Raczniak Gregory A, Gaines Joanna, Bulkow Lisa R, Kinzer Michael H, Hennessy Thomas W, Klejka Joseph A, Bruce Michael G
Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Anchorage, AK, USA.
Epidemic Intelligence Service, Division of Applied Sciences, Scientific Education and Professional Development Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Int J Circumpolar Health. 2016 Feb 23;75:30603. doi: 10.3402/ijch.v75.30603. eCollection 2016.
Community-acquired methicillin-resistant Staphylococcus aureus and methicillin-sensitive S. aureus infections are common to south-western Alaska and have been associated with traditional steambaths. More than a decade ago, recommendations were made to affected communities that included preventive skin care, cleaning methods for steambath surfaces, and the use of protective barriers while in steambaths to reduce the risk of S. aureus infection.
A review of community medical data suggested that the number of skin infection clinical encounters has increased steadily over the last 3 years and we designed a public health investigation to seek root causes.
Using a mixed methods approach with in-person surveys, a convenience sample (n=492) from 3 rural communities assessed the range of knowledge, attitudes and practices concerning skin infections, skin infection education messaging, prevention activities and home self-care of skin infections.
We described barriers to implementing previous recommendations and evaluated the acceptability of potential interventions. Prior public health messages appear to have been effective in reaching community members and appear to have been understood and accepted. We found no major misconceptions regarding what a boil was or how someone got one. Overall, respondents seemed concerned about boils as a health problem and reported that they were motivated to prevent boils. We identified current practices used to avoid skin infections, such as the disinfection of steambaths. We also identified barriers to engaging in protective behaviours, such as lack of access to laundry facilities.
These findings can be used to help guide public health strategic planning and identify appropriate evidence-based interventions tailored to the specific needs of the region.
社区获得性耐甲氧西林金黄色葡萄球菌感染和甲氧西林敏感金黄色葡萄球菌感染在阿拉斯加西南部很常见，并且与传统蒸汽浴有关。十多年前，已向受影响社区提出了一些建议，包括预防性皮肤护理、蒸汽浴表面清洁方法以及在蒸汽浴时使用防护屏障以降低金黄色葡萄球菌感染风险。
对社区医疗数据的回顾表明，在过去3年中皮肤感染临床就诊人数稳步增加，我们设计了一项公共卫生调查以寻找根本原因。
采用混合方法，通过面对面调查，从3个农村社区选取了一个便利样本（n = 492），评估了有关皮肤感染、皮肤感染教育信息、预防活动和皮肤感染家庭自我护理的知识、态度和行为范围。
我们描述了实施先前建议的障碍，并评估了潜在干预措施的可接受性。先前的公共卫生信息似乎有效地传达给了社区成员，并且似乎已被理解和接受。我们没有发现关于疖子是什么或人们如何患上疖子的重大误解。总体而言，受访者似乎担心疖子是一个健康问题，并表示他们有预防疖子的动机。我们确定了当前用于避免皮肤感染的做法，例如蒸汽浴消毒。我们还确定了采取保护行为的障碍，例如无法使用洗衣设施。
这些发现可用于帮助指导公共卫生战略规划，并确定适合该地区特定需求的基于证据的适当干预措施。
