title: Parasitic worms: knowledge, attitudes, and practices in Western Côte d'Ivoire with implications for integrated control.
abstract: BACKGROUND
  In the developing world where parasitic worm infections are pervasive, preventive chemotherapy is the key strategy for morbidity control. However, local knowledge, attitudes, and practices (KAP) of parasitic worms are poorly understood, although such information is required for prevention and sustainable control.
  
  
  METHODS
  We carried out KAP surveys in two rural communities of Côte d'Ivoire that were subjected to school-based and community-based research and control activities. We used qualitative and quantitative methods. The former included observations, in-depth interviews with key informants, and focus group discussions with school children and adults. Quantitative methods consisted of a structured questionnaire administered to household heads.
  
  
  RESULTS
  Access to clean water was lacking in both communities and only a quarter of the households had functioning latrines. There was a better understanding of soil-transmitted helminthiasis than intestinal schistosomiasis, but community-based rather than school-based interventions appeared to improve knowledge of schistosomiasis. In the villages with community-based interventions, three-quarters of household interviewees knew about intestinal schistosomiasis compared to 14% in the village where school-based interventions were implemented (P<0.001). Whereas two-thirds of respondents from the community-based intervention village indicated that the research and control project was the main source of information, only a quarter of the respondents cited the project as the main source.
  
  
  CONCLUSIONS
  Preventive chemotherapy targeting school-aged children has limitations, as older population segments are neglected, and hence lack knowledge about how to prevent and control parasitic worm infections. Improved access to clean water and sanitation is necessary, along with health education to make a durable impact against helminth infections.
authors.affiliation: Unité de Formation et de Recherche (UFR) Sciences Sociales, Université de Cocody-Abidjan, Abidjan, Côte d'Ivoire.
authors.forename: Cinthia A
authors.initials: CA
authors.lastname: Acka
authors.forename: Giovanna
authors.initials: G
authors.lastname: Raso
authors.forename: Eliézer K
authors.initials: EK
authors.lastname: N'goran
authors.forename: Andres B
authors.initials: AB
authors.lastname: Tschannen
authors.forename: Isaac I
authors.initials: II
authors.lastname: Bogoch
authors.forename: Essane
authors.initials: E
authors.lastname: Séraphin
authors.forename: Marcel
authors.initials: M
authors.lastname: Tanner
authors.forename: Brigit
authors.initials: B
authors.lastname: Obrist
authors.forename: Jürg
authors.initials: J
authors.lastname: Utzinger
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D007560:Cote d'Ivoire / Q000453:epidemiology; D005192:Family Health; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006373:Helminthiasis / Q000453:epidemiology* / Q000469:parasitology / Q000517:prevention & control* / Q000635:transmission; D006376:Helminths / Q000472:pathogenicity*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D012424:Rural Population; D011795:Surveys and Questionnaires; D055815:Young Adult