is necessary . Health education is effective means to prevent schistosomiasis with particular emphasis on the factors influencing such beliefs and practices . Previous studies regarding knowledge, attitudes and practices in schistosomiasis that explained a crucial need for focusing health messages among endemic communities , but no empirical studies were conducted especially in endemic schistosomiasis communities in Samar. This demonstrates that schistosomiasis remains a major public health problem in the province. Thus, the researcher was motivated to conduct this investigation.
Finally, this study would help the farmers, Local Government Units and Healthcare providers to strengthen health programs and redirect policies regarding prevention of schistosomiasis. This also enlightens them that knowledge is not only a man’s factor to treat this disease but also their practices. The study aims to provide depth assessment on the rural residents against schistosomiasis in an endemic community in Eastern Philippines.
Each respondent was given enough time to answer each question. The researchers discussed that the answers remain confidential; the whole research instruments were accomplished according to the purpose of this study. However, None of this respondents were infected of the disease.
The questionnaire has three parts. Part 1: Discussed the demographic profile such as name (using only code numbers), age, sex, educational attainment, occupation and monthly family income. Part 2: Assessed the knowledge in schistosomiasis with 5 subscales. The scale of yes or no response options used in assessing the knowledge. Part 3: Discussed the 10 item preventive practices against schistosomiasis with five choices per item ranging from 1(not practice at all) to 5(extremely practice).
As shown in table 1, 140 respondents participated in the study which composed of 57 (40.71) male and 83 (59.29) female. More than half of the respondents were married, Roman Catholic, have toilet facilities, with monthly income Php 1,000-5,000, but only a few of them were college graduates.
|Age Group||Male (%)||Female (%)||Total|
|20 - 26||9(6.43)||14(10)||23|
|27 - 33||11(7.86)||18(12.86)||29|
|34 - 40||10(7.14)||6(4.29)||16|
|41 - 47||12(8.57)||13(9.29)||25|
|58 - 54||6(4.29)||8(5.71)||14|
|55 - 61||4(2.86)||13(9.29)||17|
|62 – 68||3(2.14)||6(4.29)||9|
|69 – 75||2(1.43)||5(3.57)||7|
|High School Level||14(26.42)||24(17.14)||38|
|High School Graduate||21(39.62)||21(15)||42|
|Php 6,000 -10,000||13(9.29)||18(12.86)||31|
|Php 11,000 - 15,000||10(7.14)||12(8.57)||22|
|Php 16,000 - 20,000||3(2.14)||1(0.71)||4|
|With toilet facility||50(87.72)||63 (75.90)||113|
|Without toilet facility||7(12.28)||20 (24.10)||27|
Knowledge about schistosomiasis. Table 2 presents the multiple responses concerning the knowledge of respondents about schistosomiasis. More than half of the respondents (both male and female) indicated that worms, dirty water, swimming in lakes and drinking dirty water cause schistosomiasis. The symptoms to which respondents reported were varied considerably and usually not associated with schistosomiasis were also reported (Table 2).
|Knowledge on Schistosomiasis||Male||Female|
|Knowledge on the cause of schistosomiasis|
|Swimming in lakes causes schistosomiasis||116||82.9||24||17.1|
|Drinking dirty water causes schistosomiasis||108||77.1||32||22.9|
|Knowledge about the symptoms of schistosomiasis|
|Pain during micturation||31||22.1||109||77.9|
|Swelling of the abdomen||105||75.0||35||25.0|
|Knowledge about the transmission of schistosomiasis|
|Swimming in dirty water||121||86.9||29||13.1|
|Urinating in water||70||50.0||70||50.0|
|defecating in water||90||64.3||50||35.7|
|Stepping over human feces||102||72.9||38||27.1|
|Knowledge about areas one can get infected with schistosomiasis|
|water collection areas||92||65.7||38||34.3|
|Knowledge about preventive and control measures of schistosomiasis|
|Avoiding swimming in lakes||113||80.7||27||19.3|
|Avoiding urinating in lakes||109||77.9||31||22.1|
|Avoiding defecating in lakes||114||81.4||26||18.6|
|Use of toilets when defecating||107||76.4||33||24.4|
|Wearing of slippers||103||73.6||37||24.7|
|Wearing of boots||113||80.7||27||19.3|
|Wearing of gloves||99||70.7||41||29.3|
|Avoiding the use of water from river||107||76.4||33||24.6|
|Boiling water before drinking||113||80.7||27||19.3|
About 121 or 86.9 percent from the male respondents responded swimming in dirty water can transmit the disease. However, there were some of the respondents in male and female answered sexual intercourse and mosquitoes which are not considered a mode of transmission. Meanwhile, more than half from the male respondents responded that they could acquire the disease through a lake, rivers, rice field, water collection areas and toilet. Meanwhile, more than half of the female respondents answered that they could acquire the disease through toilet facility. Finally, a significant number of respondents are knowledgeable about preventive and control measures.
Respondent’s preventive practices on schistosomiasis. Table 3 shows the respondents’ preventive practices on schistosomiasis. Results showed that respondents had attained relatively scores on these preventive practices.
|Means||Standard Deviation||Means||Standard Deviation|
|Avoids swimming in rivers||2.94||0.97||3.04||1. 13|
|Avoids urinating in rivers||3.01||1.08||3.12||1.19|
|Avoids defecating in rivers||3.49||1.15||3.33||0.94|
|Uses toilet when defecating||2.90||0.86||3.08||1.02|
|Wear boots in the rice fields||2.96||0.78||2.47||0.83|
|Wear gloves in the rice fields||2.26||0.47||2.26||0.47|
|Avoids use of water from river when washing clothes||2.66||0.77||2.66||0.77|
|Wash hands and feet after contact with dirty water||3.64||1.11||3.64||1.11|
|Boils water before drinking it||2.60||0.86||2.60||0.86|
The regression model knowledge towards schistosomiasis, as described in the table 4, the coefficient determination table of the regression model is 0.474 which indicates that about 47.4 percent of the variation of knowledge explained by age and income. This means a weak prediction of the independent variable to dependent variables. To fully disclose the knowledge of the participants, 52.6 percent of the variation of knowledge explained by other factors. Furthermore, for every 1 point unit increase of age level, there is a corresponding 0.214 unit increase in knowledge. It has a p-value of 0.000, which is lesser than the significant level of 0.05. Next, for every one unit increase in income, there is a corresponding 0.142 increase in knowledge. It has a p-value of 0.000, which is lesser than the significant level of 0.05.
|Variable||R||R2||Adjusted R2||Std. Error of the Estimate|
|Civil status||0.137||0.743||0.855 ns||0.685|
The regression model preventive practices, as described in the table 5, the coefficient determination table of the regression model is 0.367 which indicates that about 36.7 percent of the variation of preventive practices explained by age. This indicates a weak prediction of the independent variable to dependent variables. To fully disclose the preventive practices of the participants, 63.3 percent of the variation of preventive practices explained by other factors. Furthermore, for every 1 point unit increase of age level, there is a corresponding 0.258 unit increase of preventive practices. It has a p-value of 0.000, which is lesser than the significant level of 0.05.
|Variable||R||R2||Adjusted R2||Std. Error of the Estimate|
|Civil status||0.391||0.683||-0.853 ns||0.685|
Table 5: Regression model preventive practices.
Note: ** Significant at p<0.01 (2 tailed).
Emphasizing the preventive practices is vital against schistosomiasis. However, most of the studies were conducted in small villages. Thus, further research is needed to explore the relationships between the knowledge and preventive practices on schistosomiasis in a wider region. Another highlight of the study is the age and income which have significant relationships with the knowledge and preventive practices on schistosomiasis [14,22]. This is worth noting since the previous study pointed out that age, was the most important factor significantly associated with the knowledge and preventive practices on schistosomiasis, but not the income level . However, the previous study discussed that age was generally found not to be statistically significant . Thus, more empirical data is needed to determine the significance of age to knowledge and preventive practices. Other findings of the study revealed that income has significant relationships in knowledge towards schistosomiasis. These results showed that the family income of the respondents was below the poverty monthly per capita income of Php 8,378 per month . Poverty increases the chance of getting infected with this disease. Previous studies also described that lack of money was cited as reasons for failure to visit a hospital/health center. Nevertheless, this suggests that people with higher economic status could have better access to information combined with the effect of generalized education. This could assure a better understanding and comprehension of information. Thus, further research could be developed in determining the effect of poverty in schistosomiasis endemic community.
In order to halt transmission of the parasite in such community, treatment regimen as well as other control programs should also target especially younger age groups and lower socioeconomic class.
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Copyright: © 2017 Joseph U Almazan, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.