Factors Influencing Practices Towards Water, Sanitation And Hygiene With Occurrence Of Tungiasis Among Pupils In Schools With A Feeding Programme In Ganze Sub County, Kenya

Background: Tungiasis is a parasitic tropical disease caused by female Tunga penetrans which causes different health disabilities hence the need for behavior change. Main objective of the study was to determine the association of WASH on tungiasis occurrence among pupils in schools implementing Home Grown School Meals Programme. Methods: A school-based cross-sectional study design was employed in which data from a control and intervention sites were compared. 24 schools (12 as control and 12 as intervention) were included. 10 pupils aged 5-15yrs were targeted from each school, totaling to 240 participants. Guardians of the 240 pupils in the selected schools were also interviewed. Quantitative data was collected through a pretested structured questionnaire. The data was keyed-into the SPSS version 23 and analysed. Results: Study findings indicate that majority of the pupils aged between 10 - 14 years were 69.7%, while those aged between 15-18years were 25.5% and the least was aged between 5-9 years old at 5.0%. Majority of the pupils were in class 5-6 forming 48.7% of the responses, followed by classes 7-8 at 46.7% while classes 3-4 at 4.6 %. The study results indicate that 54% of the pupils were female and 46% male. It was noted that there is statistical significance among pupils and infested by tungiasis (χ2=6.00, df = 1, P<0.005) within the past 3 months. Gender (χ2= , df = 1, P<0.005), training on health related issues at school (χ2= 3.938, df = 1, P<0.005), as well implementation of Home Grown School Meals Programme (HGSMP) (χ2= 1.455, df = 1, P<0.005) had a significance association with tungiasis infestation occurrence. Toilet usage (χ2= 2.088, df = 1, P>0.005), availability of water (χ2= 0.836, df = 2, P>0.005), availability of handwashing facilities (χ2= 0.141, df = 1, P>0.005) had no significant association with occurrence of tungiasis. Further significance was noted on demographic (β = 0.867, P=.000) behavioural (β = 0.924, P=.000), environmental factors (β = 0.689, P=.000) and tungiasis infestation. Conclusions: Study indicates that environmental, demographic and behavioral factors significantly predict tungiasis infestation. WASH related diseases, Trainings on WASH and implementation of HGSMP have a positive relationship with tungiasis infestation. Control programs need to adopt a more comprehensive approach at the school level. Health education is also imperative to significantly reduce the spread and morbidity from tungiasis. From the study environmental, demographic and behavioral factors significantly predict tungiasis.