'None of my ancestors ever discussed this disease before!' How disease information shapes adaptive capacity of marginalised rural populations in India.
'None of my ancestors ever discussed this disease before!' How disease information shapes adaptive capacity of marginalised rural populations in India.
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DOI：
10.1371/journal.pntd.0009265
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发表时间：
2021-03
影响因子：
3.8
通讯作者：
Purse BV
中科院分区：
文献类型：
--
作者：
Asaaga FA;Rahman M;Kalegowda SD;Mathapati J;Savanur I;Srinivas PN;Seshadri T;Narayanswamy D;Kiran SK;Oommen MA;Young JC;Purse BV
小农和部落社区往往被边缘化，极易受到新出现的人畜共患病的影响，因为他们获得医疗保健的机会相对较少，健康状况较差，靠近疾病风险源，以及他们的社会和生计组织。然而，获得相关和及时的疾病信息，可以加强他们的适应能力仍然具有挑战性，并在经验文献中的特点。本文通过探讨疾病信息在塑造小农和部落群体对Kyasanur森林病（KFD）（一种蜱传病毒性出血热）的适应能力方面的作用来解决这一差距。我们进行了家庭调查（n = 229）和深入采访（n = 25）在两个受影响的地区-希莫加和Wayanad-在西高止山脉地区。我们的研究结果表明，尽管对KFD的认识普遍有限，但与无法获得疾病信息的家庭相比，获得疾病信息可以提高家庭实施适应策略的倾向。在实施的各种适应策略中，接种疫苗，避免森林访问，穿着防护服和鞋类，受访者认为，在爆发季节，使用邻苯二甲酸二甲酯油和收入多样化是重要的适应措施。即便如此，我们还是发现了个体之间在接触疾病信息及其对实质性适应行动的贡献方面的显著差异。家庭报告了实施适应战略的几个障碍，包括缺乏疾病信息、现有疫苗效力低、不信任、宗教文化情绪和生计问题。我们还发现，非正式的信息共享提供了一个很有前途的途径，从健康推广的角度来看，虽然与潜在的扭曲的消息，通过错误的信息和/或报告偏见的权衡。总的来说，我们的研究结果强调了将疾病信息与参与性方式相结合并实施干预措施的重要性，这些干预措施充分解决了健康的社会决定因素，以增强家庭对KFD和其他被忽视的地方性人畜共患病的适应能力。人们普遍认为，小农和部落社区极易受到人畜共患疾病（动物和人之间传播的疾病）的影响。这主要是由于他们获得医疗保健的机会相对较少，而且靠近疾病风险源。虽然获得相关和及时的疾病信息可以提高他们的适应能力，但仍然很困难，而且人们对疾病的了解很少。根据两个受影响地区（Shimoga和Wayanad）的调查数据（n = 229）和深入访谈（n = 25），我们探讨了疾病信息在塑造适应Kyasanur森林病（KFD）中的作用，KFD是一种蜱传病毒性出血热。我们发现，尽管对KFD的认识有限，获得疾病信息提高家庭的可能性，以实施适应战略相比，家庭没有访问it. Households确定了几个障碍，实施适应战略，包括，缺乏疾病信息，现有疫苗的低效率，不信任，宗教文化情绪，和生计问题。我们的研究结果强调了背景化疾病信息和以参与性方式实施干预措施的相关性，以加强家庭对KFD和其他被忽视的地方性人畜共患病的适应能力。
Smallholder farmer and tribal communities are often characterised as marginalised and highly vulnerable to emerging zoonotic diseases due to their relatively poor access to healthcare, worse-off health outcomes, proximity to sources of disease risks, and their social and livelihood organisation. Yet, access to relevant and timely disease information that could strengthen their adaptive capacity remain challenging and poorly characterised in the empirical literature. This paper addresses this gap by exploring the role of disease information in shaping the adaptive capacity of smallholder farmer and tribal groups to Kyasanur Forest Disease (KFD), a tick-borne viral haemorrhagic fever. We carried out household surveys (n = 229) and in-depth interviews (n = 25) in two affected districts–Shimoga and Wayanad–in the Western Ghats region. Our findings suggest that, despite the generally limited awareness about KFD, access to disease information improved households’ propensity to implement adaptation strategies relative to households that had no access to it. Of the variety of adaptation strategies implemented, vaccination, avoiding forest visits, wearing of protective clothing and footwear, application of dimethyl phthalate (DMP) oil and income diversification were identified by respondents as important adaptive measures during the outbreak seasons. Even so, we identified significant differences between individuals in exposure to disease information and its contribution to substantive adaptive action. Households reported several barriers to implement adaptation strategies including, lack of disease information, low efficacy of existing vaccine, distrust, religio-cultural sentiments, and livelihood concerns. We also found that informal information sharing presented a promising avenue from a health extension perspective albeit with trade-offs with potential distortion of the messages through misinformation and/or reporting bias. Altogether, our findings stress the importance of contextualising disease information and implementing interventions in a participatory way that sufficiently addresses the social determinants of health in order to bolster households’ adaptive capacity to KFD and other neglected endemic zoonoses. There is widespread consensus that smallholder farmer and tribal communities are highly vulnerable to zoonotic diseases (illness passed between animals and people). This is largely due to their relatively poor access to healthcare and closeness to sources of disease risks. Although access to relevant and timely disease information could enhance their adaptive capacity, remain difficult and poorly understood. Drawing on survey data (n = 229) and in-depth interviews (n = 25) in two affected districts (Shimoga and Wayanad); we explored the role of disease information in shaping adaptation to Kyasanur Forest Disease (KFD), a tick-borne viral haemorrhagic fever. We found that despite the limited awareness about KFD, access to disease information improved households’ likelihood to implement adaptation strategies as compared to households that had no access to it. Households identified several barriers to implementation of adaptation strategies including, lack of disease information, low efficacy of existing vaccine, distrust, religio-cultural sentiments, and livelihood concerns. Our findings highlight the relevance of contextualising disease information and implementing interventions in a participatory manner in order to strengthen households’ adaptive capacity to KFD and other neglected endemic zoonoses.
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DOI：
10.1098/rstb.2016.0172
发表时间：
2017-07-19
期刊：
Philosophical transactions of the Royal Society of London. Series B, Biological sciences
影响因子：
--
作者：
Bardosh KL;Scoones JC;Grace D;Kalema-Zikusoka G;Jones KE;de Balogh K;Waltner-Toews D;Bett B;Welburn SC;Mumford E;Dzingirai V
通讯作者：
Dzingirai V
影响因子：
3.8
作者：
Kasabi, Gudadappa S.;Murhekar, Manoj V.;Mehendale, Sanjay M.
通讯作者：
Mehendale, Sanjay M.
影响因子：
5.4
作者：
Berrang-Ford, Lea;Dingle, Kathryn;Edge, Victoria
通讯作者：
Edge, Victoria
影响因子：
4.7
作者：
Maguire-Rajpaul, Victoria A.;Khatun, Kaysara;Hirons, Mark A.
通讯作者：
Hirons, Mark A.
DOI：
10.1073/pnas.1208059110
发表时间：
2013-05-21
影响因子：
11.1
作者：
Jones, Bryony A.;Grace, Delia;Pfeiffer, Dirk Udo
通讯作者：
Pfeiffer, Dirk Udo