Hostname: page-component-848d4c4894-x24gv Total loading time: 0 Render date: 2024-06-12T01:14:00.140Z Has data issue: false hasContentIssue false

‘WE CAN’T GET WORMS FROM COW DUNG’: REPORTED KNOWLEDGE OF PARASITISM AMONG PASTORALIST YOUTH ATTENDING SECONDARY SCHOOL IN THE NGORONGORO CONSERVATION AREA, TANZANIA

Published online by Cambridge University Press:  09 October 2015

Rita Isabel Henderson*
Affiliation:
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
Jennifer Hatfield
Affiliation:
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
Susan Kutz
Affiliation:
Department of Ecosystem Public Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, Canada
Saningo Olemshumba
Affiliation:
Endulen Hospital, Ngorongoro Conservation Area, Tanzania
Frank Van Der Meer
Affiliation:
Department of Ecosystem Public Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, Canada
Mange Manyama
Affiliation:
Department of Anatomy, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
Sheri Bastien
Affiliation:
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
*
1Corresponding author. Email: rihender@ucalgary.ca

Summary

Records at the Endulen Hospital in the Ngorongoro Conservation Area (NCA), Tanzania, reveal that soil-transmitted helminth infections and protozoa are consistently in the top ten diagnoses for Maasai pastoralists, indicating a significant public health concern. Nevertheless, Maasai pastoralist adaptations to life in close proximity to livestock and to unreliable access to water raise important questions about experiences of, and resiliency to, parasitic infections. Though these infections are particularly prevalent among youth in low- and middle-income countries (LMIC), a focus on resiliency highlights local capacity to recover from and prevent illness. For instance, how is human parasitism perceived and experienced among communities displaying behaviours that studies have associated with transmission of diarrhoeal diseases, such as open defecation? Among these communities, how is parasitism seen to impact the health and development of children? And, what resources are available to endure or mitigate this heavy disease burden among affected communities? This study draws on formative research carried out in May 2014 in anticipation of an innovative school-based and youth-driven water, sanitation and hygiene education intervention rolled out in two boarding schools in the NCA in subsequent months. The initiative is grounded in a One Health approach to health promotion, drawing on partnerships in medicine, public health and veterinary medicine to appreciate the unique interactions between humans, animals and the environment that shape well-being among pastoralist communities. Qualitative data generated through group discussions with secondary school youth (n=60), Maasai teachers (n=6) and a women’s group (n=8) in the NCA convey existing knowledge of the prevalence, prevention and treatment of human parasitism. An underlying principle of the larger initiative is to engage youth as creative agents of change in developing and sustaining locally relevant health promotion strategies. Findings highlight practical knowledge around certain ‘neglected tropical diseases’, namely helminths, among pastoralist communities in the NCA, in turn feeding into the development of the science fair and related interventions.

Type
Research Article
Copyright
Copyright © Cambridge University Press, 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Allen, T. & Parker, M. (2011) The ‘Other Diseases’ of the Millennium Development Goals: rhetoric and reality of free drug distribution to cure the poor’s parasites. Third World Quarterly 32(1), 91117.Google Scholar
Asaolu, S. O. & Ofoezie, I. E. (2003) The role of health education and sanitation in the control of helminth infections. Acta Tropica 86, 283294.Google Scholar
Bastion, S., Herthington, E., Hatfield, J., Kutz, S. & Manama, M. (in press) Youth driven innovation in sanitation solutions for Maasai pastoralists in Tanzania: conceptual framework and project design. Global Journal for Health Education and Promotion.Google Scholar
Baum, F., MacDougall, C. & Smith, D. (2006) Participatory action research. Journal of Epidemiology & Community Health 60(10), 854857.Google Scholar
Bethony, J., Brooker, S., Albonico, M., Geiger, S., Loukas, A., Diemert, D. & Hotez, P. (2006) Soil-transmitted helminth infections: ascariasis, trichuriasis, and hookworm. Lancet 367, 15211532.Google Scholar
Bushe, G. & Kassam, A. (2005) When is appreciative inquiry transformational? Journal of Applied Behavioral Science 41(2), 161181.CrossRefGoogle Scholar
Bussmann, R. W., Gilbreath, G. G., Solio, J., Lutura, M., Lutuluo, R., Kunguru, K. & Mathenge, S. G. (2006) Plant use of the Maasai of Sekenani Valley, Maasai Mara, Kenya. Journal of Ethnobiology and Ethnomedicine 2(22), doi: 10.1186/1746-4269-2-22.Google Scholar
Fade, S. (2004) Using interpretative phenomenological analysis for public health nutrition and dietetic research: a practical guide. Proceedings of the Nutrition Society 63, 647653.Google Scholar
Feasey, N., Wansbrough-Jones, M., Mabey, D. C. W. & Solomon, A. W. (2010) Neglected tropical diseases. British Medical Bulletin 93, 179200.Google Scholar
Fereday, J. & Muir-Cochrane, E. (2006) Demonstrating rigor using thematic analysis: a hybrid approach of inductive and deductive coding and theme development. International Journal of Qualitative Methods 5(1), Article 7.Google Scholar
Freeman, M. C., Greene, L. E., Dreibelbis, R., Saboori, S., Muga, R., Brumback, B. & Rheingans, R. (2012) Assessing the impact of a school-based water treatment, hygiene and sanitation programme on pupil absence in Nyanza Province, Kenya: a cluster-randomized trial. Tropical Medicine and International Health 17(3), 380391.Google Scholar
Freeman, M. C., Clasen, T., Brooker, S. J., Akoko, D. O. & Rheingans, R. (2013a) The impact of a school-based hygiene, water quality and sanitation intervention on soil-transmitted helminth reinfection: a cluster-randomized trial. American Journal of Tropical and Medical Hygiene 89, 875883.CrossRefGoogle ScholarPubMed
Freeman, M. C., Clasen, T., Dreibelbis, R., Saboori, S., Greene, L. E., Brumback, B. et al. (2013b) The impact of a school-based water supply and treatment, hygiene and sanitation programme on pupil diarrhea: a cluster-randomized trial. Epidemiological Infection, May 24th, pp. 1–12, epub ahead of print.Google Scholar
Geerts, S. & Gryseels, B. (2000) Drug resistance in human helminths: current situation and lessons from livestock. Clinical Microbiology Review 13, 207222.Google Scholar
Grigorenko, E. L., Sternberg, R. J., Jukes, M., Alcock, K., Lambo, J., Ngorosho, D. et al. (2006) Effects of antiparasitic treatment on dynamically and statically tested cognitive skills over time. Journal of Applied Developmental Psychology 27, 499526.CrossRefGoogle Scholar
Hinchliffe, S. (2015) More than one world, more than one health: re-configuring interspecies health. Social Science & Medicine 129, 2835.Google Scholar
Jia, T-W., Melville, S., Utzinger, J., King, C. & Zhou, X-N. (2012) Soil-transmitted helminth reinfection after drug treatment: a systematic review and meta-analysis. PLoS Neglected Tropical Diseases 6(5), e1621.Google Scholar
Miguel, E. & Kremer, M. (2004) Worms: identifying impacts on education and health in the presence of treatment externalities. Econometrica 72(1), 159217.Google Scholar
Mills, A. & Milewski, A. (2007) Geophagy and nutrient supplementation in the Ngorongoro Conservation Area, Tanzania, with particular reference to selenium, cobalt and molybdenum. Journal of Zoology 271(1), 110118.Google Scholar
Mireku, M., Boivin, M., Davidson, L., Ouédraogo, S., Koura, G., Alao, M. et al. (2015) Impact of helminth infection during pregnancy on cognitive and motor functions of one-year-old children. PLoS Neglected Tropical Diseases 9(3), e0003463.Google Scholar
Molyneux, D. & Malecela, M. (2011) Neglected Tropical Diseases and the Millennium Development Goals – why the ‘other diseases’ matter: reality versus rhetoric. Parasites & Vectors 4, 234.Google Scholar
Morse, J. M. & Field, P. A. (1995) Qualitative Research Methods for Health Professionals. Sage, Thousand Oaks, CA.Google Scholar
Nyanza, E., Premji, J. & Mannion, T. (2014) Geophagy practices and the content of chemical elements in the soil eaten by pregnant women in artisanal and small scale gold mining communities in Tanzania. BMC Pregnancy Childbirth 14, 144.Google Scholar
Olsen, A., Samuelsen, H. & Onyango-Ouma, W. (2001) A study of risk factors for intestinal helminth infections using epidemiological and anthropological approaches. Journal of Biosocial Science 33(4), 569584.Google Scholar
Parker, M. & Allen, T. (2014) De-politicizing parasites: reflections on attempts to control the control of neglected tropical diseases. Medical Anthropology 33(3), 223239.Google Scholar
Patil, S., Arnold, B., Salvatore, A., Briceno, B., Ganguly, S., Colford, J. Jr & Gertler, P. (2014) The effect of India’s Total Sanitation Campaign on defecation behaviors and child health in rural Madhya Pradesh: a cluster randomized controlled trial. PLoS Medicine 11(8), e1001709.Google Scholar
Prendergrast, A. J. & Humphrey, J. H. (2014) The stunting syndrome in developing countries. Annals of Tropical Paediatrics 34(4), 250265.Google Scholar
Pullan, R., Smith, J., Jasrasaria, R. & Brooker, S. (2014) Global numbers of infection and disease burden of soil transmitted helminth infections in 2010. Parasites & Vectors 7, 37.Google Scholar
Reperant, L., Cornaglia, G. & Ostserhaus, A. (2013) The importance of understanding the human–animal interface. In Mackenzie, J., Jeggo, M., Daszak, P. & Richt, J. (eds) One Health: The Human–Animal–Environment Interfaces in Emerging Infectious Diseases. The Concept and Examples of a One Health Approach. Current Topics in Microbiology and Immunology Series Vol. 365. Springer, Berlin, pp. 4982.Google Scholar
Sakti, H., Nokes, C., Hertanto, W. S., Hall, A., Bundy, D. A. P. & Satoto (1999) Evidence for an association between hookworm infection and cognitive function in Indonesian school children. Tropical Medicine & International Health 4, 322334.Google Scholar
Smith, J., Taylor, E. M. & Kingsley, P. (2015) One World-One Health and neglected zoonotic disease: elimination, emergence and emergency in Uganda. Social Science & Medicine 129, 1219.Google Scholar
Taylor-Robinson, D., Maayan, N., Soares-Weiser, K., Donegan, S. & Garner, P. (2012) Deworming drugs for soil-transmitted intestinal worms in children: effects on nutritional indicators, haemoglobin and school performance. Cochrane Database of Systematic Reviews 11, CD000371.Google Scholar
Vercruysse, J., Albonico, M., Behnke, J. M., Kotze, A. C., Prichard, R. K., McCarthy, J. et al. (2011) Is anthelmintic resistance a concern for the control of human soil-transmitted helminths? International Journal for Parasitology: Drugs and Drug Resistance 1, 1427.Google ScholarPubMed
WHO (2006) Preventive Chemotherapy in Human Helminthiasis: Coordinated Use of Anthelminthic Drugs in Control Interventions: A Manual for Health Professionals and Programme Managers. World Health Organization, Geneva.Google Scholar
Ziegelbauer, K., Speich, B., Mausezahl, D., Bos, R., Keiser, J. & Utzinger, J. (2012) Effect of sanitation on soil-transmitted helminth infection: systematic review and meta-analysis. PLoS Medicine 9(1), doi: 10.1371/journal.pmed.1001162.CrossRefGoogle ScholarPubMed
Zinsstag, J. (2012) Convergence of ecohealth and One Health. Ecohealth 1(9), 371373.Google Scholar