Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Johns Hopkins Center for Communication Programs, Baltimore, Maryland.
Am J Trop Med Hyg. 2020 May;102(5):971-981. doi: 10.4269/ajtmh.19-0578.
Zika virus, which is transmitted by mosquitoes and through sexual transmission, disproportionally affects the human fetus. Guatemala experienced a surge of Zika cases beginning in 2016. We conducted a qualitative study of community perceptions of the seriousness of Zika, as well as the effectiveness, feasibility, and collective efficacy of Zika prevention actions. Free listing elicited the preventive actions salient for 68 participants comprising pregnant women, men with a pregnant partner, and women likely to become pregnant; 12 focus group discussions in a highland and a lowland town explored other concepts through rank orderings of prevention practices depicted on cards. Participants' initial concern about Zika, based on recent experience with chikungunya and high media coverage, diminished because of its mild symptoms and reduced media coverage. Participants identified more than 32 salient preventive actions, many of which are considered effective by programs. Participants ranked water storage container cleaning and regular unspecified cleaning of the house and its surroundings as highly effective, feasible, and of high collective efficacy; however, the actions lacked the specificity needed to effectively destroy mosquito eggs. Community-level removal of tires and discarded containers had lower collective efficacy than household-level implementation because of the municipal and community cooperation needed. Condom use, although salient for Zika prevention, was hindered by gender roles. The findings indicate space for increasing self-efficacy for condom use among fathers-to-be, abandoning nonspecific terms such as "cleaning" and "standing water," increasing people's skills in using bleach as an ovicide, and promoting antenatal care and family planning counseling.
寨卡病毒通过蚊子和性传播，对人类胎儿的影响不成比例。危地马拉在 2016 年开始爆发寨卡病毒病例。我们对社区对寨卡病毒严重性的看法，以及寨卡病毒预防措施的有效性、可行性和集体效能进行了定性研究。自由列表列出了 68 名参与者（包括孕妇、有孕妇伴侣的男性和可能怀孕的女性）认为重要的预防措施；在一个高地镇和一个低地镇进行了 12 次焦点小组讨论，通过对卡片上描绘的预防措施进行排序，探讨了其他概念。由于寨卡病毒的症状较轻，媒体报道减少，参与者最初对寨卡病毒的担忧（基于最近对基孔肯雅热和大量媒体报道的经验）有所减少。参与者确定了 32 多种重要的预防措施，其中许多措施被项目认为是有效的。参与者将水储存容器清洁和定期对房屋及其周围环境进行一般性清洁评为高度有效、可行且具有高度集体效能；然而，这些行动缺乏有效消灭蚊子卵所需的特异性。由于需要市政和社区合作，社区层面清除轮胎和废弃容器的集体效能低于家庭层面的实施。尽管避孕套的使用对预防寨卡病毒很重要，但由于性别角色的限制，它受到了阻碍。研究结果表明，有必要提高准父亲使用避孕套的自我效能，摒弃“清洁”和“死水”等非特定术语，提高人们使用漂白剂作为杀卵剂的技能，并促进产前护理和计划生育咨询。
