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Impact of Schistosomiasis Education on Schistosomiasis Prevention Practices among School Children in Rural Nigeria

Abstract

Schistosomiasis is an important neglected tropical disease that affects communities where people have frequent contact with freshwater bodies that support the transmission cycle of the parasite. School-aged children in rural communities may be particularly vulnerable because of activities such as swimming, bathing, fishing, farming, playing, and other forms of freshwater contact. Schistosomiasis education provides children with information about the disease, modes of transmission, symptoms, health risks, preventive measures, safe water practices, appropriate sanitation, avoidance of risky freshwater contact, personal hygiene, and the importance of seeking appropriate healthcare when symptoms occur. Schistosomiasis prevention practices refer to the actions undertaken by school children to reduce their risk of acquiring the infection, including avoiding unnecessary contact with potentially contaminated freshwater, using safer water sources, maintaining personal hygiene, practicing appropriate sanitation, and seeking timely healthcare when symptoms or suspected exposure occur. In rural Nigeria, inadequate prevention practices may be associated with limited knowledge, dependence on freshwater sources, inadequate water and sanitation facilities, cultural practices, recreational activities in freshwater, poverty, and limited access to reliable health information and healthcare services. Effective schistosomiasis education may improve children's knowledge, risk perception, confidence, and adoption of appropriate preventive practices. Against this background, this study investigates the impact of schistosomiasis education on schistosomiasis prevention practices among school children in rural Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and the Knowledge-Attitude-Practice framework. The Health Belief Model provides a framework for understanding children's prevention decisions through perceived susceptibility to schistosomiasis, perceived severity, perceived benefits of preventive practices, perceived barriers, and cues to action. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, peer influence, family support, school environment, and behaviour in shaping preventive health practices. The Knowledge-Attitude-Practice framework provides a basis for examining how schistosomiasis education may improve children's knowledge and attitudes and influence prevention practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how schistosomiasis education may influence prevention practices among school children in rural Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from pupils in selected rural primary and secondary schools in schistosomiasis-endemic communities in Nigeria using age-appropriate structured questionnaires, schistosomiasis knowledge assessments, and prevention-practice checklists. Because the participants are children, parental or guardian consent and appropriate child assent procedures will be obtained in accordance with applicable ethical requirements. A multistage sampling technique will be employed to select states, local government areas, rural communities, schools, classes, and eligible pupils. Where feasible, selected schools or pupil groups will be assigned to intervention and comparison groups. Pupils in the intervention group will receive structured, age-appropriate schistosomiasis education covering disease transmission, symptoms, health consequences, risky freshwater activities, safe water practices, sanitation, personal hygiene, prevention, and appropriate healthcare-seeking. Schistosomiasis prevention practices will be assessed using indicators such as frequency and type of freshwater contact, avoidance of high-risk water activities, use of safer water sources, personal hygiene, sanitation practices, and healthcare-seeking following suspected exposure or symptoms. Where feasible, self-reported practices will be complemented by observation of water and sanitation conditions within schools and communities. Descriptive statistics will be used to summarize pupils' sociodemographic characteristics, previous exposure to schistosomiasis information, knowledge levels, freshwater exposure patterns, and prevention-practice scores. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and multiple regression analysis, will be used to determine the impact of schistosomiasis education on prevention practices. Where appropriate, prevention practices before and after the intervention will be compared. Diagnostic tests will also be conducted to assess the reliability of the research instruments, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that schistosomiasis education has a significant positive impact on schistosomiasis prevention practices among school children in rural Nigeria. Children exposed to structured schistosomiasis education are expected to demonstrate improved knowledge of transmission routes, symptoms, health consequences, risky freshwater activities, and available preventive measures. Education may encourage children to reduce unnecessary contact with potentially contaminated freshwater, adopt safer water and hygiene practices, improve sanitation behaviour, and seek appropriate healthcare when symptoms or suspected exposure occur. Practical demonstrations, school health clubs, peer education, and repeated health messages are expected to strengthen children's ability to apply prevention knowledge in their daily lives. However, education alone may not eliminate exposure because children in rural communities may depend on freshwater bodies for domestic activities, bathing, swimming, fishing, farming, and other essential needs. Limited access to safe water, inadequate sanitation facilities, poverty, and environmental conditions may also constrain the adoption of recommended practices. Consequently, schistosomiasis education is expected to be most effective when supported by safe water infrastructure, improved sanitation, appropriate disease-control programmes, school health services, community participation, and accessible healthcare. The study is expected to contribute to the literature on schistosomiasis prevention, neglected tropical diseases, school health, child health education, water-related diseases, environmental health, community health, epidemiology, and public health in Nigeria by providing empirical evidence on the impact of schistosomiasis education on prevention practices among school children in rural communities. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Nigeria Centre for Disease Control and Prevention, Federal Ministry of Education, state ministries of health and education, National Primary Health Care Development Agency, schools, local government health authorities, community health workers, neglected tropical disease programmes, development partners, and policymakers regarding strategies for strengthening schistosomiasis prevention among school-aged children. The study will also provide evidence-based recommendations for integrating schistosomiasis education into school health programmes, strengthening practical water-safety and hygiene education, improving access to safe water and sanitation, promoting community participation in disease-control activities, strengthening early detection and treatment, and reducing freshwater-related exposure to schistosomiasis among school children in rural Nigeria.

Keywords: Schistosomiasis education, schistosomiasis prevention practices, school children, rural Nigeria, schistosomiasis prevention, neglected tropical diseases, freshwater exposure, school health, water-related diseases, health education, environmental health, hygiene practices, sanitation, epidemiology, public health.