College of Humanities and Social sciences, Makerere University, Kampala, Uganda.
College of Veterinary medicine, animal resources & biosecurity, Makerere University, Kampala, Uganda.
BMC Infect Dis. 2024 Aug 8;24(1):797. doi: 10.1186/s12879-024-09717-y.
Brucellosis is an infectious zoonotic disease that poses serious health threats around the world including Uganda. Brucellosis is caused by Brucella spp., the bacteria being transmitted via contact through skin breaks, via inhalation, or orally through the consumption of raw milk and other dairy products. The aim of this study was to investigate self-reported prevalence, knowledge, and perceptions towards brucellosis transmission, within agro-pastoralist communities in the Nakasongola district, central Uganda.
This study employed a cross-sectional survey design. A semi-structured questionnaire was developed and administered to 398 participants selected through convenience sampling method. The survey gathered information on socio-demographic characteristics, knowledge of brucellosis transmission, symptoms, preventive measures, and self-reported prevalence of brucellosis. Qualitative data involved the use of six focus group discussions, identifying factors for transmission based on their perceived level of risk or impact using ranking by proportional piling.
A majority (99.2%, n = 398) had heard about brucellosis and 71.2% were aware of the zoonotic nature of the disease. There were varied responses regarding transmission routes, symptoms, and preventive measures. Self-reported prevalence was relatively high (55.5%). Following adjusted analysis, factors such as subcounty, source of income, knowledge about symptoms of brucellosis, whether brucellosis is treatable, perception, and living close to animals were statistically significant. Participants from Wabinyonyi had 2.7 higher odds of reporting brucellosis than those from Nabiswera, aOR = 2.7, 95%CI 1.4-5.5. Crop farming and livestock had much higher odds of reporting brucellosis than those earning from casual sources, aOR = 8.5, 95%C 1.8-40.1 and aOR = 14.4, 95%CI 3.1-67.6, respectively. Those who had knowledge about symptoms had 6.9 higher odds of reporting brucellosis than who mentioned fever, aOR = 4.5, 95%CI 2.3-18.3. Likewise, living close with animals and handling aborted fetuses (aOR = 0.4, 95%CI: 0.17-0.86), (aOR = 0.2,95% CI: 0.07-0.0.42,) had significantly lower odds for self-reported prevalence compared to those who believed did not cause brucellosis. Risk factors identified included, handling of aborted fetuses and living in close proximity with animals. Overall, there was a moderate statistical agreement in the ranking across the focus groups discussion (W = 0.48, p < 0.01; n = 6).
While awareness of brucellosis is high in the community, understanding of the transmission routes, clinical symptoms, and preventive measures varied. Investigating the understanding and assessing knowledge, perceptions and self-reported prevalence in this region indicated a necessity for risk communication strategies and community-based interventions to better control brucellosis transmission.
布鲁氏菌病是一种传染性人畜共患疾病，在全球范围内对人类健康构成严重威胁，包括乌干达。布鲁氏菌病是由布鲁氏菌属细菌引起的，通过皮肤破裂接触、吸入或食用生牛奶和其他乳制品经口传播。本研究旨在调查乌干达中部 Nakasongola 区农牧社区中布鲁氏菌病传播的自我报告流行率、知识和认知。
本研究采用横断面调查设计。通过便利抽样法选择了 398 名参与者，使用半结构式问卷收集了社会人口统计学特征、布鲁氏菌病传播知识、症状、预防措施和自我报告的布鲁氏菌病流行率信息。定性数据包括 6 次焦点小组讨论，根据他们对风险或影响的感知程度，使用比例堆积法对传播因素进行排名。
大多数（99.2%，n=398）听说过布鲁氏菌病，71.2%知道该疾病的人畜共患性质。对于传播途径、症状和预防措施，存在不同的反应。自我报告的流行率相对较高（55.5%）。经调整分析，亚县、收入来源、布鲁氏菌病症状知识、是否可治疗、认知以及与动物近距离接触等因素具有统计学意义。与来自 Nabiswera 的参与者相比，来自 Wabinyonyi 的参与者报告布鲁氏菌病的可能性高 2.7 倍，aOR=2.7，95%CI 1.4-5.5。种植作物和饲养牲畜的人比从事临时工的人更有可能报告布鲁氏菌病，aOR=8.5，95%CI 1.8-40.1 和 aOR=14.4，95%CI 3.1-67.6。与提到发热的人相比，那些了解症状的人报告布鲁氏菌病的可能性高 6.9 倍，aOR=4.5，95%CI 2.3-18.3。同样，与动物近距离接触和处理流产胎儿（aOR=0.4，95%CI：0.17-0.86）、（aOR=0.2，95%CI：0.07-0.0.42）与那些认为流产不会导致布鲁氏菌病的人相比，自我报告的流行率的可能性显著降低。确定的风险因素包括处理流产胎儿和与动物近距离接触。总体而言，焦点小组讨论的排名存在中度统计学一致性（W=0.48，p<0.01；n=6）。
尽管社区对布鲁氏菌病的认识较高，但对传播途径、临床症状和预防措施的了解各不相同。在该地区进行的理解调查和知识、认知和自我报告的流行率评估表明，需要实施风险沟通策略和基于社区的干预措施，以更好地控制布鲁氏菌病的传播。
