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秘鲁马德雷德迪奥斯省跨洋公路沿线社区对健康和鼠传疾病的认知

Community perceptions of health and rodent-borne diseases along the Inter-Oceanic Highway in Madre de Dios, Peru.

作者信息

Salmón-Mulanovich Gabriela, Powell Amy R, Hartinger-Peña Stella M, Schwarz Lara, Bausch Daniel G, Paz-Soldán Valerie A

机构信息

Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.

US Naval Medical Research Unit No. 6, Callao, Peru.

出版信息

BMC Public Health. 2016 Aug 9;16:755. doi: 10.1186/s12889-016-3420-3.

Abstract

BACKGROUND

Madre de Dios is located in the southeastern Amazonian region of Peru. Rodents have been estimated to be the reservoirs for up to 50 % of emerging zoonotic pathogens, including a host of viruses, bacteria, and parasites. As part of a larger study involving both human and animal research, this study serves to obtain a broader understanding of the key challenges and concerns related to health and rodent-borne illnesses from the perspective of the people living in these communities.

METHODS

We used a mixed methods approach, which comprised of 12 focus group discussions, 34 key informant interviews and the application of a survey (n = 522) in four communities along the Inter-Oceanic Highway (IOH) in Madre de Dios, Peru over a two-year period.

RESULTS

Although 90 % of survey respondents answered that rodents can transmit diseases and had seen rodents in their homes and immediate surroundings, most could not name specific rodent-borne diseases and, when probed, described rodents as pests or nuisance animals, but were not concerned about acquiring illnesses from them. Key informant interview data suggests that there has been a perceived increase in the amount of rodents in the communities since the construction of the IOH, however this potential increase was not coupled with increased knowledge about diseases or perceived risks among these key informants. Health providers also mentioned a lack of diagnostic tools specific for rodent-borne illnesses. This may be related to the fact that although a common rodent-borne disease like leptospirosis is frequently detected in the region, it is not routinely and readily diagnosed, therefore the real burden of the disease and exposure risk can be underestimated. If rodent-borne diseases are not on the radar of health professionals, they may not consider presumptive treatment, which could result in unnecessary morbidity and mortality.

CONCLUSION

Awareness of rodent-borne diseases is still lacking in the area, even among health care professionals within the communities, despite the known burden of diseases like leptospirosis. We expect to report further findings as we obtain more information from all the study components.

摘要

背景

马德雷德迪奥斯位于秘鲁亚马逊地区东南部。据估计,啮齿动物是高达50%的新出现的人畜共患病原体的宿主,包括许多病毒、细菌和寄生虫。作为一项涉及人类和动物研究的更大规模研究的一部分,本研究旨在从生活在这些社区的人们的角度,更广泛地了解与健康和啮齿动物传播疾病相关的关键挑战和问题。

方法

我们采用了混合方法,在两年时间里,在秘鲁马德雷德迪奥斯跨洋公路沿线的四个社区进行了12次焦点小组讨论、34次关键信息提供者访谈,并应用了一项调查(n = 522)。

结果

尽管90%的调查受访者回答说啮齿动物可以传播疾病,并且在他们的家中和周围环境中见过啮齿动物,但大多数人说不出具体的啮齿动物传播疾病的名称,当被追问时,他们将啮齿动物描述为害虫或讨厌的动物,但并不担心会因它们而患病。关键信息提供者访谈数据表明,自跨洋公路建设以来,社区中啮齿动物的数量明显增加,然而,这种潜在的增加并没有伴随着这些关键信息提供者对疾病或感知风险的认识增加。卫生保健人员还提到缺乏针对啮齿动物传播疾病的诊断工具。这可能与以下事实有关:尽管像钩端螺旋体病这样常见的啮齿动物传播疾病在该地区经常被检测到,但它并没有得到常规和及时的诊断,因此疾病的实际负担和接触风险可能被低估。如果啮齿动物传播疾病没有引起卫生专业人员的注意,他们可能不会考虑进行推定治疗,这可能导致不必要的发病和死亡。

结论

尽管已知钩端螺旋体病等疾病的负担,但该地区仍然缺乏对啮齿动物传播疾病的认识,即使在社区内的卫生保健专业人员中也是如此。随着我们从所有研究组成部分获得更多信息,我们预计会报告进一步的研究结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d00/4979164/d869dd5ae520/12889_2016_3420_Fig1_HTML.jpg

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