TY - JOUR

T1 - Understanding ethnic differences in behaviour relating to Schistosoma mansoni re-infection after mass treatment

AU - Pinot de Moira, Angela

AU - Kabatereine, Narcis B

AU - Dunne, David W

AU - Booth, Mark

PY - 2011/3

Y1 - 2011/3

N2 - It is now widely recognized that a decentralized approach to the control of parasitic infections in rural sub-Saharan populations allows for the design of more effective control programmes and encourages high compliance. Compliance is usually an indicator of treatment success, but cannot be used as a measure of long-term benefit since re-infection will be strongly influenced by a number of factors including the social ecology of a community. In this paper qualitative and quantitative methods are used to identify and understand the structural and behavioural constraints that may influence water contact behaviour and create inequalities with respect to Schistosoma re-infection following anti-helminth drug treatment. The research is set in a community where participant engagement has remained uniformly high throughout the course of a 10-year multidisciplinary study on treatment and re-infection, but where levels of re-infection have not been uniform and, because of variations in water contact behaviour, have varied by age, sex and ethnic background. Variations in the biomedical knowledge of schistosomiasis, socioeconomic constraints and ethnic differences in general attitudes towards life and health are identified that may account for some of these behavioural differences. The observations highlight the benefits of understanding the socio-ecology of control and research settings at several levels (both between and within ethnic groups); this will help to design more effective and universally beneficial interventions for control and help to interpret research findings.

AB - It is now widely recognized that a decentralized approach to the control of parasitic infections in rural sub-Saharan populations allows for the design of more effective control programmes and encourages high compliance. Compliance is usually an indicator of treatment success, but cannot be used as a measure of long-term benefit since re-infection will be strongly influenced by a number of factors including the social ecology of a community. In this paper qualitative and quantitative methods are used to identify and understand the structural and behavioural constraints that may influence water contact behaviour and create inequalities with respect to Schistosoma re-infection following anti-helminth drug treatment. The research is set in a community where participant engagement has remained uniformly high throughout the course of a 10-year multidisciplinary study on treatment and re-infection, but where levels of re-infection have not been uniform and, because of variations in water contact behaviour, have varied by age, sex and ethnic background. Variations in the biomedical knowledge of schistosomiasis, socioeconomic constraints and ethnic differences in general attitudes towards life and health are identified that may account for some of these behavioural differences. The observations highlight the benefits of understanding the socio-ecology of control and research settings at several levels (both between and within ethnic groups); this will help to design more effective and universally beneficial interventions for control and help to interpret research findings.

KW - Adolescent

KW - Adult

KW - Aged

KW - Anthelmintics/therapeutic use

KW - Child

KW - Child, Preschool

KW - Ethnicity/psychology

KW - Female

KW - Focus Groups

KW - Health Behavior/ethnology

KW - Health Knowledge, Attitudes, Practice

KW - Humans

KW - Male

KW - Middle Aged

KW - Patient Compliance/ethnology

KW - Schistosomiasis/drug therapy

KW - Secondary Prevention

KW - Sex Factors

KW - Uganda/epidemiology

KW - Water Supply

KW - Young Adult

U2 - 10.1017/S002193201000060X

DO - 10.1017/S002193201000060X

M3 - Journal article

C2 - 21092361

VL - 43

SP - 185

EP - 209

JO - Journal of Biosocial Science

JF - Journal of Biosocial Science

SN - 0021-9320

IS - 2

ER -