Malaria Knowledge, Attitudes, and Practices in Mankranso, Ghana

Madeline Johns, University of Notre Dame

Abstract​​​
Malaria remains one of the most widespread and deadly diseases in the developing world. Specifically, Ghana is one of the 15 highest burden malaria countries (Severe Malaria Observatory, 2022). To end the endemicity of malaria in Ghana, concerted efforts must be made to improve malaria surveillance, testing, and the distribution of prevention tools. The success of intervention programs like these hinges on the willingness of a population to accept and utilize them. Therefore, it is critical that psychosocial research is conducted, prior to the implementation of an antimalarial procedure, to ensure that the procedure is adopted by the population. One method of collecting this psychosocial data is through the use of a Knowledge, Attitudes, and Practices (KAP) survey. This summer, I traveled to Mankranso, Ghana to administer a self-developed KAP survey related to malaria. I assessed adult residents’ perceptions of malaria severity and their malaria health-seeking behaviors. My overall goal with this project is to create the opportunity for future successful and culturally relevant malaria interventions in Mankranso. At the end of my time in Mankranso, I had administered more than 300 surveys. Statistical analysis of these data, and my observations in the field, have gleaned insight into the malaria perceptions and health-seeking behaviors of adults in Mankranso. I found an overall strong sense of awareness and concern over malaria amongst the adults in Mankranso. However, adherence to malaria prevention and treatment protocols was most commonly exhibited by educated middle-class adults from Mankranso or the nearby city of Kumasi.

Arsenic Poisoning: The Knowledge, Attitude, and Practice of Arsenic Contamination on Impoverished Communities in Gangtok, Sikkim, India

Shreyas Chetan, University of Notre Dame

Abstract
​​​​​​Potable water contamination is extremely detrimental to the lifestyle, health, infrastructure, and development in a community. Heavy metal contaminants like arsenic are especially detrimental because of their distinctive difficulty in detection, removal, and purification. Arsenic filtration requires expensive and temperamental technology that most impoverished, uneducated, and rural communities cannot afford nor maintain. As a result, arsenicosis is a persisting medical and social obstacle disproportionately impacting the impoverished and uneducated rural communities across the world.

The Ganges Delta Basin is home to nearly 500 million people, and arsenic contamination in that region reaches more than 50 million people (Edmunds 2015). While many surrounding areas have been identified to have arsenic contamination, Gangtok, a city in Sikkim, India, has had limited arsenic research and especially a dearth of investigation on the population's perceptions and activities when dealing with water safety and cleanliness (Brinkel 2009).

My research focused on arsenic contamination through an experimental and social lens. I tested and compared 25 water samples with both a certified Hach arsenic test and a lab designed deionized iron filter to determine the distribution of arsenic contamination and the usability of cheaper and more practical tools to filter and monitor arsenic. Further, I conducted 94 randomly sourced KAP surveys to determine the population's perceptions pertaining to steps they take for water and arsenic filtration, opinions, and current comprehension levels with arsenic and water potability.

My arsenic testing data highlighted that the major sources are primarily hand pumps followed by well water, which aligned with past literature. Further, my survey analysis illustrated that while most of the population is unaware of the contamination problem and how to mitigate it, they do have concerns about their water cleanliness.

The impact of female health education and menstrual cup intervention on students’ menstrual health management in Kalongo, Uganda

Julia Hawthorne, University of Notre Dame

Abstract
Menstruation presents significant difficulties to female students in Northern Uganda, as limited resources and services create barriers to meeting menstrual needs. This increases the risk of health problems such as reproductive tract infections and anxiety. Additionally, in a study carried out across Northern Ugandan primary schools, over 70% of female students reported menstruation affected them while at school and over half of the students reported missing 1-3 days of school per menstruation (Netherlands Development Organization 2014). Menstrual health interventions have helped women overcome obstacles through education by targeting knowledge, skills, facilities, and services (Rastogi 2019). Menstrual cups, along with instructions on their use, have also demonstrated high uptake rates among women in refugee camps and primary schools in Uganda. However, menstrual cup interventions have not been investigated in an all-female vocational school setting. This study sought to assess the impact of a dual education-menstrual cup intervention on menstrual health management (MHM) in this novel setting. Participants were recruited from Saint Bakhita’s Vocational Training Center in Kalongo, Uganda (n=51). Subjects first completed a questionnaire which assessed initial MHM strategies through questions pertaining to menstrual hygiene and how menstruation impacts their daily lives. Subjects then participated in basic female health lessons covering MHM, common female health issues, STD education, and other topics. Menstrual cups were distributed with instruction on use and sterilizers were installed on school grounds. In December, participants will complete a follow-up questionnaire measuring changes in MHM strategies to assess the impact of the intervention.

Examining HPV knowledge and opinions in Gera, Tanzania

Nathaniel Cieplik, University of Notre Dame

Abstract
Globally, human papillomavirus (HPV) causes 630,000 new cancer cases each year, including the majority of cervical cancer in women. However, 90% of cancer cases linked to HPV are preventable with a two-dose vaccination series administered between the ages of 9 and 14. HPV vaccines were first introduced on the national level in Tanzania in 2018, a step forward in combating cervical cancer, the most common cancer afflicting Tanzanian women. To understand how rural areas have responded to the 2018 rollout, I partnered with the Kashambya Hospital in Gera, a collection of villages in northwest Tanzania. In Gera, I conducted verbal surveys in Swahili, collecting demographics and assessing knowledge, opinions, and future intentions to better understand community perceptions on the HPV vaccine. Women were targeted for these surveys due to the disproportionate impact of HPV on women, the potential to make women aware of the severe side effects linked to HPV, and the fact that the HPV vaccine is currently only approved for Tanzanian girls. Preliminary interview-survey hybrids (n=8) were conducted before fully rolling out surveys (n=98). Possible respondents were identified non randomly via connections with local leadership. Survey results indicate that awareness about HPV and the HPV vaccine is extremely low among adult women in Gera, most of whom were mothers of young girls of vaccine-eligible age. In deciphering this low maternal awareness, I suggest multiple possible causes and propose policy changes with the potential to improve vaccination rates in Gera and other rural regions of Tanzania.