Table 2. Selected behaviour change interventions for schistosomiasis control according to intervention model.
Reference | Place | Setting | Time | Direct beneficiaries | Species | Behaviours targeted | Theory / Framework | Intervention components | Education materials | Community engagement |
---|---|---|---|---|---|---|---|---|---|---|
HEALTH EDUCATION INTERVENTIONS | ||||||||||
Chaula & Tarimo, 2014 [45] | Tanzania | Rural: Schools | 2011–2012 a | Schoolchildren (8–19) | S. haematobium | - Exposure - Treatment uptake |
Not reported (N.R.) | - Health education: Advocacy campaigns alongside two successive MDA campaigns. - Treatment: MDA with praziquantel |
N.R. | No |
Cline & Hewlett, 1996 [46] | Cameroon | Rural: villages | 1991–1993 a | Schoolchildren a | S. haematobium | - Exposure - Transmission - Treatment seeking |
N.R. | - Health education: - Training for elementary school teachers and health centre staff. - Health centres developed education plans. - Private and public school, Koranic schools and community groups supported education activities. - Classroom-based education with sensitisation materials twice per year (‘season of transmission’ and ‘season of symptoms’). - Drawing and writing competitions, with prizes. - Supervision by health centre staff and district chief of preventive medicine. - Treatment: - School-based diagnostic tests and tests-and-treatment services in primary care at a cost (0.25$ and 1.50$, respectively). - Snail control: Molluscicides in two intervention villages. |
- lip-chartsb - Postersb - Brochuresb |
Community organisations supported dissemination of health messages. |
Ejike et al., 2017 [47] | Nigeria | Rural: Schools | Jul–Aug 2014 | Schoolchildren (5–19) | S. haematobium | - Exposure | N.R. | - Health education: Play with educational board game daily at school breaks for 2 months. | - Board game | No |
Ejike et al., 2021 [48] | Nigeria | Rural: schools | Oct 2018-Mar 2019 | Schoolchildren (5–19) | S. haematobium | - Exposure - Transmission - Treatment uptake |
N.R. | - Health education: Playing with board game daily during school breaks, over 6 months. - Treatment: MDA with praziquantel |
- Board game | No |
Favre et al., 2021 [49] | Brazil | Urban and Rural: schools | Ag 2013 –Dec 2015 | Schoolchildren (10–15) | S. mansoni | - Exposure - Treatment uptake |
N.R. | - Health education: - 5-day training for schoolteachers with 6-month refresher session. - Twice a week lectures for schoolchildren over 3 months. - Thematic fairs (e.g., song, plays, games). - PC treatment: Targeted treatment with praziquantel |
- Animated video c - Video-documentary c - Snail samples. |
No |
Garba et al, 2001 [50] | Niger | Rural: villages and schools | 1991–1996 | General population | S. haematobium | - Exposure | N.R. | - Health education—Community: - Informative video shown in villages (up to 5 times). - Community discussions led by local health and sanitation technicians using flipcharts. - Health education—Schools: - Projection of 26m informative video in local dialect. - Distribution of informative materials and schoolbooks. |
- Educational videob - Posters and flipchartsb - School booksb |
No |
Guang-Han et al., 2005 [51] | China | Rural: schools and villages | 1992–1994 (2 villages) 1994–1996 (4 villages) a |
Schoolchildren (6–15) and adults (16–60) | S. japonicum | - Exposure - Treatment uptake |
N.R. | - Health education: - Health information through videos and exhibitions of schistosomes and snails. - Informative sessions with separate tailored messages for men, women, and children. - Teachers praised pupils’ good behaviour and penalised incorrect practices. - Public information: Warning boards near high-transmission areas. - Treatment: MDA with praziquantel. |
- Videob - Schistosome and snail exhibition - Warning boardsb |
No |
Hong et al., 2011 [52] | China | Rural: communities | 2005–2008 a | Schoolchildren (6–15) and adults (16–60) | S. japonicum | - Exposure - Treatment uptake |
N.R. | - Health education: Health information through videos, cartoons, and booklets thrice a year over three years. - Infrastructure: Lavatories and tap water for all households. Public toilets built at landing sites. - Equipment: Containers for collection of faeces for fish folk. - Snail control: Twice a year surveys, with molluscicide treatment. - Treatment (humans): Targeted treatment with praziquantel. - Treatment (livestock): Annual targeted treatment of livestock. |
- Cartoons b - Videos b - Comic-style booklets b |
No |
Jia-Gang et al., 2005 [53] | China | Rural: villages | Feb. 1999 –Feb. 2000 | Children and adults (6–60) | S. japonicum | - Treatment seeking | N.R. | - Health education: - Health information through videos and exhibitions of schistosome and snail samples. - Training on symptoms, prevention, and importance of early treatment with men, women, and children. - Treatment: MDAs with praziquantel for control group and self-referral for intervention group. |
- Video b - Schistosome and snail exhibition |
No |
Lansdown et al., 2002 [54] | Tanzania | Rural: schools | Mar 1998 –Feb 1999 | Schoolchildren (7–15) | S. mansoni and. haematobium | - Exposure - Transmission |
N.R. | Health education:- Briefing to community leaders. - 4-day workshop for teachers on active teaching, parasitology, and prevention. - Classroom-based teaching on water use, prevention and sanitation. Locally developed materials: songs, poems, pictures and plays. |
- Message boards b - Illustrations b |
- No |
N’Diaye et al., 2016 [55] | Senegal | Rural: villages | 2008–2015a | Children (0–14) | S. mansoni and haematobium | - Exposure - Transmission |
N.R. | Health education:- Village meetings with video and card games and snail samples organised by civil and religious authorities alongside MDA campaigns. - Sensitisation focus on mothers with small children.Treatment: MDAs with praziquantel during 2009–14, targeted treatment in 2015 and for pre-SAC (0–5) in 2014.Infrastructure: Pit latrines, one per ten residents built over 6 years. |
- Card games illustrating life cycle b - Video b - Snail samples |
- Villagers’ input for latrine design. - Villagers helped building latrines. |
Nagi et al. 2005 [56] | Yemen | Rural: village and school | Sep 1999 –Dec 2001 | General population | S. haematobium | - Exposure - Treatment uptake |
N.R. | Health education:- 2-day training sessions for teachers. - Trained teachers led weekly educational sessions at school. - Weekly sessions for non-enrolled children and pre-school children with their parents. - Educational sessions during khat sessions and Friday prayers. - Treatment: MDA with praziquantel. |
- Posters b | No |
Oyeyemi et al., 2018 [57] | Nigeria | Rural: communities | Jan 2016 | General population | S. haematobium | - Exposure | N.R. | - Health education: Disease information provided during urine sample collection. Infrastructure: Community borehole (post-sample collection). Treatment: Targeted treatment with praziquantel. |
N.R. | No |
Stothard et al., 2016 [58] | Tanzania | Urban and rural: schools | Dec 2005 –Jan 2007 | Schoolchildren (Primary—Class V) | S. haematobium | - Exposure. - Transmission |
N.R. | - Health education: - 30-minute talk by health educator prior distribution of comic strip. - Comic book integrated into the health curricula over a year. |
Juma na kichocho comic strip [59] | No |
Wang et al., 2013 [60] | China | Rural: villages | April to June 2009 | Adults | S. japonicum | - Exposure - Transmission - Treatment uptake |
N.R. | - Health education: - Class-based sessions with posters, display boards, and a video. - Reinforcement sessions with prize-winning quizzes. - Distribution of small goods with printed information to residents. - Treatment: Targeted treatment with praziquantel. |
- Display boards [60] - Video b - Pamphlets b - Utensils: towels, bags, containers [60] |
No. |
Wolmarans & de Knock, 2009 [61] | South Africa | Rural: schools | Jan 2004—Dec 2006. | Schoolchildren (4–14) | S. haematobium | - Exposure | N.R. | - Health education: Puppet show delivered over a 2-year period. - Treatment: Targeted treatment with praziquantel. |
- Puppet show b | No. |
Yuan et al., 2000 [62] | China | Rural: schools | July 1996 | Schoolchildren (4th grade) | S. japonicum | - Exposure | N.R. | - Health education: - 15-minute animation video presented in class - 10-minute discussion with local NTD control staff. - Distribution of educational comic to pupils. |
- Animated video b - Comic book b |
No. |
SOCIAL ENVIRONMENTAL INTERVENTIONS | ||||||||||
Nsowah-Nuamah et al. 2001 [63] | Ghana | Rural: villages | Ap. 1994- May 1997 | General population | S. haematobium | - Exposure - Transmission |
N.R. | - Health education—Passive: - Video shown in the community (once). - Briefing to local leaders with posters and flipcharts. - Educational sessions led by teachers, village, and religious leaders during regular meeting times of their organisations. - Health education—Active: - Informative video shows once a month, per 18 months. - In-depth training for community volunteers. - Trained volunteers visited parents of SAC twice a week for 18 months to educate on the disease and control measures. - Spelling and quiz competitions. c. Community organisation—Active: - Community meetings to plan activities. - Committees for safe water, latrine building and environmental management. d. Infrastructure: - Financial and technical assistance for construction of safe water supply and pit latrines as well as weed removal. - Assistance available to all communities upon request to local public development agencies. e. Treatment: MDA with praziquantel |
- Posters - Flipcharts - Videos |
- Village committees organised. - Labour for infrastructure. - Provision of local building materials (e.g., sand). |
Hurlimann et al., 2018 [64] | Cote D’Ivoire | Rural: communities | Aug. 2011—Aug. 2012 | General population | S. mansoni and haematobium | - Transmission | Community-led total sanitation (CLTS) [65] | - Planning: - Workshop with local leaders on the intervention to foster buy-in. - Local health authorities, town-hall officials, health and demographic surveillance officers and other stakeholders trained on CLTS. - Village meetings with participatory assessment of sanitation conditions and mapping of faecal contamination (trigger disgust). - Villagers design and agree on plans to become open-defaecation free (ODF). - Public event to present action plans. - Technical assistance: Trained facilitators assisted and monitored latrine building. - Infrastructure: Latrine building. - Health education: - Participatory exercises assessed knowledge and education needs. - Meetings to discuss and inform about the disease and risk practices. - Treatment: MDA with albendazole, praziquantel and ivermectin. |
- Booklets b - Posters b - Pictures b |
- Examination and mapping of open defaecation problems. - Outline of prevention measures and timelines. - Assessment of education needs and plans for education activities. - Labour for latrine building. - Local leaders led implementation. |
Madon et al., 2018 [66] | Tanzania | Rural: communities | Nov. 2015 –Ap. 2016 | General population | S. mansoni and haematobium | - Transmission | Enhanced Development Governance (ad-hoc framework) | - Organisational support: Expanded membership to social services committees (SSCs), incorporating village council members, health workers, community bank, youth & religious groups, teachers, and drug distributors. - Financial support: Start-up funds and training for income-generating activities and NTD / sanitation initiatives: cleaning schools, clearing garbage, building wells and latrines. - Health education: - NTD-WASH education through lectures and discussions. - Health education sessions held in individual households and public spaces. - Technical support: Training on design and management of NTD projects. |
N.R. | - Village council members identified new SSC members. - SSCs organised monthly village clean-up operations. - SSCs agreed on penalties to ensure compliance with sanitation standards. |
Mwanga et al., 2013 [67] | Tanzania | Rural: communities d | 2008 a | General population | S. mansoni | - Exposure. - Treatment seeking |
Participatory Hygiene and Sanitation Transformation (PHAST) [68,69] | - Health education: Trained community facilitators organised meetings with up to 24 adults to discuss risk practices and transmission in the community. - Planning: Villagers outlined community objectives, plans of action, goals, and monitoring activities. - Treatment: MDA with praziquantel. |
N.R. | - Participatory diagnosis - Participatory planning - Participatory monitoring and evaluation e |
Mwanga et al., 2015 [70] | Tanzania | Rural: communities d | 2009a | General population | S. mansoni | - Exposure. | Participatory Hygiene and Sanitation Transformation (PHAST) [68,69] | - Health education: Village meetings discussed risk practices and transmission in the community context. - Planning: Villagers outlined community objectives and plans of action. - Treatment: MDA with praziquantel and Albendazole. - Infrastructure: Pumped well. |
N.R. | - Participatory diagnosis - Participatory planning - Participatory monitoring and evaluation e |
Person et al., 2021 [71] Knopp et al., 2019 [72] |
Tanzania | Rural and Urban: schools | 2011–2017a | Children (9–12) | S. haematobium | - Exposure - Transmission - Treatment uptake |
Human-Centred Design [73] | - Health education: - Classroom based teaching with interactive materials and activities. - Public ‘Kichocho day’ events including dramas, poems, and safe games with participation of the general population. - Village meetings with educational films. - Infrastructure: Urinals and washing platforms built following residents’ inputs. - Treatment: Biannual MDAs with praziquantel. |
- lipchart with pictures of transmission sites, snails, risk activities, and treatment b - Blood fluke pictures b - Snail boards b - Drawings of lifecycle b |
- Teachers co-designed education materials, games, and plays. - Residents selected and co-designed BC strategies. - Residents co-designed and built urinals and washing platforms. |
Rassi et al., 2019 [74] | Mozambique | Rural and Urban: communities | Aug. 2014—Sep 2015, | General population | S. haematobium | - Exposure - Transmission - Treatment uptake. |
Community Dialogue Approach(75) | - Health education: - Training for volunteers on the disease, prevention, and facilitation. - Volunteers led community meetings (n = 1,500). - Meetings informed on causes, transmission, and prevention. - Planning: Residents proposed and agreed on locally-led control measures, including commitments to treatment uptake, exposure reduction, and sanitation initiatives. - Treatment: MDA with praziquantel |
- lipchart illustrating intervention b | - Local volunteers organised community dialogue events. - Participatory design of solutions and measures to promote control activities. |
PHYSICAL ENVIRONMENTAL INTERVENTIONS | ||||||||||
El Kholy et al., 1989 [76] | Kenya | Rural: villages | 1984–1985 | General population | S. haematobium | - Exposure | N.R. | a. Infrastructure: Boreholes built, b. Treatment: MDA with praziquantel for SAC |
Not Applicable (N.A.) | N.R. |
Freeman et al., 2013 [77] | Kenya | Schools f | May 2007—Nov. 2008 | Schoolchildren (7–13). | S. mansoni | - Exposure - Transmission: latrine use. |
N.R. | - Training: One parent and one teacher per school trained on health, hygiene, and maintenance of infrastructure. - Infrastructure: Latrines built according to school size (4–7 / school). - Equipment: Provision of hand washing and drinking water containers. - Technical support: One-year supply of point-of-use water treatment product. - Treatment: MDA with Albendazole and targeted treatment with praziquantel. |
N.R. | No. |
Kosinski, et al., 2016 [78] | Ghana | Rural: communities | Jun. 2008-Ag. 2010 | Schoolchildren (8–22) | S. haematobium | - Exposure: water-contact. | N.R. |
- Infrastructure: 30 m2 concrete pool fed by rainwater and pumped groundwater. - Treatment: MDA with praziquantel. |
N.A. | No |
Noda et al., 1997 [79] | Kenya | Rural: village | Feb. 1984 | General population | S. haematobium | - Exposure: water-contact. | N.R. | - Infrastructure: - One free of charge shower unit with five rooms - Five community standpipes installed, payment per bucket |
N.A. | - Water committees maintained infrastructure. |
Wepne et al., 2019 [80] | Cameroon | Rural: village | 2014–2017a | Adults: pregnant women | S. haematobium | - Exposure: water-contact. | N.R. | - Infrastructure: Installed community piped water, immediate payment upon use. | N.A. | No |
INCENTIVES CENTRED INTERVENTIONS | ||||||||||
Fink & Rockers, 2017 [81] | Zambia | Urban and Rural: communities | July 2011 | Early school aged children (6–7) | N. R. | - Treatment seeking / uptake: bring children to health centre. | Conditional cash transfer | - Financial support: Offers of cash payments if children brought to a health centre for check-up within 7 days. | N.A. | No |
Muhumuza et al., 2014 [82] | Uganda | Rural: schools | May–July 2013 | Schoolchildren (7–16) | S. mansoni | - Treatment seeking / uptake: MDA uptake. | N. R. | - Health education: 30-minute classes by trained teachers for two months to control and intervention groups. - Pre-treatment snacks: mango juice and doughnuts given prior drug distribution. - Treatment: MDA with praziquantel. |
N.R. | No |
a. No further details provided
b. Source material not referenced or reproduced
c. Videos available online: animated video, video-documentary
d. Study sites in different regions for publications by the same author
e. Items obtained from framework guidelines
f. Rurality not reported