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肯尼亚游牧民和非游牧民的动物和人类布鲁氏菌病知识、态度和实践比较。

Comparison of knowledge, attitude, and practices of animal and human brucellosis between nomadic pastoralists and non-pastoralists in Kenya.

机构信息

Washington State University Global Health Program, Washington State University, Nairobi, Kenya.

Jaramogi Oginga Odinga University of Science and Technology, Bondo, Kenya.

出版信息

BMC Public Health. 2020 Feb 24;20(1):269. doi: 10.1186/s12889-020-8362-0.

Abstract

BACKGROUND

The seroprevalence of brucellosis among nomadic pastoralists and their livestock in arid lands is reported to be over10-fold higher than non-pastoralists farmers and their livestock in Kenya. Here, we compared the seroprevalence of nomadic pastoralists and mixed farming with their knowledge of the disease and high-risk practices associated with brucellosis infection.

METHODS

Across-sectional study was conducted in two counties - Kiambu County where farmers primarily practice smallholder livestock production and crop farming, and Marsabit County where farmers practice nomadic pastoral livestock production. Stratified random sampling was applied, in which sublocations were initially selected based on predominant livestock production system, before selecting households using randomly generated geographical coordinates. In each household, up to three persons aged 5 years and above were randomly selected, consented, and tested for Brucella spp IgG antibodies. A structured questionnaire was administered to the household head and selected individuals on disease knowledge and risky practices among the pastoralists and mixed farmers compared. Multivariable mixed effects logistic regression model was used to assess independent practices associated with human Brucella spp. IgG seropositivity.

RESULTS

While the majority (74%) of pastoralist households had little to no formal education when compared to mixed (8%), over 70% of all households (pastoralists and mixed farmers) had heard of brucellosis and mentioned its clinical presentation in humans. However, fewer than 30% of all participants (pastoralists and mixed farmers) knew how brucellosis is transmitted between animals and humans or how its transmission can be prevented. Despite their comparable knowledge, significantly more seropositive pastoralists compared to mixed farmers engaged in risky practices including consuming unboiled milk (79.5% vs 1.7%, p < 0.001) and raw blood (28.3% vs 0.4%, p < 0.001), assisting in animal birth (43.0% vs 9.3%, p < 0.001), and handling raw hides (30.6% vs 5.5%, p < 0.001).

, CONCLUSION: Nomadic pastoralists are more likely to engage in risky practices that promote Brucella Infection, probably because of their occupation and culture, despite having significant knowledge of the disease.

摘要

背景

据报道,干旱地区游牧牧民及其牲畜的布鲁氏菌病血清流行率比肯尼亚的非牧民农民及其牲畜高出 10 倍以上。在这里,我们比较了游牧牧民和混合农业的血清流行率及其对疾病的了解以及与布鲁氏菌感染相关的高危行为。

方法

在基安布县和马萨比特县进行了一项横断面研究,基安布县的农民主要从事小规模牲畜生产和作物种植,而马萨比特县的农民从事游牧牲畜生产。采用分层随机抽样,最初根据主要的牲畜生产系统选择子位置,然后使用随机生成的地理坐标选择家庭。在每个家庭中,随机选择年龄在 5 岁及以上的多达 3 人进行布鲁氏菌 spp IgG 抗体检测。对户主和选定人员进行了结构化问卷调查,以比较游牧民和混合农民的疾病知识和高危行为。使用多变量混合效应逻辑回归模型来评估与人类布鲁氏菌 spp IgG 血清阳性相关的独立行为。

结果

虽然与混合农业(8%)相比,大多数(74%)游牧牧民家庭几乎没有接受过正规教育,但超过 70%的家庭(游牧牧民和混合农民)听说过布鲁氏菌病,并提到了其在人类中的临床表现。然而,不到 30%的所有参与者(游牧牧民和混合农民)知道布鲁氏菌病如何在动物和人类之间传播,以及如何预防其传播。尽管他们的知识水平相当,但与混合农民相比,明显更多的血清阳性游牧牧民从事高危行为,包括饮用未煮沸的牛奶(79.5%比 1.7%,p<0.001)和生血(28.3%比 0.4%,p<0.001),协助动物分娩(43.0%比 9.3%,p<0.001),以及处理生皮(30.6%比 5.5%,p<0.001)。

结论

尽管游牧牧民对该疾病有显著的了解,但他们可能由于职业和文化原因,更有可能从事促进布鲁氏菌感染的高危行为。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b50/7041083/b3962a28c4a5/12889_2020_8362_Fig1_HTML.jpg

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