Kloos Helmut, Rodrigues Julio Cézar Alves Paixão, Pereira Wesley Rodrigues, Velásquez-Meléndez Gustavo, Loverde Phillip, Oliveira Rodrigo Corrêa, Gazzinelli Andréa
Department of Epidemiology and Biostatistics, University of California Medical Center, San Francisco, CA 94143-0560, USA.
Acta Trop. 2006 Jan;97(1):31-41. doi: 10.1016/j.actatropica.2005.08.006. Epub 2005 Oct 4.
A new combined methodology consisting of direct observation and two types of interviews (internal and external interviews) was evaluated for use in exposure risk assessment in schistosomiasis. Specific objectives were to determine its usefulness in achieving equitable coverage of gendered exposure risk and its efficiency in identifying water contact behavior in a rural area in Brazil with different settlement patterns, land use and domestic water supplies. Of the 2476 water contacts recorded, 1223 (49.4%) were identified by direct observation, 946 (38.2%) by internal interviews and 307 (12.4%) by external interviews. Significantly longer mean durations of contacts were recorded for females and greater mean percentage of body surface exposed for males (P<0.01), reflecting differences in gendered water contact activities. Direct observation identified slightly more male contacts, external interviews significantly more male contacts (P<0.006), and internal interviews moderately more female contacts. The three methods recorded mean numbers of contacts and mean TBM (total body minutes) per person, declining with age. Significant differences were found between the three methods in regard to frequency and/or intensity of washing clothes, fetching water, washing utensils, washing multiple parts of the body, and bathing. The three methods also recorded differentially frequencies and exposure intensities in the three study communities, among different age groups, by gender and for individual study members. These activity-, locality-, age/gender- and person-specific patterns reflect the relative efficiency and complementarity of the three methods in settlements with different land use, access to streams and water supplies.
一种由直接观察和两种访谈方式（内部访谈和外部访谈）组成的新的综合方法被评估用于血吸虫病暴露风险评估。具体目标是确定其在实现对性别化暴露风险的公平覆盖方面的有用性，以及在巴西一个具有不同居住模式、土地利用和家庭供水情况的农村地区识别水接触行为的效率。在记录的2476次水接触中，通过直接观察识别出1223次（49.4%），通过内部访谈识别出946次（38.2%），通过外部访谈识别出307次（12.4%）。记录显示女性接触的平均持续时间显著更长，男性身体表面暴露的平均百分比更高（P<0.01），这反映了性别化水接触活动的差异。直接观察识别出的男性接触略多一些，外部访谈识别出的男性接触显著更多（P<0.006），内部访谈识别出的女性接触略多一些。这三种方法记录了每人的接触平均数和平均总身体分钟数（TBM），且随年龄下降。在洗衣服、取水、洗餐具、清洗身体多个部位和洗澡的频率和/或强度方面，这三种方法存在显著差异。这三种方法还记录了三个研究社区、不同年龄组、按性别以及个别研究对象的不同频率和暴露强度。这些活动、地点、年龄/性别和个人特定的模式反映了这三种方法在具有不同土地利用、靠近溪流情况和供水条件的定居点中的相对效率和互补性。
