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Community perception and role in prevention of Guinea worm disease.


 In Kitgum district of northern Uganda in 1992, natural group and focus group discussions and key informant interviews were conducted to examine the knowledge, attitudes, practices, and beliefs of the people concerning Guinea Worm disease (GW disease) and its transmission, prevention, and treatment. Most people could describe the cause and treatment of Coo (local name of GW disease). More than 58% thought dirty or bad water was the main cause of Coo. 63.2% believed that drinking contaminated water was the cause. 13.1% did not know the cause of GW disease. Few people clearly understood how GW is transmitted. People received treatment from the nearest health unit (42%), traditional healers (34%), self-medication (16%), and drug shops (8%). 55.3% of key informants believed that Coo cases had increased. The perceived reasons for the increase were drinking dirty water (42.8%), migration (38.1%), no medicine (9.5%), and increased population (4.8%). Suggestions for community action to halt transmission of GW included provision of safe water, educating each other, boiling water, and filtering water. The community perceived that the government and nongovernmental organizations could drill new boreholes, bring in medications, repair broken boreholes, protect water sources, and provide education to stop the spread of GW disease. Water sources were shallow wells, streams, rivers, valley dams, and boreholes. 77.3% of boreholes did not work. Most other water sources were inadequately protected from GW infestation. Some community members perceived boiling water as tedious and difficult. Most people thought that there was nothing or little they could do to prevent contamination of water sources. Few had heard health education messages about Guinea Worm disease. Many people wanted the use of plays, drama, and videos in villages to communicate GW prevention messages.
