Parasitic worms: knowledge, attitudes, and practices in Western Côte d'Ivoire with implications for integrated control.
Parasitic worms: knowledge, attitudes, and practices in Western Côte d'Ivoire with implications for integrated control.
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DOI：
10.1371/journal.pntd.0000910
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发表时间：
2010-12-21
影响因子：
3.8
通讯作者：
Utzinger J
中科院分区：
文献类型：
--
作者：
Acka CA;Raso G;N'goran EK;Tschannen AB;Bogoch II;Séraphin E;Tanner M;Obrist B;Utzinger J
在寄生虫感染普遍存在的发展中国家，预防性化疗是控制发病率的关键策略。然而，当地对寄生虫的知识、态度和做法（KAP）了解甚少，尽管这些信息是预防和可持续控制所必需的。我们在Côte科特迪瓦的两个农村社区开展了KAP调查，并开展了以学校和社区为基础的研究和控制活动。我们采用了定性和定量方法。前者包括观察、对主要举报人的深入访谈，以及对在校儿童和成人的焦点小组讨论。定量方法包括对户主进行结构化问卷调查。两个社区都缺乏清洁用水，只有四分之一的家庭有可用的厕所。与肠道血吸虫病相比，人们对土壤传播的血吸虫病有更好的了解，但以社区为基础的干预措施似乎比以学校为基础的干预措施更能提高对血吸虫病的认识。在实施社区干预措施的村庄，四分之三的家庭受访者了解肠道血吸虫病，而在实施学校干预措施的村庄，这一比例为14% （P<0.001）。来自社区干预村的三分之二的受访者表示，研究和控制项目是信息的主要来源，但只有四分之一的受访者将该项目列为主要来源。针对学龄儿童的预防性化疗具有局限性，因为老年人群被忽视，因此缺乏关于如何预防和控制寄生虫感染的知识。改善获得清洁水和卫生设施的机会是必要的，同时还要进行健康教育，以对寄生虫感染产生持久的影响。有必要更好地了解社区对被忽视的热带病的知识、态度和做法，以改进预防和控制工作。我们在Côte科特迪瓦西部的两个村庄（msamulapleu和Zouatta II）研究了寄生虫感染的社会文化方面，并在那里开展了研究和控制活动。Zouatta II采用的是基于社区的方法，而m<s:1> lapleu采用的是基于学校的干预措施。KAP调查采用定性和定量方法进行。虽然两个村庄对寄生虫感染有一定的了解，但我们发现两个村庄在肠道血吸虫病方面存在重要差异：Zouatta II村对这种疾病有更好的了解。然而，即使是在Zouatta II实施的基于社区的研究和控制工作，也无法将所传达的信息转化为与水接触有关的预防行为。我们的研究结果表明，仅针对学龄儿童的研究和控制活动所传达的寄生虫感染KAP存在缺陷，因为老年人群被遗漏。因此，为了有效控制寄生虫，必须对儿童和成人进行教育，干预措施应包括获得驱虫药物、清洁水和卫生设施。
In the developing world where parasitic worm infections are pervasive, preventive chemotherapy is the key strategy for morbidity control. However, local knowledge, attitudes, and practices (KAP) of parasitic worms are poorly understood, although such information is required for prevention and sustainable control. We carried out KAP surveys in two rural communities of Côte d'Ivoire that were subjected to school-based and community-based research and control activities. We used qualitative and quantitative methods. The former included observations, in-depth interviews with key informants, and focus group discussions with school children and adults. Quantitative methods consisted of a structured questionnaire administered to household heads. Access to clean water was lacking in both communities and only a quarter of the households had functioning latrines. There was a better understanding of soil-transmitted helminthiasis than intestinal schistosomiasis, but community-based rather than school-based interventions appeared to improve knowledge of schistosomiasis. In the villages with community-based interventions, three-quarters of household interviewees knew about intestinal schistosomiasis compared to 14% in the village where school-based interventions were implemented (P<0.001). Whereas two-thirds of respondents from the community-based intervention village indicated that the research and control project was the main source of information, only a quarter of the respondents cited the project as the main source. Preventive chemotherapy targeting school-aged children has limitations, as older population segments are neglected, and hence lack knowledge about how to prevent and control parasitic worm infections. Improved access to clean water and sanitation is necessary, along with health education to make a durable impact against helminth infections. There is a need to better understand communities' knowledge, attitudes, and practices (KAP) of neglected tropical diseases to improve prevention and control efforts. We studied the socio-cultural aspects of parasitic worm infections in two villages (Mélapleu and Zouatta II) of western Côte d'Ivoire, where research and control activities have been implemented. Zouatta II was exposed to a community-based approach, while school-based interventions were implemented in Mélapleu. KAP surveys were carried out using qualitative and quantitative methods. Although there was some knowledge of parasitic worm infections in both villages, we found important differences between the two villages regarding intestinal schistosomiasis: there was a better understanding of this disease in Zouatta II. However, even the community-based research and control efforts implemented in Zouatta II were ineffective in transforming the information conveyed into preventive behavior related to water contact. Our results suggest that KAP of parasitic worm infections conveyed by research and control activities targeting only school-aged children have shortcomings as older population groups are left out. Hence, for effective control of parasitic worms, children and adults must be educated and interventions should include access to deworming drugs, clean water and sanitation.
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DOI：
10.4269/ajtmh.2007.76.956
发表时间：
2007-05-01
影响因子：
3.3
作者：
Beck-Woerner, Christian;Raso, Giovanna;Utzinger, Juerg
通讯作者：
Utzinger, Juerg
影响因子：
2.4
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Bruun, B.
影响因子：
3.5
作者：
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Pritchett, LH
影响因子：
5.4
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通讯作者：
KLOOS, H
影响因子：
1.5
作者：
Mwanga, JR;Magnussen, P;Aagaard-Hansen, J
通讯作者：
Aagaard-Hansen, J