Community perceptions, attitude, practices and treatment seeking behaviour for schistosomiasis in L. Victoria islands in Uganda.
Community perceptions, attitude, practices and treatment seeking behaviour for schistosomiasis in L. Victoria islands in Uganda.
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DOI：
10.1186/1756-0500-7-900
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发表时间：
2014-12-11
影响因子：
1.8
通讯作者：
Fenwick A
中科院分区：
文献类型：
--
作者：
Kabatereine N;Fleming F;Thuo W;Tinkitina B;Tukahebwa EM;Fenwick A
乌干达维多利亚湖的 150 个岛屿上居住着超过 20 万人，其中大多数感染了曼氏血吸虫。尽管自 2003 年以来一直在实施控制该疾病的计划，但由于水上运输成本高昂，该计划在岛屿上的实施力度不够。 2011 年和 2012 年，全球被忽视的热带病网络 (GNNTD) 通过血吸虫病控制倡议 (SCI) 提供了财政支持，以简化岛屿上的治疗服务，在此期间，治疗覆盖率一直在增加。我们进行了一项研究，目的是评估社区对该疾病的存在、其体征、症状、原因和传播以及态度、实践和求医行为的认识。这是一项横断面描述性研究，使用预先测试的访谈者对学校、医疗机构和社区中有意选择的个人进行问卷调查。频率分布表、图表和交叉表是数据呈现的主要形式。我们的结果表明，要有效控制岛屿血吸虫病，必须克服许多挑战。许多人，尤其是年轻人，不断地从一个岛屿迁移到另一个岛屿，寻找更丰富的渔场，而众所周知，这些群体会错过大规模化疗的治疗。不幸的是，卫生机构的病例管理非常差；卫生设施数量少，人员不足，主要是非技术人员，他们因疟疾和艾滋病毒等其他疾病而不堪重负，而且卫生设施中吡喹酮的供应不足。此外，卫生条件很差，没有干净的水，社区对血吸虫病的了解也很低，即使是生物医学人员也是如此。我们的结果表明，该计划应该在 2020 年代以后继续以发病率控制为目标，直到采取预防措施，而不是消除。政府应提供足够的训练有素的卫生工作者，并在所有岛屿卫生设施中储备吡喹酮。
Over 200,000 people, most of them infected with Schistosoma mansoni inhabit 150 islands in Lake Victoria in Uganda. Although a programme to control the disease has been ongoing since 2003, its implementation in islands is inadequate due to high transport costs on water. In 2011 and 2012, the Global Network for Neglected Tropical Diseases (GNNTD) through Schistosomiasis Control Initiative (SCI) provided financial support to ease treatment delivery on the islands and over the period, therapeutic coverage has been increasing. We conducted a study with an objective to assess community awareness of existence of the disease, its signs, symptoms, causes and transmission as well as attitude, practice and health seeking behavior. This was a cross sectional descriptive study which used pre-tested interviewer administered questionnaire among purposively selected individuals in schools, health facilities and communities. Frequency distribution tables, graphs and cross tabulations were the main forms of data presentation. Our results showed that there are numerous challenges that must be overcome to achieve effective control of schistosomiasis in the islands. Many people especially young men are constantly on the move from island to island in search for richer fishing grounds and such groups are commonly known to miss treatment by mass chemotherapy. Unfortunately case management in health facilities is very poor; health facilities are few and understaffed mainly with unskilled personnel who are overburdened by other illnesses such as malaria and HIV and the supply of praziquantel in health facilities is inadequate. Furthermore, sanitation is appalling, no clean water and community knowledge about schistosomiasis is low even among biomedical staff. Rather than elimination, our results indicate that the programme should continue to target morbidity control beyond the 2020s until preventive measures have been instituted. The government should provide adequate trained health workers and stock praziquantel in all island health facilities.