Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia.
Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan 16150, Malaysia.
Int J Environ Res Public Health. 2018 Apr 6;15(4):693. doi: 10.3390/ijerph15040693.
Little is known on the knowledge, attitudes and preventive practices (KAP) of leptospirosis worldwide. This study embarked on assessing the KAP of leptospirosis among rural communities in Malaysia. A total of 444 participants (223 male; 221 female) aged between 18 and 81 years old were surveyed by using a self-administered questionnaire. A majority of participants had poor knowledge level (57.0%), unacceptable attitudes (90.3%) and unacceptable preventive practices (69.1%) on leptospirosis, and only 29.7% knew "rat-urine disease" as leptospirosis. Only 34.2% of the participants knew the bacteria could enter via wound lesions. Ethnicity and income were strongly associated with knowledge level and preventive practices, respectively (-values < 0.05). As for attitudes, ethnicity, income and education type were significantly associated (-values < 0.05). Only 36.5% of the participants were willing to see a doctor and did not mind if their house or surrounding area is dirty (59.7%). Surprisingly, only 32.9% had used rubber boots during floods. By logistic regression analysis, ethnicity was the only significant predictor for both knowledge level (an odds ratio (AOR) = 0.39, 95% confidence interval (CI) = 0.222-0.680) and preventive practices (AOR = 1.81, 95% CI = 1.204-2.734). Ethnicity (AOR = 0.40, 95% CI = 0.239-0.665), income (AOR = 1.58, 95% CI = 1.041-2.385) and education type (AOR = 3.69, 95% CI = 1.237-10.986) were strong predictors for attitudes. Among the KAP variables, attitude (AOR = 4.357, 95% CI = 2.613-7.264) was the only predictor for the preventive practices by logistic regression analysis. The KAP elements on leptospirosis are still lacking and poor health seeking behavior and attitudes are of our utmost concern. Thus, effective strategies should be planned to impart knowledge, and develop proactive approaches and good preventive modules on leptospirosis to this leptospirosis-prone community.
全世界对钩端螺旋体病的知识、态度和预防措施（KAP）知之甚少。本研究旨在评估马来西亚农村社区的钩端螺旋体病的 KAP。共调查了 444 名参与者（223 名男性；221 名女性），年龄在 18 至 81 岁之间，采用自我管理问卷进行调查。大多数参与者对钩端螺旋体病的知识水平较差（57.0%），态度不可接受（90.3%），预防措施不可接受（69.1%），只有 29.7%知道“鼠尿病”为钩端螺旋体病。只有 34.2%的参与者知道细菌可以通过伤口进入。种族和收入与知识水平和预防措施密切相关（P 值均<0.05）。至于态度，种族、收入和教育类型与态度显著相关（P 值均<0.05）。只有 36.5%的参与者愿意就医，不介意自己的房屋或周围环境是否肮脏（59.7%）。令人惊讶的是，只有 32.9%的人在洪水期间使用过橡胶靴。通过逻辑回归分析，种族是知识水平（比值比（AOR）=0.39，95%置信区间（CI）=0.222-0.680）和预防措施（AOR=1.81，95%CI=1.204-2.734）的唯一显著预测因素。种族（AOR=0.40，95%CI=0.239-0.665）、收入（AOR=1.58，95%CI=1.041-2.385）和教育类型（AOR=3.69，95%CI=1.237-10.986）是态度的强烈预测因素。在 KAP 变量中，态度（AOR=4.357，95%CI=2.613-7.264）是通过逻辑回归分析预测预防措施的唯一因素。钩端螺旋体病的 KAP 要素仍然缺乏，不良的寻医行为和态度令人担忧。因此，应计划制定有效的策略，向这个易感染钩端螺旋体病的社区传授知识，并制定积极主动的方法和良好的预防模块。
