Infectious Diseases Division, International Centre for Diarrheal Disease Research, Dhaka, Bangladesh.
School of Public Health and Community Medicine, UNSW, Sydney, Australia.
PLoS One. 2021 Jan 28;16(1):e0244552. doi: 10.1371/journal.pone.0244552. eCollection 2021.
In low-and middle-income countries, determining the cause of death of any given individual is impaired by poor access to healthcare systems, resource-poor diagnostic facilities, and limited acceptance of complete diagnostic autopsies. Minimally invasive tissue sampling (MITS), an innovative post-mortem procedure based on obtaining tissue specimens using fine needle biopsies suitable for laboratory analysis, is an acceptable proxy of the complete diagnostic autopsy, and thus could reduce the uncertainty of cause of death. This study describes rumor surveillance activities developed and implemented in Bangladesh, Mali, and Mozambique to identify, track and understand rumors about the MITS procedure. Our surveillance activities included observations and interviews with stakeholders to understand how rumors are developed and spread and to anticipate rumors in the program areas. We also engaged young volunteers, local stakeholders, community leaders, and study staff to report rumors being spread in the community after MITS launch. Through community meetings, we also managed and responded to rumors. When a rumor was reported, the field team purposively conducted interviews and group discussions to track, verify and understand the rumor. From July 2016 through April 2018, the surveillance identified several rumors including suspicions of organs being harvested or transplanted; MITS having been performed on a living child, and concerns related to disrespecting the body and mistrust related to the study purpose. These rumors, concerns, and cues of mistrust were passed by word of mouth. We managed the rumors by modifying the consent protocol and giving additional information and support to the bereaved family and to the community members. Rumor surveillance was critical for anticipating and readily identifying rumors and managing them. Setting up rumor surveillance by engaging community residents, stakeholders, and volunteers could be an essential part of any public health program where there is a need to identify and react in real-time to public concern.
在中低收入国家，由于医疗体系获取途径有限、资源匮乏的诊断设施以及对完整诊断性尸检接受程度有限，确定任何特定个体的死亡原因都存在障碍。微创组织取样（MITS）是一种基于使用细针活检获取组织样本的创新型死后程序，适合实验室分析，是完整诊断性尸检的可接受替代方法，因此可以减少死亡原因的不确定性。本研究描述了在孟加拉国、马里和莫桑比克开展和实施的谣言监测活动，以识别、跟踪和了解有关 MITS 程序的谣言。我们的监测活动包括观察和采访利益攸关方，以了解谣言是如何产生和传播的，并预测项目地区的谣言。我们还让年轻志愿者、当地利益攸关方、社区领导和研究人员报告 MITS 推出后社区中传播的谣言。通过社区会议，我们还管理和应对谣言。当报告谣言时，实地小组有目的地进行访谈和小组讨论，以跟踪、核实和了解谣言。从 2016 年 7 月至 2018 年 4 月，监测活动发现了一些谣言，包括怀疑器官被采集或移植；MITS 曾在一个活着的孩子身上进行，以及对不尊重尸体和对研究目的不信任的担忧。这些谣言、担忧和不信任的线索都是口口相传的。我们通过修改知情同意书并向死者家属和社区成员提供额外的信息和支持来管理谣言。谣言监测对于预测和及时识别谣言并加以管理至关重要。通过让社区居民、利益攸关方和志愿者参与建立谣言监测，可以成为任何公共卫生计划的重要组成部分，这些计划需要实时识别和应对公众关切。
