Knowledge, practices and challenges of livestock farmers and animal health workers for zoonotic urogenital schistosomiasis control in Malawi

Abstract

Background Schistosomiasis is a major neglected tropical disease (NTD) in Malawi, increasingly recognized as zoonotic due to hybridization between human and animal schistosome species. While mass drug administration (MDA) programmes target humans, chemotherapy options for livestock are nascent and, more importantly, levels of general awareness about zoonotic transmission within livestock stakeholders needs to be assessed. Methods A cross-sectional mixed-methods study was conducted in Mangochi and Chikwawa districts. Quantitative data were collected through survey questionnaires with 273 livestock farmers, and qualitative insights were obtained from in-depth interviews with 14 animal health workers. Descriptive statistics and Chi-square tests assessed knowledge and practices, while thematic analysis explored systemic barriers and opportunities for control. Results Over half of farmers (57.9%) recognized zoonotic transmission, yet only 0.8% linked schistosomiasis to animals. Awareness of zoonoses was significantly higher in Chikwawa than Mangochi ( p < 0.001), reflecting district-level differences in historical disease control programming. Farmers most often cited rabies and tuberculosis as zoonoses, while schistosomiasis was rarely mentioned. Animal health workers acknowledged zoonotic risks but reported systemic challenges, including inadequate veterinary infrastructure, personnel shortages and drug unavailability. Conclusion Recognition of urogenital schistosomiasis as a zoonotic disease among farmers is limited, and veterinary system constraints hinder effective control. Given the documented role of livestock and schistosome hybrids in transmission, integrating animal health into national schistosomiasis programmes is essential. A One Health approach combining farmer education, strengthened veterinary services and coordinated human - animal interventions offers the most viable path toward reducing transmission and advancing elimination goals.