The Story of Shukuru – a film to enhance knowledge, attitudes, and practices regarding schistosomiasis and related elimination interventions in Pemba, Tanzania.

Background: Schistosomiasis is a neglected tropical disease affecting individuals in 79 countries, primarily in sub-Saharan Africa. The World Health Organization recommends the treatment, snail control, and behavior change interventions to decrease prevalence, but culturally tailored interventions remain rare. Here we aim to determine the impact of an educational film on schistosomiasis-related knowledge, attitudes, and practices among schoolchildren and adults in Pemba, Tanzania. Methodology/Principal Findings: From November 2023 to February 2024, a survey was conducted among adult community members in 20 administrative areas in Pemba on their preferences for a planned film about schistosomiasis. The film was produced in March 2024 based on these suggestions and filmed in Pemba. In July 2024, a pretest-posttest study in ten administrative areas assessed the film’s impact on schistosomiasis-related knowledge, attitudes, and willingness to change behavior among children and adults. Binomial generalized linear mixed-effects models estimated changes in knowledge and attitudes before versus after viewing. Of 882 participants surveyed in 2023/24, 810 (91.8%) were willing to watch a film about schistosomiasis, most commonly on TV (545, 67.3%). The impact study included 195 children and 195 adults. The odds of a correct knowledge answer were 39% higher after viewing (OR 1.39, 95% CI 1.29-1.50, p<0.001), and the odds of a positive attitude were 77% higher (OR 1.77, 95% CI 1.47-2.12, p<0.001). Before the film, 71.9% (200/278) of participants used natural water bodies for daily activities, and 72.5% (145/200) of these never used protective clothing. Afterward, 88.2% (240/272) reported being likely to avoid water bodies and 54.4% (148/272) likely to use protective clothing. Conclusions/Significance: An educational film developed from community input and filmed locally increased knowledge and attitudes among children and adults and fostered willingness to adopt self-protective behaviors. However, willingness alone is insufficient without infrastructure (e.g., wells, tap water) to change behavior. Therefore, such investments remain essential for schistosomiasis elimination.