Health-Seeking Behavior Regarding Schistosomiasis Treatment in the Absence of a Regular Mass Drug Administration (MDA) Program: The Case of Endemic Communities Along Lake Albert in Western Uganda

Abstract

Abstract Introduction Schistosomiasis poses a serious public health and social challenge affecting over 240,000,000 people, the majority of whom live in sub-Saharan Africa. Although the World Health Organization (WHO) recommends praziquantel (PZQ) drug treatment through regular mass drug administration (MDA), in endemic areas, it is hindered by funding gaps. We explored the health seeking behaviors of communities along Lake Albert in Western Uganda, regarding schistosomiasis treatment in the absence of a regular MDA program. Methods and Materials We conducted a community-based qualitative study. We interviewed 12 local leaders, village health teams, and health workers and conducted 28 focus group discussion sessions with 251 purposively selected community members. The audio recordings of the data were transcribed and analyzed using a thematic analysis model. Results Generally, participants seldom seek medication for schistosomiasis-related signs and symptoms from government hospitals and health centers II, III and IV despite their availability; instead, they rely on the MDA program and, in its absence, private clinics and drug shops nearby or traditional sources like which doctors and herbalists. The absence of PZQ drugs in the government health facility, health workers’ negative attitude towards patients, long distances to the government hospitals and health facilities, poor and inaccessible roads, medication-related costs, and negative perceptions of the PZQ drug informed by past experiences with MDA force people to seek medication from sources other than the government. Conclusions Availability and accessibility of PZQ seem to be a big challenge, especially for endemic communities such as Kagadi and Ntoroko. But even when it is available at government hospitals and health facilities, its uptake is hampered by health systems, and community-related and socio-cultural factors. Thus there is a need to bring schistosomiasis drug treatment and services closer to endemic communities and stock nearby facilities with PZQ. At the same time, endemic communities should be encouraged to take PZQ as the prevalence of schistosomiasis in the lake area is very high. Contextualised awareness-raising campaigns are needed to debunk myths and misconceptions surrounding the drug.