Modification of behaviour and attitude in the control of schistosomiasis. 1. Observations on water-contact patterns and perception of infection.

Observations on the water-contact patterns of 2136 residents of Admin community in Nigeria were conducted at four streams between February 1993 and January 1994. Urine samples collected from those observed were used to estimate the prevalence and intensity of Schistosoma haematobium infection. A questionnaire was also completed for each of the subjects, to test their perception of urinary schistosomiasis and its transmission. Infection was detected in 1076 (50.4%) of the subjects, with peak prevalence among those aged 10-14 years. Intensity of infection was more closely correlated with the number of water contacts (r = 0.97) than with the total duration of the exposure (r = 0.77), emphasising the importance of specific/multiple activities, and of the surface area of the body submerged, in transmission. One stream (Culvet) was identified as the main transmission point, with bathing/swimming and fishing as the main activities predisposing people to infection. The awareness of urinary schistosomiasis and its symptom (blood in urine) were high but specific knowledge about the parasite, its vector and the interaction between the parasite and vector in the parasite's life-cycle were extremely low. Activities that require behaviour and attitude modification have been identified and encouraged as components in the control of schistosome-attributable morbidity (in the absence of pipe-borne water).