Department of Research in Emerging and Zoonotic Infectious Diseases, Gorgas Memorial Institute for Health Studies, Calle 35, Panamá, PANAMA.
Universidad Interamericana de Panamá, Panamá, PANAMA.
PLoS Negl Trop Dis. 2020 Feb 27;14(2):e0008111. doi: 10.1371/journal.pntd.0008111. eCollection 2020 Feb.
Hantaviruses are a group of single-stranded RNA viruses carried by small rodent reservoirs, transmitted to humans through inhalation of aerosolized particles of rodent feces, urine, or saliva. In Panama, the Choclo orthohantavirus has been associated with Hantavirus Pulmonary Syndrome (n = 54) and Hantavirus Fever (n = 53). In 2018, there were 107 cases of hantavirus diseases, the majority in the Tonosí district, and 4 deaths. As there is no vaccine or treatment for hantavirus, proper prevention measures by community members is key to stopping outbreaks.
We investigated hantavirus knowledge, attitudes, and practices in one corregimiento of Tonosí, Panama to determine what factors influence uptake of prevention practices and high level of knowledge. We conducted a cross-sectional survey with 124 residents covering hantavirus knowledge, attitudes based in the Health Belief Model (perceived severity, perceived susceptibility, perceived obstacles, perceived benefits, and cues to action) and prevention practices. There was an overall high level of knowledge (median score: 4/6), though 20% did not know the route of transmission. The mean number of reported practices performed per person was 8.4 (range: 4-12). Most people had heard of hantavirus through other community members. In linear regression, lower perceived obstacles predicted higher preventive practice score. Reported obstacles to preventive practices included physical restrictions, such as age and health state. In ordinal logistic regression, higher education level and knowing more people who had previously been sick with hantavirus contributed to higher knowledge score.
Future interventions should focus on removing barriers to performing preventive practices. As most people learned of hantavirus through community members, interventions should be community-based and involve those who have experienced the disease. Any future education materials should address confusions about route of transmission and be targeted at those with a lower education level.
汉坦病毒是一组由小型啮齿动物储存的单链 RNA 病毒，通过吸入啮齿动物粪便、尿液或唾液气溶胶化的颗粒传播给人类。在巴拿马，Choclo orthohantavirus 与汉坦病毒肺综合征（n = 54）和汉坦病毒发热（n = 53）有关。2018 年，巴拿马共有 107 例汉坦病毒病病例，大多数发生在托尼西区，并有 4 人死亡。由于目前尚无汉坦病毒疫苗或治疗方法，因此社区成员采取适当的预防措施是阻止疫情爆发的关键。
我们调查了巴拿马托尼西市一个区的汉坦病毒知识、态度和实践情况，以确定哪些因素影响预防措施的采用和高水平的知识。我们对 124 名居民进行了横断面调查，内容涵盖汉坦病毒知识、基于健康信念模型的态度（感知严重程度、感知易感性、感知障碍、感知益处和行动线索）和预防措施。总体而言，知识水平较高（中位数：4/6），尽管 20%的人不知道传播途径。报告的人均实施预防措施的次数为 8.4 次（范围：4-12 次）。大多数人通过其他社区成员听说过汉坦病毒。在线性回归中，较低的感知障碍预示着更高的预防实践评分。报告的预防实践障碍包括身体限制，如年龄和健康状况。在有序逻辑回归中，较高的教育水平和认识更多以前患有汉坦病毒病的人有助于提高知识得分。
未来的干预措施应侧重于消除实施预防措施的障碍。由于大多数人通过社区成员了解到汉坦病毒，因此干预措施应该以社区为基础，并涉及那些经历过这种疾病的人。任何未来的教育材料都应解决传播途径的混淆问题，并针对教育水平较低的人群。
