“我们将受污染的肉晾干以使其安全”：2019 年肯尼亚基苏木爆发炭疽疫情期间对炭疽知识、态度和实践的评估。
'We dry contaminated meat to make it safe': An assessment of knowledge, attitude and practices on anthrax during an outbreak, Kisumu, Kenya, 2019.
机构信息
Field Epidemiology and Laboratory Training Program, Ministry of Health, Nairobi, Kenya.
出版信息
PLoS One. 2021 Nov 4;16(11):e0259017. doi: 10.1371/journal.pone.0259017. eCollection 2021.
INTRODUCTION
Anthrax is the highest-ranked priority zoonotic disease in Kenya with about ten human cases annually. Anthrax outbreak was reported in Kisumu East Sub County after some villagers slaughtered and ate beef from a cow suspected to have died of anthrax. We aimed at establishing the magnitude of the outbreak, described associated factors, and assessed community knowledge, attitude, and practices on anthrax.
METHODS
We reviewed human and animal records, conducted case search and contact tracing using standard case definitions in the period from July 1through to July 28, 2019. A cross-sectional study was conducted to assess community knowledge, attitude, and practices towards anthrax. The household selection was done using multistage sampling. We cleaned and analyzed data in Ms. Excel and Epi Info. Descriptive statistics were carried out for continuous and categorical variables while analytical statistics for the association between dependent and independent variables were calculated.
RESULTS
Out of 53 persons exposed through consumption or contact with suspicious beef, 23 cases (confirmed: 1, probable: 4, suspected: 18) were reviewed. The proportion of females was 52.17% (12/23), median age 13.5 years and range 45 years. The attack rate was 43.4% (23/53) and the case fatality rate was 4.35% (1/23). Knowledge level, determined by dividing those considered to be 'having good knowledge' on anthrax (numerator) by the total number of respondents (denominator) in the population regarding cause, transmission, symptoms and prevention was 51% for human anthrax and 52% for animal anthrax. Having good knowledge on anthrax was associated with rural residence [OR = 5.5 (95% CI 2.1-14.4; p<0.001)], having seen a case of anthrax [OR = 6.2 (95% CI 2.8-14.2; p<0.001)] and among those who present cattle for vaccination [OR = 2.6 (95% CI 1.2-5.6; p = 0.02)]. About 23.2% (26/112) would slaughter and sell beef to neighbors while 63.4% (71/112) would bury or burn the carcass. Nearly 93.8% (105/112) believed vaccination prevents anthrax. However, 5.4% (62/112) present livestock for vaccination.
CONCLUSION
Most anthrax exposures were through meat consumption. Poor knowledge of the disease might hamper prevention and control efforts.
简介
炭疽是肯尼亚优先级最高的动物传染病，每年约有 10 例人类病例。在基苏木东县的一些村民屠宰并食用一头疑似死于炭疽的牛的牛肉后，报告了炭疽疫情。我们旨在确定疫情的规模，描述相关因素，并评估社区对炭疽的知识、态度和实践。
方法
我们回顾了人类和动物的记录，使用 2019 年 7 月 1 日至 7 月 28 日期间的标准病例定义进行了病例搜索和接触者追踪。进行了一项横断面研究，以评估社区对炭疽的知识、态度和实践。家庭选择采用多阶段抽样。我们使用 Ms. Excel 和 Epi Info 清洗和分析数据。连续和分类变量采用描述性统计，依赖和独立变量之间的分析统计采用计算。
结果
在 53 名因食用或接触可疑牛肉而暴露的人中，有 23 例（确诊：1 例，可能：4 例，疑似：18 例）进行了审查。女性比例为 52.17%（12/23），中位年龄为 13.5 岁，范围为 45 岁。攻击率为 43.4%（23/53），病死率为 4.35%（1/23）。知识水平通过将被认为对炭疽有“良好知识”的人（分子）除以人群中关于炭疽病因、传播途径、症状和预防的总应答者（分母）来确定，人为炭疽的知识水平为 51%，动物炭疽的知识水平为 52%。对炭疽有良好的认识与农村居住有关[比值比（OR）=5.5（95%置信区间 2.1-14.4；p<0.001)]，曾见过炭疽病例[OR=6.2（95%置信区间 2.8-14.2；p<0.001)]和曾带牛去接种疫苗的人[OR=2.6（95%置信区间 1.2-5.6；p=0.02)]。约 23.2%（26/112）会屠宰并将牛肉卖给邻居，而 63.4%（71/112）会将尸体掩埋或焚烧。近 93.8%（105/112）认为接种疫苗可预防炭疽。然而，只有 5.4%（62/112）会带牲畜去接种疫苗。
结论
大多数炭疽暴露是通过食用肉类引起的。对该疾病的知识匮乏可能会阻碍预防和控制工作。
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