赞比亚社区中与猪带绦虫病和囊虫病相关的知识、态度和实践。
Community knowledge, attitudes and practices related to Taenia solium taeniosis and cysticercosis in Zambia.
机构信息
Ministry of Health, Government of the Republic of Zambia.
Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia.
出版信息
PLoS Negl Trop Dis. 2023 Aug 10;17(8):e0011375. doi: 10.1371/journal.pntd.0011375. eCollection 2023 Aug.
BACKGROUND
Several studies on Taenia solium taeniosis / cysticercosis (TSTC) have been conducted in Zambia. However, none has assessed community knowledge, attitudes and practices related to TSTC and epilepsy.
METHODS
A community-based cross-sectional study was conducted between November and December 2022. The design consisted of a questionnaire-based survey conducted in each of the 25 purposely selected villages in Chiparamba Rural Health Centre (RHC) catchment area in Chipata district of the Eastern Province.
RESULTS
A total of 588 participants comprising 259 (44%) males and 329 (56%) females with median age of 42 years (range 17 to 92 years) were interviewed. Awareness of the signs and symptoms of taeniosis and human cysticercosis (HCC), including transmission and prevention measures was very low. Whilst the majority had heard about epilepsy, they were not able to link HCC to epilepsy. Most participants were aware of cysticerci in pigs (PCC) including its predilection sites but were not aware of mode of transmission and prevention measures. The pork meat inspection by trained professionals was also not a common practice in the area. Risk perception of T. solium infections was thus very low. Overall knowledge, attitude and practice scores related to T. solium infections and to epilepsy were very low with median scores of 0.38 (IQR 0.25-0.54) for knowledge, 0.25 (0.25-0.50) for attitudes, and 0.31 (0.25-0.44) for practices. Males had better knowledge on TSTC (median = 0.42, p = 0.017, r = 0.098) and better practice scores (median = 0.38, p = < 0.001, r = 0.154) compared to females though the effect size was small. With regards to sanitation and hygiene washing with soap and water was reported by many but only few had a hand washing facility near their latrines.
CONCLUSION
The study shows overall poor knowledge, attitudes and practices related to TSTC among the community of Chiparamba RHC in Chipata district of the Eastern Province of Zambia. This poses a serious challenge for control and elimination of T. solium infections and thus efforts to improve knowledge, attitudes and practices should be made using a One Health approach for the control and elimination of TSTC. Educational programs about TSTC transmission, signs and symptoms, prevention, management and control need to be scaled up in the study area and Zambia as a whole.
背景
赞比亚已经开展了多项关于猪带绦虫病/囊尾蚴病（TSTC）的研究。然而，尚无研究评估与 TSTC 和癫痫相关的社区知识、态度和实践。
方法
本项基于社区的横断面研究于 2022 年 11 月至 12 月间在奇帕塔区奇帕兰巴农村保健中心（Chiparamba Rural Health Centre，RHC）的 25 个选定村庄中进行。设计方案包括在每个村庄进行基于问卷的调查。
结果
共采访了 588 名参与者，其中 259 名（44%）为男性，329 名（56%）为女性，中位数年龄为 42 岁（范围为 17 至 92 岁）。对带绦虫病和人类囊尾蚴病（HCC）的体征和症状、传播和预防措施的认识非常低。尽管大多数人听说过癫痫，但他们无法将 HCC 与癫痫联系起来。大多数参与者都知道猪囊尾蚴（cysticerci in pigs，PCC），包括其偏好部位，但不知道传播途径和预防措施。受过培训的专业人员对猪肉进行检查在该地区也不是常见做法。因此，对猪带绦虫感染的风险感知非常低。与猪带绦虫感染和癫痫相关的总体知识、态度和实践评分非常低，知识的中位数评分为 0.38（IQR 0.25-0.54），态度的中位数评分为 0.25（0.25-0.50），实践的中位数评分为 0.31（0.25-0.44）。与女性相比，男性对 TSTC 的了解更好（中位数=0.42，p=0.017，r=0.098），实践评分也更好（中位数=0.38，p<0.001，r=0.154），尽管效应量较小。关于卫生和个人卫生，许多人报告说用肥皂和水洗，但只有少数人在厕所附近设有洗手设施。
结论
本研究表明，在赞比亚奇帕塔区奇帕兰巴农村保健中心社区中，与 TSTC 相关的总体知识、态度和实践均较差。这对控制和消除猪带绦虫感染构成了严重挑战，因此，应采用“同一健康”方法来提高知识、态度和实践，以控制和消除 TSTC。需要在研究区域和赞比亚范围内扩大有关 TSTC 传播、体征和症状、预防、管理和控制的教育计划。
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