Household Restrictions on Children’s Contact with Lake Water in Schistosomiasis-Endemic Communities of Western Kenya

Children living in schistosomiasis-endemic lakeshore communities may face repeated exposure to contaminated freshwater during swimming, bathing, fishing, playing, or accompanying family members to the lake. Because children are particularly vulnerable to infection and may have limited ability to recognize or avoid environmental risks, household decisions about restricting lake-based activities can play an important role in prevention. This study examined whether households restricted children’s lake-based water activities because of schistosomiasis concerns, identified factors associated with such restrictions, and documented the reasons caregivers gave for restricting children’s contact with lake water. We utilized a cross-sectional design, drawing on survey data collected from 1,273 adults residing across three lakeshore communities in Kisumu County, Kenya. Respondents were asked about restrictions placed on children’s activities in response to schistosomiasis risk, the reasons for these restrictions, children’s treatment-seeking, and household decision-making regarding their care. Multivariable logistic regression was used to examine associations between activity restriction and respondent, household, schistosomiasis awareness, and community characteristics. We also used descriptive statistics to summarize the reasons for restriction and the gender distribution of children whose activities were restricted. Our findings will contribute to a better understanding of how households respond to child schistosomiasis risk through treatment-seeking and water-contact restriction. They will also inform community-based prevention strategies that improve treatment decisions, reduce children’s exposure to potentially contaminated freshwater, and account for household practices, local risk perceptions, and families’ dependence on lake-based activities.