The Application of Health Education and Health Promotion In Consolidation of Schistosomiasis Transmission Interrupted Period In Lake Area, China

Abstract Background: In China, 387 counties had reached the criteria of schistosomiasis transmission interruption by the end of 2018, including 26 counties in Jiangxi province. In recent years, however, the intermediate host - Oncomelania hupensis and schistosomiasis cases, as well as schistosome-infected snails, re-occurred or re-emerged in 9 transmission-interrupted counties, in Jiangxi Province. Surveillance on intermediate host and disease is the main strategy of schistosomiasis control in areas where the schistosomiasis transmission interrupted in China. Mobilizing residents to discover and report snails is a good method for improving snail surveillance. However, lack of awareness and passive behavior towards schistosomiasis control of residents is the main reason for the re-occurrence and spread of snails in schistosomiasis transmission-interrupted areas in China. The objective of this study was to assess the effect of health education and health promotion model of “information communication + behavior participation + behavior encouragement” to consolidate the achievements in lake area of China, where the transmission of schistosomiasis had been interrupted. Until recent years, there are few reports on the evaluation of the effect of health education and health promotion behavior intervention. The research results of this paper will not only consolidate and develop the existing achievements of schistosomiasis control in the areas where transmission is interrupted, prevent the epidemic from rising and reviving, but also play an important role in the implementation of the national health equity including residents in schistosomiasis endemic areas in the outline of "Healthy China 2030" and the implementation of the commitments of "2030 Agenda for Sustainable Development" of the United Nations.Methods: Two villages, Laoxia as control village and Xubo as experimental village, including its primary schools were located in Anyi County, Jiangxi Province, the typical region of lake and marshland area. The villagers aged 16-60 and pupils aged 8-10 were involved in the research. A model of interventions consisting of health education and promotion, namely, “information communication + behavior participation +behavior encouragement”, was implemented in the experimental village after the baseline survey with no significant difference in knowledge, attitude, belief and practice (KABP) regarding schistosomiasis control was detected before intervention.Results: After intervention, the percentages of villagers owning knowledge, appropriate attitude with regard to schistosomiasis control increased from 33.04% and 45.54% to 93.91%, and 92.17% (P<0.01), respectively. The corresponding percentages for pupils increased from 12.88% and 6.82% to 97.64% and 62.20%(P<0.01), respectively. Both groups showed a significant increase in the percentage in believing that schistosomiasis can be eliminated, while no significant changes were observed in the two study groups of the control village. i.e., the percentages with such believing in adult villagers and pupils rose from 28.57% and 3.79% to 96.52% and 71.65% (P<0.01), respectively. In addition, both the compliance towards snail survey of adult villagers and the compliance towards knowledge dissemination of pupils were significantly increased to 81.74% and 90.55% in the experimental village (P<0.01), respectively.Conclusions: The measures of “information communication + behavior participation +behavior encouragement” can be considered as an effective model of health education and promotion for consolidating the achievement of schistosomiasis control in transmission-interrupted areas in China.