Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisbon, Portugal.
Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Institute of Hygiene and Tropical Medicine (IHMT), NOVA University Lisbon (UNL), Lisbon, Portugal.
Parasit Vectors. 2023 Oct 25;16(1):381. doi: 10.1186/s13071-023-05982-z.
Control of leishmaniasis in the Mediterranean Basin relies on the active contributions from researchers in the fields of animal, human and environmental health. The application of knowledge, perceptions and practices (KPP) questionnaires to health students and professionals in Europe could be fundamental to identify and explore gaps in KPP, highlighting the diversity of conceptions related to this disease between students and professionals active in (One) Health. The objective of this study was to characterize and compare the current knowledge, perceptions and practices regarding leishmaniasis among subgroups of students and health professionals in Portugal through the application of an online questionnaire.
A cross-sectional study targeted the population of health students and professionals in Portugal, including students in medicine, veterinary medicine and environmental health, physicians, veterinarians and environmental health technicians. Potential participants were approached by email via universities and professional societies and organizations and provided with the link to access the online questionnaire. Answers to the self-administered sociodemographic and KPP questionnaire were collected between July and December 2022. Individual KPP scores were calculated by summing grades defined for each question. Logistic regression models were used to search for potential associations, and the results were expressed at estimated crude and adjusted odds ratios with 95% confidence intervals.
In total, 486 participants were included in this study: 254 students and 232 professionals. Overall, 75% of the participants reported having heard of both human and animal leishmaniasis, and > 80% reported hearing about the disease during their course work (although this was significantly lower among those in the field of environmental health). Around 90% of participants identified the pathogenic agent as a parasite, and an arthropod bite was identified as the main route of transmission by > 95%. Animal leishmaniasis was considered to be diagnosed in Portugal by 87% of participants and human leishmaniasis by only 69%. The main barriers pointed out by professionals to the control of leishmaniasis were: lack of knowledge in the general population, failures in the early diagnosis and treatment of diseased animals, absence/inefficacy of vector control programs and lack of knowledge in human health professionals. Median knowledge and perception scores were higher among professionals in the animal health field and higher in professionals than in students. Median practice scores were not significantly different between groups and subgroups. The multivariate analysis revealed that a longer period of study (for students) and having seen cases of leishmaniasis (for physicians) were associated with above-mentioned median knowledge score.
Most health students and professionals are knowledgeable about the cause and transmission route of leishmaniasis. However, recognition of the disease as autochthonous in humans is less common, highlighting the importance of promoting an approach to this infection through a One-Health lens. A national structured plan to control leishmaniasis could overcome some of the barriers pointed out by professionals, namely by implementing systematic phlebotomine surveillance and integrated reporting of animal and human cases of disease.
地中海盆地的利什曼病控制依赖于动物、人类和环境卫生领域研究人员的积极贡献。在欧洲，向卫生专业学生和专业人员应用知识、观念和实践（KPP）问卷，可以从根本上确定和探索 KPP 中的差距，突出学生和从事（一）健康专业人员对这种疾病的观念的多样性。本研究的目的是通过应用在线问卷，描述和比较葡萄牙学生和卫生专业人员亚组中关于利什曼病的当前知识、观念和实践。
本横断面研究针对葡萄牙的卫生专业学生和专业人员，包括医学、兽医学和环境卫生专业的学生、医生、兽医和环境卫生技术人员。通过大学和专业协会和组织向潜在参与者发送电子邮件，并向他们提供访问在线问卷的链接。2022 年 7 月至 12 月期间收集了自我报告的社会人口学和 KPP 问卷的答案。通过为每个问题定义的分数来计算个体 KPP 分数。使用逻辑回归模型寻找潜在关联，结果以估计的粗和调整比值以及 95%置信区间表示。
共有 486 名参与者纳入本研究：254 名学生和 232 名专业人员。总体而言，75%的参与者听说过人类和动物利什曼病，80%以上的参与者在课程学习中听说过这种疾病（尽管这在环境卫生领域的参与者中明显较低）。约 90%的参与者将病原体识别为寄生虫，超过 95%的参与者将节肢动物叮咬确定为主要传播途径。约 87%的参与者认为葡萄牙可以诊断动物利什曼病，而只有 69%的参与者认为可以诊断人类利什曼病。专业人员指出的控制利什曼病的主要障碍是：普通人群知识匮乏、患病动物的早期诊断和治疗失败、缺乏/无效的病媒控制计划以及人类卫生专业人员知识匮乏。动物卫生领域专业人员的知识和观念得分中位数较高，专业人员的得分中位数高于学生。组间和亚组间的实践得分中位数无显著差异。多变量分析显示，学习时间较长（对学生而言）和见过利什曼病病例（对医生而言）与上述知识得分中位数较高相关。
大多数卫生专业学生和专业人员都了解利什曼病的病因和传播途径。然而，人们对这种疾病在人类中的地方性认识较少，这突出了通过一种健康视角来促进对这种感染的关注的重要性。一项国家结构化计划来控制利什曼病，可以克服专业人员指出的一些障碍，例如实施系统的白蛉监测和动物与人类疾病病例的综合报告。
