School of Public Health, Makerere University, Kampala, Uganda.
Department of Veterinary Population Medicine, University of Minnesota, Saint Paul, Minnesota United States of America.
PLoS Negl Trop Dis. 2021 Jan 6;15(1):e0008633. doi: 10.1371/journal.pntd.0008633. eCollection 2021 Jan.
Zoonotic diseases pose a significant health challenge at the human-wildlife interface, especially in Sub-Saharan Africa where ecosystem services contribute significantly to local livelihoods and individual well-being. In Uganda, the fragmented forests of Hoima district, form part of a "biodiversity and emerging infectious disease hotspot" composed of communities with high dependency on these wildlife protected areas, unaware of the associated health risks. We conducted a cross-sectional mixed methods study from March to May 2017 and interviewed 370 respondents, using a semi-structured questionnaire from eight villages neighbouring forest fragments in Hoima District, Uganda. Additionally, a total of ten (10) focus group discussions (FGDs) consisting of 6-10 men or women were conducted to further explore the drivers of hunting and perception of zoonotic disease risks at community level. Qualitative and quantitative data were analysed using content analysis and STATA version 12 respectively. We found twenty-nine percent (29.0%, CI: 24.4-33.9) of respondents were engaged in hunting of wildlife such as chimpanzee (Pan troglodytes) and 45.8% (CI: 40.6-51.0), cane rats (Thryonomyidae spp). Acquisition of animal protein was among the main reasons why communities hunt (55.3%, CI: 50.1-60.4), followed by "cultural" and "medicinal" uses of wildlife and or its parts (22.7%, CI: 18.6-27.4). Results further revealed that hunting and bushmeat consumption is persistent for other perceived reasons like; bushmeat strengthens the body, helps mothers recover faster after delivery, boosts one's immunity and hunting is exercise for the body. However, respondents reported falling sick after consumption of bushmeat at least once (7.9%, CI: 5.3-11.1), with 5.3% (CI: 2.60-9.60) reporting similar symptoms among some family members. Generally, few respondents (37.0%, CI: 32.1-42.2) were aware of diseases transmissible from wildlife to humans, although 88.7% (CI: 85.0-92.0) had heard of Ebola or Marburg without context. Hunting non-human primate poses a health risk compared to edible rats (cane rats) and wild ruminants (cOR = 0.4, 95% CI = 0.1-0.9) and (cOR = 0.7, 95% CI = 0.2-2.1) respectively. Study suggests some of the pathways for zoonotic disease spillover to humans exist at interface areas driven by livelihoods, nutrition and cultural needs. This study offers opportunities for a comprehensive risk communication and health education strategy for communities living at the interface of wildlife and human interactions.
人畜共患病在人与野生动物的交界地区构成了重大的健康挑战，尤其是在撒哈拉以南非洲，那里的生态系统服务对当地生计和个人福祉有重大贡献。在乌干达，霍伊马区支离破碎的森林构成了一个“生物多样性和新出现的传染病热点”的一部分，其中包括高度依赖这些受保护野生动物地区的社区，但它们并不知道这其中的健康风险。我们于 2017 年 3 月至 5 月期间进行了一项横断面混合方法研究，在乌干达霍伊马区的 8 个森林碎片附近的村庄采访了 370 名受访者，使用了一份半结构式问卷。此外，还进行了总共 10 次（10 次）焦点小组讨论（FGD），每次讨论由 6-10 名男性或女性组成，以进一步探讨狩猎的驱动因素和社区一级对人畜共患病风险的认识。定性和定量数据分别使用内容分析和 STATA 版本 12 进行分析。我们发现，29.0%（29.0%，置信区间：24.4-33.9）的受访者从事野生生物的狩猎，如黑猩猩（Pan troglodytes）和 45.8%（CI：40.6-51.0），甘蔗鼠（Thryonomyidae spp）。获取动物蛋白是社区狩猎的主要原因之一（55.3%，CI：50.1-60.4），其次是野生动物及其部分的“文化”和“药用”用途（22.7%，CI：18.6-27.4）。结果进一步表明，狩猎和食用野生动物的情况仍然存在，其他原因包括：食用野生动物可以增强体质，帮助产妇分娩后更快恢复，增强免疫力，狩猎是身体锻炼。然而，受访者报告说，他们至少有一次因食用野生动物而生病（7.9%，CI：5.3-11.1），其中 5.3%（CI：2.60-9.60）报告说，一些家庭成员也有类似的症状。一般来说，很少有受访者（37.0%，CI：32.1-42.2）意识到可以从野生动物传播到人身上的疾病，尽管 88.7%（CI：85.0-92.0）听说过埃博拉或马尔堡，但没有具体背景。与食用鼠类（甘蔗鼠）和野生反刍动物（cOR = 0.4，95%CI = 0.1-0.9）和（cOR = 0.7，95%CI = 0.2-2.1）相比，猎捕非人类灵长类动物对健康构成的风险更大。研究表明，在生计、营养和文化需求驱动的交界地区，一些人畜共患病溢出到人类的途径已经存在。这项研究为生活在野生动物和人类相互作用交界地区的社区提供了一个全面的风险沟通和健康教育战略的机会。
