Knowledge, Attitudes, and Perceptions of Women toward Female Genital Schistosomiasis in Rural Communities in Southwest Nigeria

Background: Female Genital Schistosomiasis (FGS) is considered as one of the leading neglected sexual and reproductive health diseases in sub-Saharan Africa and it is estimated to affect 56 million women and girls in the region. It is more prevalent in rural areas and underdeveloped urban communities where open water sources are common. Nigeria has one of the highest burdens of FGS in West Africa, with the disease endemic all over the 36 states of the country. Despite this, there is no specific plan for FGS in the country due to the wide gap in epidemiological survey and knowledge. This study aimed to assess and evaluate the knowledge, attitude, and perception (KAP) of women living in rural communities in Southwest region of Nigeria and contribute to the research on FGS in Nigeria.

Methods: This descriptive cross-sectional study, guided by the Health Belief Model, was conducted among 227 women and girls in rural communities in five states across the Southwest region of Nigeria namely Oyo, Ogun, Osun, Ondo, and Ekiti. Participants were selected through purposive community sampling and systematic household sampling. Data were collected through validated, face-to-face questionnaires administered by trained female data collectors in local language. Statistical analyses included descriptive statistics and Generalized Estimating Equations (GEE) to evaluate the influence of socio-demographic factors on KAP levels.

Results: A total of 227 women participated in the research, with mean age 32.3 ± 15, out of which 62.6% have higher education and 71.4% have heard of FGS before, majorly from health centers (27.8%). Participants showed good knowledge with mean score of 5.08 ± 2.5 and attitude and perception are generally positive with 7.73 ± 1.8 and 7.35 ± 1.6 respectively. Multi-variable GEE analysis demonstrated that Knowledge scores were significantly predicted by age group (p < 0.001) and income category (p = 0.007), where lower-income cohorts and younger age brackets – especially late adolescent – exhibited lower baseline knowledge. Attitude scores were significantly driven by marital status (p = 0.033), education level (p = 0.004), and age group (p < 0.001), with single individuals, late adolescents, and those with primary education or below demonstrating lower attitude scores. Finally, Perception scores were significantly predicted by education level (p < 0.001) and age group (p < 0.001); late adolescents and women with secondary scored significantly lower, while those with primary education and below demonstrated an unexpected positive baseline perception trajectory.

Conclusion: While women in rural Southwest Nigeria demonstrate positive attitudes towards health-seeking behaviors, a significant knowledge gap exists, especially among younger women and low-income cohorts. The significant correlation between education levels and KAP scores highlights the need for targeted school-based and community-led health education. These findings advocate for the integration of FGS management into existing National Control Programmes and reproductive health services. Addressing the environmental drivers alongside clinical and educational interventions is essential to reduce the burden of FGs and its associated risks in endemic rural communities.
Keywords: Female genital schistosomiasis, Women, Knowledge, Attitude, Perception