Why latrines are not used: communities' perceptions and practices regarding latrines in a Taenia solium endemic rural area in Eastern Zambia

PLoS Negl Trop Dis. 2015 Mar 4;9(3):e0003570. doi: 10.1371/journal.pntd.0003570. eCollection 2015 Mar.

Abstract

Taenia solium cysticercosis is a neglected parasitic zoonosis occurring in many developing countries. Socio-cultural determinants related to its control remain unclear. Studies in Africa have shown that the underuse of sanitary facilities and the widespread occurrence of free-roaming pigs are the major risk factors for porcine cysticercosis. The study objective was to assess the communities' perceptions, practices and knowledge regarding latrines in a T. solium endemic rural area in Eastern Zambia inhabited by the Nsenga ethno-linguistic group, and to identify possible barriers to their construction and use. A total of 21 focus group discussions on latrine use were organized separately with men, women and children, in seven villages of the Petauke district. The themes covered were related to perceived latrine availability (absence-presence, building obstacles) and perceived latrine use (defecation practices, latrine management, socio-cultural constraints).The findings reveal that latrines were not constructed in every household because of the convenient use of existing latrines in the neighborhood. Latrines were perceived to contribute to good hygiene mainly because they prevent pigs from eating human feces. Men expressed reluctance to abandon the open-air defecation practice mainly because of toilet-associated taboos with in-laws and grown-up children of the opposite gender. When reviewing conceptual frameworks of people's approach to sanitation, we found that seeking privacy and taboos hindering latrine use and construction were mainly explained in our study area by the fact that the Nsenga observe a traditionally matrilineal descent. These findings indicate that in this local context latrine promotion messages should not only focus on health benefits in general. Since only men were responsible for building latrines and mostly men preferred open defecation, sanitation programs should also be directed to men and address related sanitary taboos in order to be effective.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Animals
  • Attitude to Health
  • Child
  • Cysticercosis / epidemiology
  • Cysticercosis / transmission
  • Cysticercosis / veterinary*
  • Family Characteristics
  • Female
  • Focus Groups
  • Humans
  • Hygiene / standards
  • Male
  • Neglected Diseases / epidemiology
  • Neglected Diseases / veterinary*
  • Residence Characteristics / statistics & numerical data
  • Risk Factors
  • Sanitation / methods
  • Sex Factors
  • Swine
  • Swine Diseases / epidemiology*
  • Swine Diseases / parasitology
  • Swine Diseases / transmission*
  • Toilet Facilities / standards*
  • Toilet Facilities / statistics & numerical data
  • Zambia / epidemiology
  • Zoonoses / epidemiology*
  • Zoonoses / prevention & control*

Grants and funding

The financial support for the conduct of the research and/or preparation of the article is the Strategic Network on Neglected Diseases and Zoonoses (http://www.snndz.net/) which is an initiative from the Institute of Tropical Medicine (Antwerp, Belgium) (ITM) funded by the Third Framework Agreement between the ITM and the Belgian Development Cooperation. This funding source had no role in study design; in the collection, analysis and interpretation of data; in the writing of the article; and in the decision to submit it for publication.