Rawlins S C, Chen A, Rawlins J M, Chadee D D, Legall G
Caribbean Epidemiology Centre, Port of Spain, Trinidad and Tobago,
West Indian Med J. 2007 Mar;56(2):115-21. doi: 10.1590/s0043-31442007000200003.
To determine the level of understanding of the issues of climate change (CC)/variability (CV) and public health by populations of St Kitts and Nevis (SKN) and Trinidad and Tobago (T&T) and to find whether respondents would be willing to incorporate these values into strategies for dengue fever (DF) prevention.
Using a cluster sampling system, representative samples of the communities of SKN (227) and T&T (650) were surveyed for responses to a questionnaire document with questions on the impact of climate variability on health, the physical environment, respondents' willingness to utilize climate issues to predict and adapt to climate variability for DF prevention. Data were analyzed by Epi Info.
Sixty-two per cent SKN and 55% T&T of respondents showed some understanding of the concept of climate change (CC) and distinguished this from climate variability (CV). With regard to causes of CC, 48% SKN and 50% T&T attributed CC to all of green houses gases, holes in the ozone layer burning of vegetation and vehicular exhaust gases. However some 39.3% SKN and 31% (T&T) did not answer this question. In response to ranking issues of life affected by CC/CV in both countries, respondents ranked them: health > water resources > agriculture > biodiversity > coastal degradation. The major health issues identified for SKN and T&T respondents were: food-borne diseases > water-borne diseases > heat stresses; vector-borne diseases were only ranked 4th and 5th for SKN and T&T respondents respectively. There was in both countries a significant proportion of respondents (p < 0.001) who reported wet season-related increase of DF cases as a CC/CV link. Respondents identified use of environmental sanitation (ES) at appropriate times as a method of choice of using CC/CV to prevent DF outbreaks. More than 82% in both countries saw the use of the CC/CV information for DF prevention by prediction and control as strategic but only 50-51% were inclined to become personally involved. Currently, only 50% SKN and 45% T&T respondents claimed current involvement in DF vector surveillance and control in the last two days.
Despite the fact that knowledge and attitudes did not always coincide with practices of using ES for DF prevention, in both countries, even with CC/CV tools of prediction being available, it seems that respondents could be persuaded to use such strategies. There is a need for demonstration of the efficacy of CC/CV information and promotion of its usefulness for community involvement in DF and possibly other disease prevention.
确定圣基茨和尼维斯（SKN）以及特立尼达和多巴哥（T&T）民众对气候变化（CC）/变率（CV）和公共卫生问题的理解程度，并了解受访者是否愿意将这些认识纳入登革热（DF）预防策略中。
采用整群抽样系统，对SKN（227人）和T&T（650人）社区的代表性样本进行问卷调查，问卷内容涉及气候变率对健康、自然环境的影响，以及受访者利用气候问题预测和适应气候变率以预防登革热的意愿。数据采用Epi Info软件进行分析。
62%的SKN受访者和55%的T&T受访者对气候变化（CC）概念有一定理解，并能将其与气候变率（CV）区分开来。关于气候变化的成因，48%的SKN受访者和50%的T&T受访者认为气候变化是由温室气体、臭氧层空洞、植被燃烧和汽车尾气排放共同导致的。然而，约39.3%的SKN受访者和31%的T&T受访者未回答该问题。在对两国受气候变化/变率影响的生活问题进行排序时，受访者的排序为：健康＞水资源＞农业＞生物多样性＞沿海退化。SKN和T&T受访者确定的主要健康问题为：食源性疾病＞水源性疾病＞热应激；媒介传播疾病在SKN和T&T受访者中分别仅排在第4位和第5位。两国均有相当比例的受访者（p＜0.001）报告称，登革热病例在雨季增加与气候变化/变率有关。受访者认为在适当时候采用环境卫生（ES）是利用气候变化/变率预防登革热疫情的首选方法。两国超过82%的受访者认为利用气候变化/变率信息通过预测和控制来预防登革热具有战略意义，但只有50 - 51%的人倾向于亲自参与。目前，仅50%的SKN受访者和45%的T&T受访者称在过去两天参与了登革热媒介监测和控制工作。
尽管在利用环境卫生预防登革热方面，知识和态度并不总是与实践相符，但在两国，即使有气候变化/变率预测工具，似乎仍可说服受访者采用此类策略。有必要展示气候变化/变率信息的有效性，并宣传其对社区参与登革热及可能的其他疾病预防的有用性。
