van den Broek J, O'Donoghue J, Ishengoma A, Masao H, Mbega M
Jaques van den Broek, Royal Tropical Institute, Amsterdam, The Netherlands.
Lepr Rev. 1998 Mar;69(1):57-74. doi: 10.5935/0305-7518.19980007.
To assess the impact of a 7-year intensive health education campaign about leprosy delivered by workers of the Kindwitwi Leprosy Trust to schoolchildren and general public in Rufiji District. Knowledge, attitude and beliefs towards leprosy were measured in Rufiji and compared to neighbouring Kisarawe District as control. Lessons learned from this analysis may be useful for the planning and evaluating of health education campaigns. Interview of schoolchildren, general public, community leaders, traditional healers and medical staff in both districts. A stratified randomized sampling scheme was used, with stratification for urban and rural settings. A representative sample of schoolchildren, general public, community leaders, traditional healers and medical staff in Rufiji District and in the control area of Kisarawe District was interviewed. The interviews were partly structured and partly open. The results of the interviews were analysed in the context of epidemiological leprosy data from 1985 till 1995, and demographic data of both districts. Data entry and statistical analysis was done using FileMaker Pro, Stata and Excel computer packages. We did not observe positive effects of the health education campaign on the indicators regarding early diagnosis of leprosy with less disability. Leprosy case detection was declining in both districts. We found that the campaign had a favourable impact on the knowledge and the attitude of schoolchildren in Rufiji District. We could demonstrate a relationship between increased knowledge of leprosy and a positive, less stigmatizing attitude. Knowledge of leprosy was better in Rufiji as compared to Kisarawe, but only among schoolchildren. We found indications that low level of education, rural residence, older age, female gender and Moslem religion were associated with stigmatizing attitudes and beliefs towards leprosy. Knowledge about leprosy reactions among medical staff interviewed was not optimal. The exact outcome of the sustained campaign in Rufiji District was difficult to assess because no comparison could be made with the situation prior to the campaign. However, the health education campaign was associated with increased knowledge and diminished tendency to stigmatize leprosy among schoolchildren. Health education campaigns have to be sustained and have to cover a broad sector of the society in order to induce behavioural changes in the community. The focus of health education should be rural communities and schools, and pay special attention to women, religious leaders and traditional healers. Awareness of diagnosis and treatment of leprosy reactions among medical staff should be improved.
评估金德维蒂麻风病信托基金的工作人员在鲁菲吉区向学童和公众开展的为期7年的麻风病强化健康教育运动的影响。在鲁菲吉区测量了对麻风病的知识、态度和信念，并与邻近的基萨拉韦区作为对照进行比较。从该分析中吸取的经验教训可能有助于健康教育运动的规划和评估。对两个区的学童、公众、社区领袖、传统治疗师和医务人员进行访谈。采用分层随机抽样方案，按城乡环境进行分层。对鲁菲吉区和基萨拉韦区控制区的学童、公众、社区领袖、传统治疗师和医务人员进行了代表性抽样访谈。访谈部分结构化，部分开放。在1985年至1995年的麻风病流行病学数据以及两个区的人口统计数据背景下分析访谈结果。使用FileMaker Pro、Stata和Excel计算机软件包进行数据录入和统计分析。我们没有观察到健康教育运动对麻风病早期诊断且残疾较少的指标产生积极影响。两个区的麻风病病例发现率都在下降。我们发现该运动对鲁菲吉区学童的知识和态度产生了有利影响。我们能够证明麻风病知识的增加与积极的、较少歧视性的态度之间存在关联。与基萨拉韦相比，鲁菲吉区对麻风病的了解更好，但仅限于学童。我们发现有迹象表明，低教育水平、农村居住、年龄较大、女性性别和穆斯林宗教与对麻风病的歧视性态度和信念有关。接受访谈的医务人员对麻风病反应的了解并不理想。由于无法与运动前的情况进行比较，很难评估鲁菲吉区持续开展的运动的确切结果。然而，健康教育运动与学童中知识的增加和对麻风病歧视倾向的减少有关。健康教育运动必须持续进行，并且必须覆盖社会的广泛领域，以便在社区中引发行为改变。健康教育的重点应该是农村社区和学校，并特别关注妇女、宗教领袖和传统治疗师。应提高医务人员对麻风病反应诊断和治疗的认识。
