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Indian Journal of Community Medicine

Awareness and Practices Regarding Factors Associated with Lymphatic Filariasis in a Municipal Area of North Kerala

Author(s): M. Jayakumary, S. Jayadevan, B. Divakaran, C.H. Jeesha, S. Dass

Vol. 31, No. 2 (2006-04 - 2006-06)

Introduction

Filariasis is a disease with serious economic and social consequences as it affects many young working adults of both sexes1. The chronic manifestation in the form of lymphoedema and elephantiasis, could inflict grave social wounds upon the persons affected. Slum dwellers with inadequate housing and no basic sanitation are at the highest risk of infection with W. bancrofti transmitted by C. quinquefasciates, and it is the rural poor who are affected by filariasis transmitted by other species2. People's knowledge about mode of spread and prevention is very important for the effective control of this disease. The aim of the present study was to assess the knowledge, attitude and practice regarding various risk factors related to lymphatic filariasis in the area.

Methodology

This population-based cross sectional study was conducted in Taliparamba Municipal area, which is endemic for bancroftian filariasis. The period of study was from October 2000 to March 2001. All individuals present in the houses at the time of visit were included except those whose age was either less than 10 years or more than 80 years. This study was conducted with the help of enumerators selected from the respective wards. They visited each house and collected data regarding the socio-economic status, family particulars and detail of the mode of spread, activity of National Filarial Control Programme (NFCP) unit, prevalent practices against mosquito bite etc.

Results

A total of 7596 persons participated in the study, out of which 38% were males and 62% were females. The maximum number of females (1058/4679) were seen in the age group of 30 - 39 years. Maximum number of males (548/2917) were in the age group of 40 - 49 years. Population above 70 years of age accounted for only 7% of the studied population. The religion and gender wise distribution showed that more than 68% males and 70% females were Hindus. Christian population formed only 4%. Illiterate persons were less than 1% in the present study. Nearly 5% of both males and females studied upto postgraduate or professional level (Table I).

Table - I: Education and Gender distribution

Education Male Female Total
No. % No. % No. %
Illiterate 9 0.30 6 0.14 15 0.20
Primary 600 20.57 972 20.77 1572 20.70
Secondary 375 12.86 550 11.75 925 12.18
High School 1289 44.19 1947 41.61 3236 42.60
Pre- Degree 270 9.26 659 14.08 929 12.23
Degree 225 7.71 342 7.31 567 7.46
Post Graduate 30 1.03 45 0.96 75 0.99
Professional 119 4.08 158 3.38 277 3.65
Total 2917 100.00 4679 100.00 7596 100.00

Of the total population studied, 24% of the persons residing in the area felt that filariasis is a major problem in the area. It was observed that more than 60% of both males and females were aware that the spread of filariasis is due to mosquito bite. About 20% of the people had no idea as to whether mosquitoes will cause the spread of the disease or not (Table - II).

Table II: Knowledge regarding spread of Filariasis according to gender

Gender Spread of filariasis
Yes No Don't know Total
No. % No. % No. %
Male 1770 60.68 476 16.32 671 23.00 2917
Female 3121 66.70 646 13.81 612 19.49 4679

There was a statistically significant association between education and knowledge regarding the spread of disease (p<0.001). Only 40% of the total people interviewed believed that filariasis is preventable. There was a statistically significant association between the literacy level and knowledge regarding prevention of filariasis (p<0.001). It was also observed that 60% of the interviewed population were practicing one or the other preventive measures to protect themselves from mosquito bite. Majority were using mosquito net. People acquired knowledge regarding various aspects related to filariasis from different sources. More than 50% acquired knowledge either from the All India Radio or from TV. Only 13% of the total study group had no information regarding filariasis and the literacy levels of these people were found to have a significant association (p<0.001) with their lack of information. Only 22.2% (1688) of the total study group were aware about the NFCP and its Unit situated in the area. Out of them 17.4% believed that the activity of NFCP Unit was to conduct surveys only and 37% believed that the activities of the NFCP Unit are conducting Night Blood Examination (NBE) only. Only 8% believed that NFCP Unit is responsible for larvicidal spraying in the area at regular interval. 35% of them believed that the responsibility of this unit included more than one activity. The educational status of the people had a significant association (p<0.0001) with their knowledge regarding activities of NFCP.

Discussion

Seventy percent of the study population was Hindu, a fact endorsed in the census (2001). The literacy rate according to census is 92.8% in Kerala, which is also reflected in the present study (99%). Even though the area is endemic for filariasis, only 24% of the people were aware that filariasis is a problem in that area and this shows the lack of knowledge about the diseases prevalent in their area. In the present study, around 65% of the interviewed people knew the fact that the spread of this disease is caused by mosquito bite. Ramaiah et al3 observed that only 20% of the population knew that the spread of the disease is through mosquito bite. In their study, the literacy rate was very low compared to the present study. The present study observed a statistically significant association between the education level, knowledge regarding the spread of this disease and prevention. It was also observed in their study that among those who are not affected by the disease, only 13% believed that filariasis can be prevented and another 50% were uncertain about whether the disease can be prevented or not. In present study, people were more aware about the prevention and spread of the disease. This may be due to the high literacy rate in the area. Study conducted by Lu et al4 also observed that only less than 15% of the people were aware about the role of mosquito in the transmission of filariasis. Study by Muhondwa5 observed the role of literacy of the respondents and their knowledge about filariasis and its transmission. This study also supports the above finding.

In the present study, 60% of the people were using one or the other method as a personal protective measure to prevent mosquito bite and also 60% knew that the spread of the disease is through mosquito bite. This shows that, those who knew about the mode of spread of the disease were using mosquito prevention methods. Use of preventive methods was found to have a significant association (p<0.01) with the literacy level of the people. From the study it was observed that AIR and TV played a vital role in imparting knowledge to the people of the study area. Information given by the Health worker is very minimal and also 13% of the total population interviewed had absolutely no information regarding filariasis. It was interesting to note that only 22.2% of them were aware of the NFCP Unit functioning in the area.

From the study it is concluded that only those who knew about filariasis, its mode of spread and prevention were taking necessary preventive measures: Health education campaigns play a vital role in creating awareness among the general public. More over it is important to look into the community participation, which is the backbone of the success of any programme.

References

  1. Lymphatic Filariasis - The disease and its control. 5th Report of WHO Expert Committee on Filariasis, WHO Technical Report series No. 821, Geneva: WHO, 1992.
  2. Weekly Epidemiological Record, Geneva: WHO, 2002; 16(77): 125-132.
  3. Ramaiah K D, Vijay kumar K, and Ramu K. Knowledge and beliefs about transmission, prevention and control of lymphatic filariasis in rural areas of South India. Tropical Medicine and International Health 1996; 4: 433-438.
  4. Lu A G, Valencia L B, Llagas L. Filariasis - A study of knowledge, attitude and practices of the people of Sorsgon. Social and Economic Research Project Report, WHO Geneva 1988.
  5. Muhondwa EPY. Community participation in filariasis control: The Tanzania Experiment, TDR/SER/SWG(4)/WP, WHO, Geneva, 1983.

Deptt. of Community Medicine,
Maulana Azad Medical College, New Delhi.
e-mail: [email protected]
Received: 17.11.2004

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