Huebl Lena, Nnyombi Aloysious, Apoko Patricia, Okello Denis, Walakira Eddy, Kutalek Ruth
Unit Medical Anthropology and Global Health, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria.
Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
PLoS Negl Trop Dis. 2025 Jul 14;19(7):e0013251. doi: 10.1371/journal.pntd.0013251. eCollection 2025 Jul.
Yellow fever (YF), a mosquito-borne viral hemorrhagic fever, is endemic to Uganda and has caused numerous outbreaks in recent years. This study explored local perceptions of YF outbreaks among vulnerable groups in Uganda to inform future public health campaigns.
A qualitative study examined community perceptions of YF and its treatment practices. Data were collected in six districts where YF outbreaks were reported in 2010 and 2016. A total of 76 individuals participated, comprising 43 semi-structured interviews, 10 expert interviews, and 4 focus group discussions, including vulnerable groups of older adults ≥ 65 years and pregnant women. Data were analyzed using grounded theory.
Participants often recognized jaundice but did not distinguish YF from other causes of jaundice, such as newborn jaundice, severe malaria or hepatitis. Nevertheless, participants still considered YF a deadly disease. It was perceived to be transmitted through multiple pathways, including mosquito bites, airborne transmission, close contact with sick individuals, sexual intercourse, vertical transmission during pregnancy, poor hygiene, and certain foods. Treatments ranged from herbal remedies to visiting health centers. Several YF survivors shared first-hand experience, often relying on traditional medicine due to limited access to health facilities, diagnostic options, and no specific treatment for YF. In remote areas, participants often did not know the cause of the outbreak, as awareness campaigns focused on symptoms, prevention, and mass vaccination.
CONCLUSIONS/SIGNIFICANCE: If YF is not seen as a distinct disease entity, implementing diagnostic and preventive measures may be impeded. Moreover, failure to diagnose YF in clinical settings can hamper timely outbreak response. We recommend strengthening health literacy through health education and public participation in vulnerable communities with programs tailored to local needs, given that other infectious diseases are prevalent in the region. Furthermore, we propose that access to diagnostic testing for YF may be enhanced.
黄热病是一种由蚊子传播的病毒性出血热，在乌干达呈地方性流行，近年来已引发多次疫情。本研究探讨了乌干达弱势群体对黄热病疫情的当地认知，以为未来的公共卫生运动提供信息。
一项定性研究考察了社区对黄热病及其治疗方法的认知。在2010年和2016年报告有黄热病疫情的六个地区收集数据。共有76人参与，包括43次半结构化访谈、10次专家访谈和4次焦点小组讨论，参与者包括65岁及以上的老年人和孕妇等弱势群体。采用扎根理论对数据进行分析。
参与者通常能识别黄疸，但无法将黄热病与其他黄疸病因区分开来，如新生儿黄疸、重症疟疾或肝炎。尽管如此，参与者仍认为黄热病是一种致命疾病。人们认为它可通过多种途径传播，包括蚊虫叮咬、空气传播、与患者密切接触、性交、孕期垂直传播、卫生条件差以及某些食物。治疗方法从草药疗法到前往健康中心就诊不等。几位黄热病幸存者分享了第一手经验，由于获得医疗设施、诊断选择有限且黄热病无特效治疗方法，他们往往依赖传统医学。在偏远地区，参与者通常不知道疫情的起因，因为宣传活动侧重于症状、预防和大规模疫苗接种。
结论/意义：如果黄热病不被视为一种独特的疾病实体，可能会阻碍诊断和预防措施的实施。此外，在临床环境中未能诊断出黄热病会妨碍及时应对疫情。鉴于该地区其他传染病也很普遍，我们建议通过健康教育加强健康素养，并让弱势群体社区的公众参与针对当地需求的项目。此外，我们建议加强黄热病诊断检测的可及性。
