Knowledge to action: assessing the impact of schistosomiasis education on community knowledge, attitudes and practices in Nelson Mandela Bay, South Africa

BACKGROUND: S

chistosomiasis, a neglected tropical disease affecting nearly 240 million people globally, remains entrenched in communities with poor access to safe water and sanitation. Between 2021 and 2022, the World Health Organisation reported a 5% rise in the global need for preventive treatment, with Africa bearing 90% of the burden.

OBJECTIVE:

This study assessed community knowledge, attitudes, and practices (KAP) regarding schistosomiasis and evaluated the impact of an educational intervention.

METHODS:

A quantitative cross-sectional design was employed. Structured pre- and post-intervention interviews were conducted with residents aged 18-65 years living within 5 km of selected water bodies. Data were captured in QuestionPro and analysed using Microsoft Excel 365 (2019) and R (version 4.3.1).

RESULTS:

Of 380 participants (51.1% male, 48.7% female, 0.3% no response), 91.3% had no prior knowledge of schistosomiasis at baseline. Post-intervention, awareness reached 100%. Pre-intervention analysis revealed a positive correlation between knowledge and attitude ( = 0.23,  < 0.001), with knowledgeable individuals more likely to seek treatment and adopt preventive measures. However, post-intervention data showed a negative correlation between attitudes and practices (r = -0.13,  = 0.013), indicating that some participants persisted in high-risk water contact despite improved attitudes.

CONCLUSION:

The intervention markedly improved awareness and attitudes but did not fully eliminate risky behaviours. This gap underscores the need for sustained context-specific behavioural change strategies that move beyond knowledge transfer to address ingrained practices. Embedding long-term community engagement into schistosomiasis control programmes is critical to breaking transmission cycles.