Prevalence rate of urinary schistosomiasis among respondents by sociodemographic characteristics:

The prevalence of urinary schistosomiasis among the study population at baseline was 38% but was reduced to 13% twelve weeks after drug treatment (Table 2). This gives about three-fold reduction in the prevalence in Martin village. Up to 60-fold and six fold reduction was reported following drug treatment respectively in Pankshin, Plateau state and Mali.^29,35 The prevalence of the disease was found to be highest among the 10-14 years age group then the prevalence reduces as the age of the respondents increases. This is as reported in several other studies, ^27,30 but a study in Ebonyi state showed a steady increase of prevalence with age from 0–25 years.²¹ The high prevalence among 10 – 14 year age group could be attributed to the water contact activities of that age group –

opportunities for group swimming and domestic activities such as fetching water, washing clothes / utensils from the stream and farm work. Those younger than them could hardly be of help in such activities or in the farm, thus the low prevalence in them.

The prevalence of infection was also higher in males (52.3%) compared to females (47.7%), though the relationship was not statistically significant P = 0.248.

Similar findings have been documented in the Northern parts of the country where males perform more of the domestic activities involving water contact compared to their females counterparts because the latter are mostly in purdah.⁵ The only water contact activity that females (65%) were found to be more exposed to than the males (33%) was the washing of cooking utensils at the stream. However, it was not statistically significant. Again this is typical of the Northern part of the country, even though the respondents are mostly from Christian background, the culture still allows for more exposure in males than females.⁶This is different in Ghana as some researchers reported higher prevalence of water contact activities and subsequently prevalence of urinary schistosomiasis among the females than males.⁴⁶

The prevalence of infection was found to be higher among respondents whose parents are skilled workers (57%) compared to farmers (36%), (Table 5), however this difference is no statistically significant P = 0.06. This could be because usually in the villages, every individual have a farm in addition to his occupation, at least to feed his family. Thus the exposure due to farming as occupation of head of household becomes neutralized because even respondents, whose parents/guardians are not basically farmers, go to the farm, to supplement income from their main occupation. There is a statistically significant relationship between age and prevalence of urinary schistosomiasis P = 0.001.

The prevalence of infection increases with age from the 5-9 year age group (lowest) to the 15-19 year age group (Table 3). This could be as a result of the difference in the activities the different age groups are involved. The chances are less for the younger ones to have access to contaminated water than the older ones that assist in farm work.

There was a statistically significant relationship between prevalence of urinary schistosomiasis and educational status of respondents P = 0.001 (Table 6). This is expected because most of those that are attending school are likely to have educated parents, from whom they could learn about the disease and also guide them on what to do to prevent infection. This also agrees to findings of studies in Ilorin and Mali.³⁵

5.5: Knowledge of respondents about urinary schistosomiasis:

The respondents have very poor general knowledge about urinary schistosomiasis.

Less than 50% of the respondents are aware of the existence of the disease (Table 3).

Several other studies revealed similar findings.^5,29,35 Some of the respondents attribute the predominant symptom of the disease, haematuria, to either sign of virility in men,

‘male menstruation’, witchcraft or nature. Some respondents, females mostly, attribute it to menstrual flow. This is similar to the findings in other rural areas in the tropics. Only 27.7% of the respondents knew the correct cause of the disease. The response to questions on mode of transmission, method of prevention and cure of the disease revealed that 24.5%, 32% and 25.5% respectively answered correctly (Figure 5, Tables 9 and 10).

This is quite low. When asked about cure of the disease, some respondents assert that it has no cure while others said it does not need treatment, as it is not even a disease.

5.6: Practices of the respondents that affects transmission of schistosomiasis:

The practice of walking bare-footed is a function of social status sand knowledge of the importance of wearing shoes. Most of the respondents that walk without shoes, reported lack of shoes as the major reason. But for the respondents that do not wear shoes because it is more convenient to walk bare-footed, health education will possibly change that attitude.

Most of the practices that exposes the respondents to increase risk of contracting urinary schistosomiasis did not improved after health education. The relationship was not statistically significant, p > 0.05 at 95% CI. The practices that did not improve include walking bare-footed, washing in the stream, fetching water from the stream and indiscriminate urination (Table 16). There was some level of improvement in the proportion of respondents that swim in the stream. This could be because it is unlikely to achieve appreciable change in behaviour within twelve weeks particularly when we did not provide alternative sources of water and toilet facilities as part of the study. For instance, provision of safe potable water and sanitary facilities, after treatment of schistosomiasis in South America has maintained a very low level of schistosomiasis prevalence of less than 1% in the community.