Department of Infectious Disease and Global Health, Cummings School of Veterinary Medicine at Tufts University, Grafton, Massachusetts, United States of America.
Department of Immunology, Research Institute for Tropical Medicine, Muntinlupa, Metro Manila, Philippines.
PLoS Negl Trop Dis. 2019 May 2;13(5):e0007358. doi: 10.1371/journal.pntd.0007358. eCollection 2019 May.
Schistosomiasis is a chronic but preventable disease that affects 260 million people worldwide. In the Philippines, 860,000 people are afflicted with Schistosoma japonicum annually, and another 6.7 million live in endemic areas. The disease's complex epidemiology as well as the influence of poverty in endemic areas demand an integrated, multi-sectoral approach to disease control. Results from behavioral or sociocultural studies on schistosomiasis could improve the content and impact of schistosomiasis control in rural villages in the Philippines. We investigated knowledge, attitudes and practices related to schistosomiasis transmission and control in an endemic village in Leyte Province, Philippines. We administered a questionnaire to 219 participants covering 1) knowledge and attitudes related to schistosomiasis, its symptoms, and its transmission; 2) attitudes and practices in relation to schistosomiasis prevention; 3) willingness to comply with public health control programs; and 4) whether the respondent had previously contracted schistosomiasis. Responses revealed fairly high measures of schistosomiasis knowledge (mean 17.0 out of 23 questions, range 6-23), but also inconsistent disease prevention behavior. A high proportion of participants (72.6%, n = 159) reported previous disease. Participant belief in the preventability of schistosomiasis was revealed to be a key attitude, as carabao owners who believed in prevention were over five times more likely to be willing to vaccinate their carabaos (OR = 5.24, 95% CI 1.20-27.68, P = 0.04). Additionally, participants who did not believe in prevention were about twice as likely to report previous disease (OR = 2.31, 95% CI 1.02-5.63, P = 0.05). Our results suggest that future public health interventions should address barriers to disease-preventing behavior, as well as maintaining community belief in disease prevention. Comprehensive disease control programs should be supplemented by sociocultural and behavioral context in order to improve their impact in endemic communities.
血吸虫病是一种慢性但可预防的疾病，影响全球 2.6 亿人。在菲律宾，每年有 86 万人感染日本血吸虫，另有 670 万人生活在流行地区。该疾病复杂的流行病学以及流行地区贫困的影响要求采取综合的、多部门的疾病控制方法。关于血吸虫病的行为或社会文化研究的结果可以改善菲律宾农村村庄血吸虫病控制的内容和效果。我们在菲律宾莱特省的一个流行村庄调查了与血吸虫病传播和控制有关的知识、态度和做法。我们向 219 名参与者发放了一份问卷，涵盖了以下内容：1）与血吸虫病及其症状和传播有关的知识和态度；2）与血吸虫病预防有关的态度和做法；3）遵守公共卫生控制计划的意愿；以及 4）受访者是否曾感染过血吸虫病。调查结果显示，参与者对血吸虫病的知识水平相当高（23 个问题中平均答对 17.0 个，范围为 6-23），但疾病预防行为不一致。相当高比例的参与者（72.6%，n=159）报告过去曾患有该病。参与者对血吸虫病可预防性的信念被证明是一种关键态度，因为相信预防的水牛所有者更有可能愿意为他们的水牛接种疫苗（OR=5.24，95%CI 1.20-27.68，P=0.04）。此外，不相信预防的参与者报告过去患病的可能性大约是其两倍（OR=2.31，95%CI 1.02-5.63，P=0.05）。我们的结果表明，未来的公共卫生干预措施应解决预防疾病行为的障碍，并保持社区对疾病预防的信念。综合疾病控制方案应辅以社会文化和行为背景，以提高其在流行社区的效果。
