Impact of School Based Health Education on Knowledge, Attitude and Practice of Grade Three Primary School Children in Zimbabwe

Objective: Grade three children (9-10 years) are recommended as the optimal study population for assessing community prevalence of schistosomiasis and soil transmitted helminthiasis (STHs).However their knowledge, attitudes and practices (KAP) of these children in relation to schistosomiasis, and malaria is not known. Methods: Using multistage sampling, grade 3 children (n=172) were randomly selected from four primary schools in Shamva and Mutare districts in Zimbabwe. And were interviewed using a pre-tested interviewer administered questionnaire. The urine filtration technique was used to determine S. haematobium infection status. Infection with S. mansoni and STHs was determined using a combination of results from the Kato Katz and formol ether concentration techniques. P. falciparum was diagnosed by examination of Giemsa stained thick blood smears. Results: The baseline knowledge proportions about the disease causes among the children were schistosomiasis (32.0%), STHs (19.2%) and malaria (4.1%) which increased after intervention to 67.4%, 71.5%, and 55.8%, respectively. Knowledge of school children about prevention measures of the same diseases improved from schistosomiasis (22.1%), STHs (19.2%), and malaria (5.8%), respectively at baseline to schistosomiasis (69.2%), STHs (66.3%) and malaria (59.3%), respectively. Prevalence of S. haematobium, S. mansoni, hookworms and P. falciparum declined from 61.2%, 17.7%, 7.3% and 21.2% at baseline to 15.9%, 3.4%, 4.1%, and 6.8% respectively. Mean infection intensities for S. haematobium and S. mansoni decreased by 94.8% and 96.6% respectively. Conclusion: School based health education improves knowledge of children about disease transmission and control measures. However lack of enabling amenities such as soap, safe and clean water, ITNs in schools and the involvement of the community are yawning gaps that deserve urgent filling.