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BMC Public Health. 2016 Apr 14;16:322. doi: 10.1186/s12889-016-2976-2.

A mixed-methods approach to understanding water use and water infrastructure in a schistosomiasis-endemic community: case study of Asamama, Ghana.

Author information

1
Department of Community Health, Tufts University, 574 Boston Avenue, Medford, Massachusetts, 02155, USA. karen.kosinski@tufts.edu.
2
Department of Civil and Environmental Engineering, Tufts University, Medford, Massachusetts, 02155, USA.
3
, Annapolis, Maryland, 21401, USA.
4
, P.O. Box 399, Teshie-Accra, Ghana.
5
, Springfield, Massachusetts, 01129, USA.
6
Mayo Medical School, Rochester, Minnesota, 55905, USA.
7
Department of Global Health, University of Washington, Seattle, Washington, 98112, USA.
8
, Somerville, Massachusetts, 02155, USA.
9
Department of Community Health, Tufts University, 574 Boston Avenue, Medford, Massachusetts, 02155, USA.

Abstract

BACKGROUND:

Surface water contaminated with human waste may transmit urogenital schistosomiasis (UGS). Water-related activities that allow skin exposure place people at risk, but public health practitioners know little about why some communities with access to improved water infrastructure have substantial surface water contact with infectious water bodies. Community-based mixed-methods research can provide critical information about water use and water infrastructure improvements.

METHODS:

Our mixed-methods study assessed the context of water use in a rural community endemic for schistosomiasis.

RESULTS:

Eighty-seven (35.2 %) households reported using river water but not borehole water; 26 (10.5 %) reported using borehole water but not river water; and 133 (53.8 %) households reported using both water sources. All households are within 1 km of borehole wells, but tested water quality was poor in most wells. Schistosomiasis is perceived by study households (89.3 %) to be a widespread problem in the community, but perceived schistosomiasis risk fails to deter households from river water usage. Hematuria prevalence among schoolchildren does not differ by household water use preference. Focus group data provides context for water preferences. Demand for improvements to water infrastructure was a persistent theme; however, roles and responsibilities with respect to addressing community water and health concerns are ill-defined.

CONCLUSIONS:

Collectively, our study illustrates how complex attitudes towards water resources can affect which methods will be appropriate to address schistosomiasis.

KEYWORDS:

Borehole; Improved water source; Mixed-methods; River; Schistosoma haematobium; Surface water; Urogenital schistosomiasis; Water infrastructure

PMID:
27076042
PMCID:
PMC4831178
DOI:
10.1186/s12889-016-2976-2
[Indexed for MEDLINE]
Free PMC Article

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