Institut Francophone pour la Medecine Tropicale, Vientiane, Lao PDR.
BMC Infect Dis. 2010 Oct 12;10:294. doi: 10.1186/1471-2334-10-294.
In Laos, small backyard poultry systems predominate (90%). The first lethal human cases of highly pathogenic avian influenza (HPAI) occurred in 2007. Few studies have addressed the impact of outbreaks and education campaigns on a smallholder producer system. We evaluated awareness and behaviours related to educational campaigns and the 2007 HPAI outbreaks.
During a national 2-stage cross-sectional randomised survey we interviewed 1098 households using a pre-tested questionnaire in five provinces representative of the Southern to Northern strata of Laos. We used multivariate analysis (Stata, version 8; Stata Corporation, College Station, TX, USA) to analyse factors affecting recollection of HPAI educational messages, awareness of HPAI, and behaviour change.
Of the 1098 participants, 303 (27.6%) received training on HPAI. The level of awareness was similar to that in 2006. The urban population considered risk to be decreased, yet unsafe behaviours persisted or increased. This contrasted with an increase in awareness and safe behaviour practices in rural areas. Reported behaviour changes in rural areas included higher rates of cessation of poultry consumption and dead poultry burial when compared to 2006. No participants reported poultry deaths to the authorities. Overall, 70% could recall an educational message but the content and accuracy differed widely depending on training exposure. Washing hands and other hygiene advice, messages given during the HPAI educational campaign, were not recalled. Trained persons were able to recall only one message while untrained participants recalled a broader range of messages. Factors associated with an awareness of a threat of AI in Laos were: having received HPAI training, literacy level, access to TV, recent information, living in rural areas.
We report a paradoxical relationship between unsafe behaviours and risk perception in urban areas, as well as exposure to HPAI training and message misinterpretation. Future educational campaigns need to be tailored to specific target populations and farming styles, for example, small holder farms as compared to commercial farms. Special attention must be given to varying risk perceptions and the risk of misinterpretation of key messages, economic hardship, and real life consequences of reporting.
老挝以小型后院家禽系统为主（90%）。2007 年首次发生高致病性禽流感（HPAI）致死人类病例。很少有研究涉及疫情爆发和教育活动对小农户生产者系统的影响。我们评估了与教育活动和 2007 年 HPAI 疫情相关的意识和行为。
在全国两阶段横断面随机调查中，我们在老挝南部到北部五个省份进行了 1098 户家庭的预测试问卷调查。我们使用多元分析（Stata，版本 8；Stata Corporation，College Station，TX，美国）分析了影响 HPAI 教育信息回忆、HPAI 意识和行为改变的因素。
在 1098 名参与者中，有 303 人（27.6%）接受了 HPAI 培训。认知水平与 2006 年相似。城市人口认为风险降低，但不安全行为仍然存在或增加。这与农村地区意识增强和安全行为做法形成对比。与 2006 年相比，农村地区报告的行为变化包括更高的家禽消费停止率和死禽埋葬率。没有参与者向当局报告家禽死亡情况。总的来说，70%的人可以回忆起一条教育信息，但内容和准确性因培训暴露而异。洗手和其他卫生建议，以及 HPAI 教育活动期间提供的信息，都没有被回忆起来。受过培训的人只能回忆起一条信息，而未受过培训的参与者则回忆起更广泛的信息。与老挝对 AI 威胁的认识相关的因素包括：接受过 HPAI 培训、文化程度、电视接入、最新信息、居住在农村地区。
我们报告了城市地区不安全行为与风险认知之间的矛盾关系，以及 HPAI 培训和信息误解的暴露。未来的教育活动需要针对特定目标人群和养殖方式进行调整，例如与商业农场相比，小型农户农场。必须特别注意不同的风险认知和关键信息的误解风险、经济困难以及报告的实际后果。
