教育对埃塞俄比亚西北部季节性和流动农业工人对黑热病预防措施的知识和实践的影响。

Impact of Education on Knowledge and Practice of Kala Azar Preventive Measures among Seasonal and Migrant Agricultural Workers in Northwest Ethiopia.

机构信息

Department of Environmental Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom.

出版信息

Am J Trop Med Hyg. 2020 Apr;102(4):758-767. doi: 10.4269/ajtmh.19-0079.

Abstract

Kala azar occurs among seasonal and migrant agricultural workers in northwest Ethiopia and accounts for almost 60% of the disease burden in the country. We conducted a quantitative study on the level of knowledge and practice of this vulnerable group in relation to kala azar transmission and acceptability of its vector control tools. A total of 403 workers were randomly selected from eight farms using a purposive sampling technique. Knowledge and practice scores were calculated based on 12 and 9 core questions, respectively. Binary logistic regression was used to identify factors associated with knowledge and practice. A large gap in knowledge of the disease and the vector was evident with 61.8%, 24.6%, and 13.6% of the workers having poor, moderate, and good levels of knowledge scores, respectively. Similarly, 95% of the seasonal workers reported poor level of use of protective measures against the bite of the sand fly vector. Good level of knowledge about kala azar and its sand fly vector was statistically associated with formal education (adjusted odds ratio [AOR] = 2.11; 95% CI = 1.17, 3.80; < 0.05) and previous exposure to health education (AOR = 4.72; 95% CI = 1.99, 11.16; < 0.001). Despite poor current knowledge and practice, a large proportion of the study participants showed interest in using vector control tools if made available, with 78% of the seasonal and migrant workers expressing some willingness to pay for different measures that can protect against sand fly bites. Therefore, we strongly recommend that comprehensive health education and vector control programs should be provided to these workers.

摘要

黑热病在埃塞俄比亚西北部的季节性和流动农业工人中发生,占该国疾病负担的近 60%。我们对这一弱势群体与黑热病传播有关的知识和实践水平以及对其病媒控制工具的可接受性进行了定量研究。我们使用目的抽样技术从八个农场中随机选择了 403 名工人。根据 12 个和 9 个核心问题,分别计算了知识和实践得分。使用二元逻辑回归来确定与知识和实践相关的因素。工人对该病和病媒的知识差距很大,分别有 61.8%、24.6%和 13.6%的工人知识得分较差、中等和良好。同样,95%的季节性工人报告说,他们在使用防护措施防止沙蝇叮咬方面的水平较差。良好的黑热病及其沙蝇病媒知识水平与正规教育有统计学关联(调整后的优势比 [AOR] = 2.11;95%置信区间 [CI] = 1.17,3.80;<0.05)和以前接受过健康教育(AOR = 4.72;95%CI = 1.99,11.16;<0.001)。尽管目前知识和实践水平较差,但研究参与者中的很大一部分表示,如果提供病媒控制工具,他们有兴趣使用,78%的季节性和流动工人表示愿意为不同的措施支付费用,这些措施可以防止沙蝇叮咬。因此,我们强烈建议向这些工人提供全面的健康教育和病媒控制计划。

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