Stewart Carree Coffee, Brieger William R
The Johns Hopkins Bloomberg School of Public Health, Baltiomore, MD 21205, USA.
Int Q Community Health Educ. 2008;29(2):123-42. doi: 10.2190/IQ.29.2.c.
Afghanistan currently has the world's largest outbreak of Cutaneous Leishmaniasis with more than 9% of the population (270,000) of Kabul affected. Transmitted through the bite of a sandfly, this disfiguring skin disease causes ulcerous lesions and permanent scarring. Physical, social, and economic consequences of the disease among those affected, their families, and communities are severe. Current control programs consist of both treatment and prevention. A clear understanding of the underlying factors influencing people's treatment-seeking behavior and utilization of prevention methods is critical for program success. However, these factors have not been well established. This article investigates illness recognition and treatment-seeking behavior, beliefs about etiology and transmission of the disease, and views of prevention and protection among the population of Istalif, a district in theKabul Province. The knowledge, attitudes, and preferences of participants in the focus groups highlight barriers to current control efforts, as well as opportunities for behavior change. An intervention strategy is proposed based on the analysis of these factors and includes an attack phase of treatment to reduce the infective human reservoir, lower morbidity, and distribution of Long-Lasting Insecticide Nets to interrupt the transmission cycle. This is followed by a maintenance phase of treatment, vector control, individual protection, health education, promotion, and community mobilization.
阿富汗目前是全球皮肤利什曼病疫情最为严重的国家,喀布尔超过9%的人口(27万)受到影响。这种毁容性皮肤病通过白蛉叮咬传播,会导致溃疡性病变和永久性疤痕。该病给患者及其家庭和社区带来了严重的身体、社会和经济后果。当前的防控项目包括治疗和预防。清楚了解影响人们寻求治疗行为和预防方法使用的潜在因素,对项目的成功至关重要。然而,这些因素尚未完全明确。本文调查了喀布尔省伊斯特利夫区居民对疾病的认知和寻求治疗行为、对病因和传播的看法以及对预防和保护的观点。焦点小组参与者的知识、态度和偏好凸显了当前防控工作的障碍以及行为改变的机会。在对这些因素进行分析的基础上,提出了一项干预策略,包括一个治疗攻坚阶段,以减少感染人群、降低发病率,并分发长效驱虫蚊帐以阻断传播周期。随后是一个维持阶段,包括治疗、病媒控制、个人防护、健康教育、推广和社区动员。
Int Q Community Health Educ. 2008
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