Infectious and Tropical Disease Institute, Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, USA
Department of Biosciences and Department of Anthropology, Durham University, UK
Rural Remote Health. 2023 Jan;23(1):6796. doi: 10.22605/RRH6796. Epub 2023 Jan 3.
Chagas disease (CD) is a neglected tropical disease that affects 6 to 7 million people worldwide. In South America, CD is a major health problem in several regions, causing more than 12 000 deaths per year. CD is caused by a parasite called Trypanosoma cruzi, mostly transmitted through the contaminated feces of certain species of triatomine bug, commonly known as the 'kissing bug'. CD is endemic in Loja province in the southern region of Ecuador, where triatomines have been found in 68% of communities. Previous promotion of healthy practices in Loja province have included educational programs directed toward youth to affirm cultural and social norms that support health and prevent CD transmission. The present study was designed to evaluate current knowledge related to CD among youth in the three communities of Loja province following previous intervention programs.
A descriptive, qualitative approach was applied using individual semi-structured interviews with 14 young people (eight females, six males) from three rural communities in Loja province. Interviews assessed knowledge about CD transmission, knowledge about the parasite-vector-disease pathway, and the role of youth in preventing Chagas disease in their communities.
Following a thematic analysis of the data, the study results showed there is cursory knowledge of the triatomine insect that can carry the causative parasite for CD. Participants were able to generally talk about the vector, habitat and prevention practices for triatomine infestation. Nevertheless, limited understanding of transmission dynamics in the parasite-vector-disease pathway itself was found. One major finding was that prevention practices were not correctly applied or followed, increasing the risk of exposure in the community. Youth also articulated that CD is stigmatized in their communities, which may be a barrier for prevention efforts.
Gaps in knowledge about the parasite-vector-disease pathway were identified among youth. Overall, youth responses indicated positive regard for prevention practices and a desire to be involved in prevention programs. Developing educational programs focusing on CD transmission may be needed to improve control and prevention of this parasitic disease. The implications of these findings are discussed for developing effective control programs in the region.
恰加斯病（CD）是一种被忽视的热带病，影响着全球 600 至 700 万人。在南美洲，CD 是多个地区的主要卫生问题，每年导致超过 12000 人死亡。CD 是由一种名为克氏锥虫的寄生虫引起的，主要通过某些种类的三锥虫（俗称“亲吻虫”）的受污染粪便传播。CD 在厄瓜多尔南部的洛哈省流行，在该省 68%的社区中发现了三锥虫。此前，洛哈省曾推广健康实践，包括针对青年的教育项目，以肯定支持健康和预防 CD 传播的文化和社会规范。本研究旨在评估在洛哈省三个社区的青年中，在实施先前干预项目后，与 CD 相关的现有知识。
采用描述性、定性方法，对洛哈省三个农村社区的 14 名青年（8 名女性，6 名男性）进行了个人半结构化访谈。访谈评估了他们对 CD 传播、寄生虫-媒介-疾病途径的了解，以及青年在预防社区中的恰加斯病方面的作用。
通过对数据的主题分析，研究结果表明，对可能携带 CD 致病寄生虫的三锥虫昆虫只有粗略的了解。参与者能够一般地谈论媒介、栖息地和预防三锥虫感染的措施。然而，对寄生虫-媒介-疾病途径本身的传播动态的了解有限。一个主要发现是，预防措施没有得到正确应用或遵循，增加了社区暴露的风险。青年们还表示，CD 在他们的社区中被污名化，这可能是预防工作的一个障碍。
发现青年对寄生虫-媒介-疾病途径的知识存在差距。总的来说，青年的反应表明他们对预防措施有积极的看法，并希望参与预防计划。可能需要制定重点关注 CD 传播的教育计划，以改善对这种寄生虫病的控制和预防。讨论了这些发现对该地区制定有效控制计划的意义。
