Community In Endemic Areas Research Articles

Factors associated with dengue fever prevention practices in endemic area

Prevention practices and the factors that influence them are essential for controlling the spread of dengue hemorrhagic fever (DHF) and effective strategic planning. This study aimed to determine the factors associated with the practice of preventing dengue fever in communities in endemic areas of Kubu Raya Regency, West Kalimantan Province, Indonesia. This study was an observational study with a cross-sectional design. The research sample was 379 households in endemic areas using a questionnaire. Collecting data was using a questionnaire with interviews. Bivariate analysis employed Chi-square test, multivariate analysis using logistic regression. Most of the respondents practiced fewer prevention; variables related to dengue fever prevention practices were income, education, knowledge about dengue prevention and health education (mass media). Regression analysis showed that the variables of education, knowledge about dengue prevention, and mass media education were related to the practice of preventing dengue fever. This study indicated that in preventing dengue fever, strategies must be developed to cultivate prevention practices and increase prevention campaigns using mass media and focus on areas with low education and knowledge in dengue prevention.

Communities' Perception, Knowledge, and Practices Related to Human African Trypanosomiasis in the Democratic Republic of Congo.

Background: The number of human African trypanosomiasis (HAT) cases in the Democratic Republic of Congo (DRC) has significantly reduced, thanks to more effective drugs and screening tools and regular mass screening. However, this potentially jeopardizes HAT control activities, especially community engagement. Methods: We used an ecological model framework to understand how various factors shape communities’ knowledge, perceptions, and behavior in this low endemicity context. Community members, frontline health providers, and policymakers were consulted using an ethnographic approach. Results: Communities in endemic areas are knowledgeable about causes, symptoms, and treatment of HAT, but this was more limited among young people. Few are aware of new HAT treatment or screening techniques. Participation in mass screening has declined due to many factors including fear and a lack of urgency, given the low numbers of cases. Delays in seeking medical care are due to confusion of HAT symptoms with those of other diseases and belief that HAT is caused by witchcraft. Conclusions: Community members see their role more in terms of vector control than participation in screening, referral, or accepting treatment. We propose recommendations for achieving sustainable community engagement, including development of an information and communication strategy and empowerment of communities to take greater ownership of HAT control activities.

Pengaruh Karakteristik Tempat Penampungan Air Terhadap Densitas Larva Aedes dan Risiko Penyebaran Demam Berdarah Dengue di Daerah Endemis di Indonesia

Dengue Hemorrhagic Fever (DHF) is influenced by the density of disease vectors. One of government program to reduce dengue cases in Indonesia is the Eradication of Mosquito Nest (PSN) through monitoring of Water Reservoirs (TPA). This study aims to determine the opportunities for TPA characteristics to influence the presence of Aedes sp. larvae in 19 provinces in Indonesia in the Riset Khusus Vektor dan Reservoir Penyakit in 2015 and 2016. The study was conducted cross sectionally in 570 areas near settlements which are dengue endemic areas and each province was taken three districts that have one DHF endemic area. The data obtained in the form of landfill characteristics variables and the presence of larvae of Aedes sp. analyzed descriptively and logistic regression. The analysis showed that 88% of the landfill contained larvae. Almost all the characteristics of the landfill examined have an effect on the existence of larvae with an average odd ratio of 3.2. Properly done landfill drainage significantly reduces the chances of mosquito eggs hatching into larvae by 11,843 times more than landfills that are rarely drained. Maintaining fish larvae in the landfill has a significant effect in reducing the population of mosquito larvae by 4.937 times. Sowing container with larvasida has the opportunity to reduce mosquito larvae by 4.483 times. The results of this study can be used as a basis for DHF control efforts in communities in endemic areas.

Community Vulnerability Map in Endemic Areas of Dengue Hemorrhagic Fever (DHF), Banyumas, Indonesia

Background: Community vulnerability is influenced by the low participation of the community in Pemberantasan Sarang Nyamuk (PSN). PSN is an activity done by society independently in their respective environment to eliminate mosquito-breeding places by 3 M (Menguras, Menutup, Mengubur). We aimed to prove the relationship between knowledge and practice of the community in PSN with the incidence of Dengue Hemorrhagic Fever (DHF), beside to describe the map of vulnerability of the community in endemic areas of DHF. Methods: This study used case control design. The population of this research is the community in the area of Puskesmas Kembaran 1 and 2. The samples were taken from Bojongsari villageas, Banyumas districtis, Indonesia one of the endemic areas of DHF from Jan 2014- Dec 2015. The number of samples was 62 respondents. Results: The community in endemic areas of knowledge about dengue was mostly good (55%) but in practice PSN was mostly less (56%). There was no correlation of knowledge with the incidence of DHF (P=0.444) and there was an association of DHF occurrence with PSN practice (P=0.010) and the vulnerability map showing many negative DHF residents living close to dengue cases. Conclusion: Community vulnerability in DHF endemic areas is dominated by densely populated settlements, Slum environmental conditions, and PSN practices are lacking. Mobilization of all components of the communityis required to participate in prevention of DHF.

Cutaneous leishmaniasis a neglected tropical disease: community knowledge, attitude and practices in an endemic area, Northwest Ethiopia

BackgroundCutaneous leishmaniasis is one of the neglected tropical diseases in the Ethiopian highlands and studies on assessment of knowledge, attitude and practice of the community in endemic areas are scanty. The study aimed to assess the knowledge, attitude towards cutaneous leishmaniasis and treatment seeking practices in people living in the endemic highlands areas in the Northwest, Ethiopia and to provide evidence-based information to guide development of appropriate interventions to reduce the impact of cutaneous leishmaniasis on communities.MethodsQuantitative cross-sectional study was conducted in cutaneous leishmaniasis endemic districts (woredas) using a semi structured questionnaire. Households were randomly selected according to probability proportional to size of households in each enumeration area. Systematic random sampling of eligible households was based on the number of households recorded during listing of households. Descriptive statistics was used to describe numerical data, organise and summarise the data in a manner that gave meaning to the numerical form. Frequency tables were used to show descriptive analysis and regression analysis was used to determine correlation between variables.ResultsMajority of respondents 321(78.7%) lived in rural areas, age ranged between 18 and 85 years and most were farmers. Illiteracy was high (47.6%) among respondents and majority 358(87.8%) had seen patients with CL. Less than quarter (21.6%) had heard about sand flies and knowledge on the peak transmission period was low (46.3%). About 192 (47.1%) of the respondents indicated disfiguring lesions were the major clinical presentations, less than half 55(27.5%) of urban residents believed CL was treatable compared to 145(72.5%) of rural residents (P < 0.001). Traditional medicines were indicated as best treatment option by 209(51.2%) compared to 114(27.9%) for modern treatment. Major factors influencing treatment options included accessibility to treatment facilities, distance and short duration of treatment. Participants expressed negative experiential attitude and perceived control towards modern treatment because of inaccessibility and distance from where modern treatment is provided.ConclusionPriority should be given to primary prevention and appropriate awareness campaigns on lesion recognition. Information on modern treatment should be intensified.

&amp;lt;i&amp;gt;Taenia solium&amp;lt;/i&amp;gt; Cysticercosis in Sub-Saharan Africa: Perspectives for a Better Control

For decades, Taenia solium cysticercosis (TSC) has remained an important constraint for public health and economic well being of the predisposed communities. Despite the fact that the disease is easily preventable, humans remain foci for transmission. They harbour the mature form of the parasite (Taenia solium) which may be curable at this stage and also easily prevented from contaminating pig feeds and environment with eggs of the parasite to break the cycle. Researchers, knowledgeable communities and international organisations such as the World Health Organisation work hard to make the disease a history. Nevertheless, persistence of the disease in endemic regions such as sub Saharan Africa is kept on increasing. While TSC in human may serve as a silent killer as it can go unnoticed for years, the immanent social cultural settings and lifestyles of the communities in endemic areas form the main concern on the epidemiology of the disease. Unless lifestyles change in endemic regions, front line research might rarely find its way into applications in an area of huge societal and economic impact, the TSC epidemiology. Sincerely, transmission of TSC is favoured by poor sanitation and hygiene which is motivated by lifestyle and poverty. What is perhaps missing is the knowledge on “why is the communities involved ease indiscriminately while almost every member of the community in endemic areas knows that indiscriminate defecation may harm their health? What social drivers are behind this motive (bush defecation)? How best can the disease be controlled and monitored? This review recommends for developing and implementing an interdisciplinary OneHealth community-based control mechanism and monitoring (surveillance) programme as standpoints towards eliminating TSC in sub-Saharan Africa and the rest endemic regions.

Chagas Disease by Oral Transmission: Cardiovascular Manifestations

Introduction: Chagas disease is the most common cause of myocarditis in South, Central and parts of North America. More than 10million Latin Americans carry the protozoan parasite Trypanosoma cruzi, 25 millions of people at risk to acquire the disease and at least one million of them will die. Transmission of parasitosis habitually depends on the participation of infected triatomines. However, acute disease caused by the accidental ingestion of contamined food, either by feces of triatomines or anal secretion of marsupials has received considerable attention recently. A sparse number of outbreaks of orally acquired human Chagas disease have been reported from Brazil, Argentina, Colombia and Venezuela. The findings in multiple outbreaks established the absence of Romana’s sign or any external point of T. cruzi entrance, presence of simultaneous onset of Chagas disease acute symptoms in members of the same family or community. The clinical manifestations are prolonged fever, dyspnea, myalgias, headache, facial and limb edema. The cardiovascular findings are myocarditis, acute congestive failure, arrhythmias, and sudden death with high mortality rate estimated at 8-35%. Diagnosis can be made by direct methods, serologic techniques, inoculation in mice of culture blood, and polymerase chain reaction. In the follow up of these patients to prevent Chagas cardiomyopathy, it is important to perform echocardiographic and electrocardiographic evaluation to keep a close eye on systolic and diastolic biventricular function and abnormalities in 12-lead electrocardiogram in asymptomatic patients. Treatment of this disease use nitro derivates compounds, to avoid the parasite proliferation but aren’t able to eliminate the entire population of T.cruzi. Conclusion: Changes in the strategy of Chagas disease control programs are mandatory; which until now are limited to vector control activities in rural Latin American communities in endemic areas.

A Large Histoplasmosis Outbreak Among High School Students in Indiana, 2001

A histoplasmosis outbreak occurred in an Indiana high school in November-December 2001. To describe the risk factors for this outbreak, we conducted a cohort study of all available students and staff (N = 682) and an environmental investigation. Of the 523 (77%) persons who displayed serologic evidence of recent Histoplasma capsulatum infection, 355 (68%) developed symptoms consistent with acute pulmonary histoplasmosis. Rototilling of soil in a school courtyard known to be a bird roosting site had been performed during school hours on November 12, 2001, 14 days before both the peak of the onset of illness and a rise in student absenteeism. Being a student (odds ratio, 3.3; 95% confidence interval, 2.2-5.0) and being a student in a classroom near the courtyard during the rototilling (odds ratio, 3.1; 95% confidence interval, 1.8-5.2) were independently associated with infection and symptomatic illness. H. capsulatum was isolated from environmental samples, including soil from the courtyard and dust collected from a filter of a heating, ventilating and air-conditioning system. Soil-disrupting activities within a school courtyard caused the largest outbreak to date of histoplasmosis among adolescents. Improved efforts are needed to educate the community in endemic areas about histoplasmosis to prevent the occurrence of such outbreaks in the future. In addition, increased awareness among health care providers of this disease would facilitate appropriate diagnosis and treatment.

Recent advances in immunity to human schistosomiasis.

For many years the epidemiological significance of immunity in human schistosomiasis has been the subject of inconclusive debate. Recently, the results of studies from Brazil and Kenya, on Schistosoma mansoni and from Zimbabwe and The Gambia on S. haematobium have confirmed the importance of protective immunity. In communities in endemic areas the development of immunity to infection only occurs after many years of exposure. In part this is due to the slow development of antibodies which are protective but also to the earlier development of antibody isotypes which lack protective capacity and which are capable of interfering with the functioning of protective antibodies. Protective antibodies appear to be of the IgE class but some IgG subclasses may also be important. Initially, blocking antibodies were thought to be predominantly IgM and IgG2 but IgG4 also seems to possess blocking activity. The early production of blocking antibodies and late production of protective antibodies may be indicative of cytokine induced immunoglobulin class switching caused by the sequential involvement of different lymphokines.