Frank Amy L, Beales Emily R, de Wildt Gilles, Meza Sanchez Graciela, Jones Laura L
University of Birmingham Medical School, University of Birmingham, Birmingham, United Kingdom.
Facultdad de medicina humana, Universidad de la Amazonia Peruana, Iquitos, Peru.
PLoS Negl Trop Dis. 2017 Sep 5;11(9):e0005755. doi: 10.1371/journal.pntd.0005755. eCollection 2017 Sep.
Dengue Fever presents a significant and growing burden of disease to endemic countries, where children are at particular risk. Worldwide, no effective anti-viral treatment has been identified, thus vector control is key for disease prevention, particularly in Peru where no vaccine is currently available. This qualitative study aimed to explore the perceptions of dengue control in caregivers' of children under 5 years in Peru, to help direct future mosquito control programmes and strategy.
Eighteen semi-structured interviews were conducted in one health centre in Iquitos, Peru. Interviews were audio-recorded, transcribed and translated by an independent translator. Data were analysed using an inductive thematic approach.
Three core analytic themes were interpreted: (1) awareness of dengue and its control, (2) perceived susceptibility of children, rural riverside communities and city inhabitants, and (3) perceived responsibility of vector control. Participants were aware of dengue symptoms, transmission and larvae eradication strategies. Misconceptions about the day-time biting behaviour of the Aedes aegypti mosquito and confusion with other mosquito-borne diseases influenced preventative practice. Community-wide lack of cooperation was recognised as a key barrier. This was strengthened by attitudes that the government or health centre were responsible for dengue control and a belief that the disease cannot be prevented through individual actions. Participants felt powerless to prevent dengue due to assumed inevitability of infection and lack of faith in preventative practices. However, children and rural communities were believed to be most vulnerable.
Perceptions of dengue control amongst caregivers to under 5's were important in shaping their likelihood to participate in preventative practices. There is a need to address the perceived lack of community cooperation through strategies creating a sense of ownership of community control and enhancing social responsibility. The belief that dengue cannot be prevented by individual actions in a community also warrants attention. Specific misconceptions about dengue should be addressed through the community health worker system and further research directed to identify the needs of certain vulnerable groups.
登革热给流行国家带来了日益严重的疾病负担，这些国家的儿童尤其面临风险。在全球范围内，尚未确定有效的抗病毒治疗方法，因此病媒控制是疾病预防的关键，在秘鲁尤其如此，该国目前没有可用的疫苗。这项定性研究旨在探讨秘鲁5岁以下儿童看护者对登革热控制的看法，以指导未来的蚊虫控制计划和策略。
在秘鲁伊基托斯的一个健康中心进行了18次半结构化访谈。访谈进行了录音，由独立翻译进行转录和翻译。使用归纳主题分析法对数据进行分析。
解读出三个核心分析主题：（1）对登革热及其控制的认识，（2）儿童、农村河畔社区和城市居民的感知易感性，以及（3）病媒控制的感知责任。参与者了解登革热症状、传播和幼虫根除策略。对埃及伊蚊白天叮咬行为的误解以及与其他蚊媒疾病的混淆影响了预防措施。社区普遍缺乏合作被认为是一个关键障碍。政府或健康中心负责登革热控制的态度以及认为疾病无法通过个人行动预防的信念强化了这一点。由于认为感染不可避免且对预防措施缺乏信心，参与者感到无力预防登革热。然而，人们认为儿童和农村社区最易受影响。
5岁以下儿童看护者对登革热控制的看法对于塑造他们参与预防措施的可能性很重要。需要通过营造社区控制的主人翁意识和增强社会责任的策略来解决社区合作不足的问题。社区中认为登革热无法通过个人行动预防的信念也值得关注。应通过社区卫生工作者系统解决关于登革热的具体误解，并开展进一步研究以确定某些弱势群体的需求。
