# Assessment of the effectiveness of public art in improving knowledge, attitude, practices and mitigation of stigmatization regarding neglected tropical diseases in South Eastern, Nigeria

## TL;DR

Public art in Nigeria helped increase awareness and reduce stigma around neglected tropical diseases, showing it can be an effective educational tool in marginalized communities.

## Contribution

Demonstrates public art as a novel, culturally relevant strategy for improving NTD awareness and reducing stigma in endemic communities.

## Key findings

- Significant increase in NTD awareness post-intervention (p < 0.05).
- Reduction in misconceptions about supernatural causes of NTDs.
- Improved acceptance of affected individuals and increased preventive behaviors.

## Abstract

Neglected Tropical Diseases (NTDs) continue to significantly impact marginalized communities, contributing to high morbidity, stigma, and social exclusion. Traditional health education strategies often fail to engage affected populations effectively. This study evaluates the impact of a community public art as an innovative tool for improving knowledge, shifting attitudes, enhancing preventive practices, and reducing stigma related to NTDs in Okwelle Community, Imo State, Nigeria.

A mixed-methods implementation research design was employed, involving 724 participants (362 at pretest and 362 at posttest). Public art installations depicting common NTDs in the study location including, Onchocerciasis, Buruli ulcer, and Lymphatic filariasis, were strategically placed in community spaces. Pretest and posttest surveys, key informant interviews, and focus group discussions were conducted to elucidate information about the influence of the public art on knowledge improvement and perception shifting. Quantitative data were analyzed using chi-square tests. Findings revealed a significant increase in NTDs awareness post-intervention (p < 0.05). Identification of disease symptoms improved, misconceptions regarding supernatural causation decreased, and preventive behaviors such as healthcare-seeking and participation in community health programs increased. Stigma reduction was evident, with greater acceptance of affected individuals and increased willingness to interact with them. Notably, 98.3% of participants supported maintaining public art as an educational tool.

Public art can be a powerful and culturally relevant medium for enhancing NTDs awareness, promoting behavior change, and reducing stigma in endemic communities. This study highlights its potential for integration into broader public health strategies to improve disease awareness and community participation. Future research should explore the scalability and long-term sustainability of public art interventions in diverse settings.

Neglected Tropical Diseases affect some of the world’s most vulnerable communities, causing illness, disability, and social stigma. Many people are unaware of these diseases or hold misconceptions that prevent early diagnosis and treatment. In this study, we explored how public art can be used as a tool to educate communities, improve knowledge, and reduce stigma associated with NTDs. We worked with community members in Okwelle, Nigeria, to create public murals that visually represented common NTDs including, Onchocerciasis, Buruli ulcer, and Lymphatic filariasis. Before the artwork was introduced, many residents had limited knowledge of these diseases, and some believed they were caused by witchcraft or punishment from a higher power. After the murals were displayed, awareness increased significantly, attitudes toward affected individuals improved, and more people took steps to prevent and treat NTDs.Our study shows that public art can be an effective and culturally relevant way to share health information, challenge stigma, and encourage healthier behaviors in underserved communities. This approach could be adapted for other public health challenges, making education more engaging and accessible to those who need it most.