title: Highly symptom-aware children were heavily infected with urinary schistosomiasis in southern Ghana.
abstract: OBJECTIVE
  To assess the relationship between the infection status of children and their knowledge, attitudes, beliefs, and practices (KABP) related to urinary schistosomiasis.
  
  
  METHODS
  Questionnaire survey.
  
  
  METHODS
  Nine schools in eight rural communities (total population: 4,636) in Ga and South Akuapem Districts, Ghana.
  
  
  METHODS
  Four hundred and six children attending primary and secondary schools.
  
  
  METHODS
  Schistosoma haematobium infection status of children and their KABP.
  
  
  RESULTS
  Of 354 children who responded and also submitted their urine samples, 297 (83.9%) tested positive for S. haematobium and the intensity of infection was 90 (95% CI: 74 to 110) eggs per 10 ml urine. General knowledge variables such as the knowledge of symptoms (p < 0.001), and knowledge of swimming or bathing in the river as a transmission route (p < 0.001) showed significant association for higher prevalence and intensity of infection. Treatment-seeking behaviour was not associated with the lower prevalence or intensity of infection. Practice variables such as washing clothes in the stream (p < 0.001) and fishing in the stream (p < 0.01) were significantly associated with both higher prevalence and higher intensity of infection. Children who knew of contact with river water as a transmission route reported more water contact activities (p < 0.001).
  
  
  CONCLUSIONS
  This study showed that highly symptom-aware people were heavily infected, and people frequently exposed to infested water were heavily infected. Moreover, highly symptom-aware people never constituted a group whose exposure was slight. Why was awareness of disease symptoms and general knowledge of the disease not linked to low infectivity? Why didn't awareness result in avoidance of infested water sources? This report highlights the urgent need to address these important questions in future research.
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Baltimore, Maryland 21205, USA. ywagats@icddrb.org
authors.forename: Y
authors.initials: Y
authors.lastname: Wagatsuma
authors.forename: M E
authors.initials: ME
authors.lastname: Aryeetey
authors.forename: F K
authors.initials: FK
authors.lastname: Nkrumah
authors.forename: D A
authors.initials: DA
authors.lastname: Sack
authors.forename: S
authors.initials: S
authors.lastname: Kojima
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D005869:Ghana / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D012552:Schistosomiasis / Q000453:epidemiology / Q000652:urine*