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多部门方法通过干预映射实现犬狂犬病控制区:初步结果。

Multisectoral approach to achieve canine rabies controlled zone using Intervention Mapping: Preliminary results.

机构信息

Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India.

Department of Community Medicine and Family Medicine, School of Public Health, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India.

出版信息

PLoS One. 2020 Dec 1;15(12):e0242937. doi: 10.1371/journal.pone.0242937. eCollection 2020.

Abstract

BACKGROUND

Annually, in India, millions of dog bite cases occur; most of them are inflicted by a stray dog. There are over 25 million dogs in the country. The rate of stray dog vaccination is suboptimal in India. This study aims to develop an intervention strategy, using Intervention Mapping framework, tailored for the target community to achieve canine rabies controlled zone.

METHODOLOGY

This is an exploratory, cross-sectional study conducted at a tertiary care Medical Institute at Jodhpur, Rajasthan, India, from 2018-2019. The semi-structured, In-Depth Discussion was conducted with a multidisciplinary planning group comprising of members from veterinary, health, and administrative sectors. The In-Depth Discussion focused on knowledge regarding complete stray dog vaccination schedule, self-efficacy (to prevent dog bites), challenges, and barriers faced by residents to achieve canine rabies controlled zone. Further, discussion with veterinary stakeholders focused on challenges faced for rigorous implementation of stray dog vaccination and sterilization.

RESULTS

In-Depth Discussion revealed the following challenges: Lack of participation by the study population for canine vaccination, incomplete knowledge about annual canine vaccination schedule, lack of understanding of dog gestures, lack of infrastructure and resources at veterinary hospitals. The majority of the dogs in the study area were stray dogs that were partially or non-vaccinated and non-sterilized. An intersectoral collaboration was achieved between the community members, veterinary stakeholders both private and Non-Governmental organisations, and heath sector. Following which 35 (76.0%) stray dogs were vaccinated, and 17 (35.4%) were sterilized with community support. Burden of dog bite cases also decreased. The stray dog density map was prepared, and community engagement activity on dog gestures was conducted.

CONCLUSION

The present study demonstrates the feasibility of achieving canine rabies controlled zone. When implemented in a phase-wise manner across all Medical and Residential complex, this strategy would ensure achieving canine rabies controlled zone through multi-stakeholder engagement.

摘要

背景

在印度,每年有数百万例狗咬伤病例,其中大多数是由流浪狗造成的。该国拥有超过 2500 万只狗。印度流浪狗的疫苗接种率不理想。本研究旨在使用干预映射框架为目标社区制定一项干预策略,以实现犬狂犬病控制区。

方法

这是一项在印度拉贾斯坦邦焦特布尔的一家三级保健机构进行的探索性、横断面研究。2018 年至 2019 年,对一个由兽医、卫生和行政部门成员组成的多学科规划小组进行了半结构式深入讨论。深入讨论的重点是关于完整的流浪狗疫苗接种时间表、自我效能(预防狗咬伤)、居民面临的挑战和障碍的知识,以实现犬狂犬病控制区。此外,与兽医利益相关者的讨论重点是严格实施流浪狗疫苗接种和绝育所面临的挑战。

结果

深入讨论揭示了以下挑战:研究人群对犬类疫苗接种的参与度不足,对年度犬类疫苗接种时间表的知识不完整,对狗的姿势缺乏了解,兽医医院缺乏基础设施和资源。研究区域内的大多数狗都是流浪狗,部分或未接种疫苗和绝育。社区成员、兽医利益相关者(包括私营和非政府组织)以及卫生部门之间实现了跨部门合作。随后,在社区的支持下,35 只(76.0%)流浪狗接种了疫苗,17 只(35.4%)流浪狗进行了绝育。狗咬伤病例的负担也有所减轻。绘制了流浪狗密度图,并开展了有关狗姿势的社区参与活动。

结论

本研究表明实现犬狂犬病控制区是可行的。当在所有医疗和住宅综合区分阶段实施时,该策略将通过多利益相关者的参与确保实现犬狂犬病控制区。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e3b/7707495/fb075a3c9dd6/pone.0242937.g001.jpg

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