An integrated approach to assess Knowledge, Attitude and Practices (KAP) regarding major Neglected Tropical Diseases endemic in the Mbengwi health district (North West Region, Cameroon)

Abstract

BackgroundPreventive chemotherapy (PCT) is the main strategy currently used to control and/or eliminate onchocerciasis (Oncho), lymphatic filariasis (LF) and Soil Transmitted Helminthiasis (STH), and community participation (through implementation of MDA or adherence to PCT) is critical to achieve this goal. However, these Neglected Tropical Diseases (NTDs) are still persisting in most endemic areas as a consequence of sub-optimal treatment coverage, the presence of systematic non-compliers in communities ... This study aimed at investigating whether the knowledge, attitudes and practices of populations about these NTDs can explain the poor trends towards elimination.\n\nMethodologyA cross-sectional survey was carried out in the Mbengwi Health District (North West Region, Cameroon) using the cluster sampling technique. Clusters were selected using the Probability Proportionate to Estimate Size strategy. In each cluster, the random walk technique was used for the selection of households, and a structure questionnaire was administered to 2-3 of its members.\n\nPrincipal FindingsA total of 254 households from 26 clusters were visited, and 514 individuals were interviewed. The sex ratio of interviewees (1.08) was unbiased, and their ages ranged between 10 and 99 years old. Though most of the respondents declared having already heard of these NTDs (41.2%, 73.7% and 89.9% for Oncho, LF and STH respectively), only a minority of them were aware of correct response of how they are acquired/transmitted (3.7%, 6.8% and 12.5% for Oncho, LF and STH respectively), and prevented (23.1%, 18.9% and 47.2% for Oncho, LF and STH respectively). Even when respondents were aware that medicines were useful to prevent and/or treat these NTDs, almost none of them knew the drug used or the treatment frequency.\n\nConclusion/SignificanceThis study reveals that interviewees exhibit poor knowledge, attitudes and practices as regards to these NTDs, although they are endemic in the study area and PCTs given yearly since a while. These misconceptions can seriously affect the adherence and contribution of populations to the success of PCTs, and it appears compulsory to improve individual knowledge, with a focus on the importance and rationale behind MDA, to optimize their attitudes and practices, especially community participation to PCTs.\n\nAuthor summaryThe control and/or elimination of Neglected Tropical Diseases (NTDs) are currently on top of the agenda of endemic countries control programs and stakeholders. Ivermectin- and Albendazole/Mebendazole-based mass distribution is currently the main strategy to control/interrupt transmission of onchocerciasis, lymphatic filariasis and soil-transmitted helminthiasis, and adherence of communities is compulsory for the success of this approach. Despite the success registered in the fight against these diseases, the trend towards elimination remains unsatisfactory in many endemic areas. This study was carried out to assess whether the perceptions, attitudes, and practices of the Mbengwi health district (North West Region, Cameroon) populations regarding these three parasitic diseases can explain the poor trend towards elimination. A cross-sectional study revealed important misconceptions about these NTDs amongst most of the respondents, which can clearly affect their adherence and contribution to the success of preventive chemotherapies, and seriously slower the momentum towards elimination.