Field Enumerators Research Articles

Drivers of vaccine hesitancy among vulnerable populations in India: a cross-sectional multi-state study.

India's Covid-19 vaccination campaign engaged frontline workers (FLWs) to encourage vaccination among vulnerable segments of society. The FLWs report encountering a variety of barriers to vaccination and are often unsuccessful despite multiple visits to the same person. This cross-sectional study aims to pinpoint which of these barriers drive vaccine hesitancy among these segments, to help streamline vaccine communication, including FLW training, to better safeguard the population. Trained field enumerators contacted 893 individuals from five states across India and collected self-reported assessments of fifteen vaccination barriers (identified through discussions with FLWs), current vaccination status and future vaccination intentions, and covariates (demographics/comorbidities). Factor analysis of the fifteen barriers yielded two factors, one relating to fear of vaccine adverse effects and a second focused on peripheral concerns regarding the vaccine. The covariates significantly associated with current vaccination status were combined under a latent class regime to yield three cluster types (health access, financial strength, and demographics). The primary analysis examined the effect of the two barrier factors, the covariate clusters, and comorbidity, on current vaccination status and future vaccine intentions. Fear of vaccine adverse effects was the primary driver of vaccine hesitancy; peripheral concerns frequently mentioned by the FLWs had no impact. Although cluster membership and the presence of comorbidities predicted vaccine uptake, neither of them materially altered the effect of fear of vaccine adverse effects with the following exception: fear of adverse effects was not associated with vaccination status among young Muslim men. Subject to limitations, these results indicate that interventions to decrease vaccine hesitancy should focus primarily on fear associated with vaccines rather than spend resources trying to address peripheral concerns.

Risk perception and intent to take precautionary actions against COVID-19 among adult population during pandemic in Nepal

This cross-sectional study sought whether there was an association between COVID-19 risk perception and the intention to take precautionary health measures among Nepalese adults aged 20 to 60 years. A multi-stage sampling technique was used to select study participants in this study. With the help of Kobo Toolbox application programs, field enumerators interviewed 1072 adults from 14 districts of Nepal in March and April of 2021. In the study, the average age of participants was 35.11 years. Over half (52%) of them were women, and 44% were the Brahmins and Chhetri caste. Apart from perceived susceptibility, the study showed that the largest group (41%) of respondents had the lowest level of perceived susceptibility. Only a few (14.8%) of respondents expressed a strong intention to take safe measures (M=1.14 ±0.35). The study results indicated that four constructs of the health belief model such as perceived severity, barriers, benefits, and self-efficacy were positively correlated (>0.05) with taking protective health measures. In contrast, perceived susceptibility was not associated (0.53) with the intention to take protective health measures. Overall, Nepalese people are reluctant to act against COVID-19 because of their low-risk perception, which makes it necessary to raise public awareness regarding COVID-19.

Pre-emptive oral cholera vaccine (OCV) mass vaccination campaign in Cuamba District, Niassa Province, Mozambique: feasibility, vaccination coverage and delivery costs using CholTool

IntroductionMozambique suffers from regular floods along its principal river basins and periodic cyclones that resulted in several cholera epidemics during the last decades. Cholera outbreaks in the recent 5 years...

Challenges associated withRhynchophorus phoenicis Fabricius (Coleoptera: Curculionidae) farming: a case study of the Ejisu-Juaben Municipality

Farming ofRhynchophorus phoenicis has been part of the human race for over 200,000 years as a productive strategy for subsistence living. Despite the remarkable interest generated in recent years, and the studies carried out by scientists in Ghana, insect rearing for food is still in its infant stage and bedeviled with enormous challenges such as managerial, extension service, technology, and marketing. In highlighting these challenges, the confirmatory factor analysis method was used to analyse the challenges facingR. phoenicis larvae farmers in the Ejisu-Juaben Municipality. The purposive sampling technique was used to sample the farmers. Closed and opened ended questionnaires were administered by ten well-trained field enumerators in a face-to-face interview in the selected communities (Donyina, Fumesua, Asotwe, Kubease, and Bomfa). The results highlighted extension, managerial, technology, and marketing as the main components containing sixteen variables with a percentage variation of 70.8% in the production ofR. phoenicis larvae. These factors were managerial challenges (25.2%), technological challenges (23.0%), extension services challenges (16.7%), and marketing challenges (6.9%).R. phoenicis larvae have great potential for sustainably providing food and livelihood for the growing population in the Ejisu-Juaben Municipality. However, the various variables under the four main challenges can be addressed by scientists across the country if the government equips and task research institutions such as the Centre for Scientific and Industrial Research (CSIR), the Savannah Agricultural Research Institute (SARI), and the Universities, with resources to come out with technologies that will enhance the production ofR. phoenicis larvae in the municipality.

GPS-based fine-scale mapping surveys for schistosomiasis assessment: a practical introduction and documentation of field implementation

BackgroundFine-scale mapping of schistosomiasis to guide micro-targeting of interventions will gain importance in elimination settings, where the heterogeneity of transmission is often pronounced. Novel mobile applications offer new opportunities for disease mapping. We provide a practical introduction and documentation of the strengths and shortcomings of GPS-based household identification and participant recruitment using tablet-based applications for fine-scale schistosomiasis mapping at sub-district level in a remote area in Pemba, Tanzania.MethodsA community-based household survey for urogenital schistosomiasis assessment was conducted from November 2020 until February 2021 in 20 small administrative areas in Pemba. For the survey, 1400 housing structures were prospectively and randomly selected from shapefile data. To identify pre-selected structures and collect survey-related data, field enumerators searched for the houses’ geolocation using the mobile applications Open Data Kit (ODK) and MAPS.ME. The number of inhabited and uninhabited structures, the median distance between the pre-selected and recorded locations, and the dropout rates due to non-participation or non-submission of urine samples of sufficient volume for schistosomiasis testing was assessed.ResultsAmong the 1400 randomly selected housing structures, 1396 (99.7%) were identified by the enumerators. The median distance between the pre-selected and recorded structures was 5.4 m. A total of 1098 (78.7%) were residential houses. Among them, 99 (9.0%) were dropped due to continuous absence of residents and 40 (3.6%) households refused to participate. In 797 (83.1%) among the 959 participating households, all eligible household members or all but one provided a urine sample of sufficient volume.ConclusionsThe fine-scale mapping approach using a combination of ODK and an offline navigation application installed on tablet computers allows a very precise identification of housing structures. Dropouts due to non-residential housing structures, absence, non-participation and lack of urine need to be considered in survey designs. Our findings can guide the planning and implementation of future household-based mapping or longitudinal surveys and thus support micro-targeting and follow-up of interventions for schistosomiasis control and elimination in remote areas.Trial registration ISRCTN, ISCRCTN91431493. Registered 11 February 2020, https://www.isrctn.com/ISRCTN91431493

Epidemiologic Pattern of Cancer in Kathmandu Valley, Nepal: Findings of Population-Based Cancer Registry, 2018.

PURPOSEAlthough cancer is an important and growing public health issue in Nepal, the country lacked any population-based cancer registry (PBCR) until 2018. In this study, we describe the establishment of the PBCR for the first time in Nepal and use the registry data to understand incidence, mortality, and patterns of cancer in the Kathmandu Valley (consisting of Kathmandu, Lalitpur, and Bhaktapur districts), which comprises 10.5% of the estimated 29 million population of Nepal in 2018.MATERIALS AND METHODSThe PBCR collects information from facilities and communities through the active process. The facilities include cancer or general hospitals, pathology laboratories, hospice, and Ayurvedic centers. In the communities, the field enumerators or female community health volunteers collected the data from the households. In addition, the Social Security and Nursing Division under the Department of Health Services, which provides subsidy for cancer treatment of underprivileged patients, was another major source of data. The collected data were verified for residence, accuracy, and completeness and then entered and analyzed using CanReg5 software.RESULTSIn the Kathmandu Valley, the PBCR registered 2,156 new cancer cases with overall age-adjusted incidence rate for all cancers of 95.7 per 100,000 population (95.3 for males and 98.1 for females). The age-adjusted mortality rate for males was 36.3 (n = 365) and for females 27.0 (n = 305) per 100,000 population. We found that the commonest cancers in males were lung and stomach, whereas in females, they were breast and lung cancer. Gallbladder cancer was among the top five common cancers in both sex.CONCLUSIONThese findings provide a milestone to understand the cancer burden in the country for the first time using the PBCR and will be helpful to develop and prioritize cancer control strategies.

A critique of status of dairy farm women empowerment and its determinants in tamil nadu

This study was undertaken among 400 dairy farm women in Salem (North-Western zone) and Vellore district (North-Eastern zone) of Tamil Nadu to estimate the level of women empowerment and factors contributing women empowerment among the milk pouring families. Women's Empowerment in Agriculture Index (WEAI) successfully used in IFRI project was adopted and translated in regional language. A well-structured interview schedule was prepared and data collected through personal interview of the dairy farm women by the trained field enumerators. The findings showed that 26.75 per cent of the dairy farm women were empowered and Empowerment Index (5DE) was 0.6801.The intensity of disempowerment (Ap) and Disempowerment Index (Mo) were 0.4367 and 0.3199 respectively. The dairy farm women in formal milk marketing had lesser intensity of disempowerment and disempowerment index than dairy farm women with informal milk marketing.

Challenges and Way Forward for Establishing Population Based Cancer Registry in Nepal.

Population Based Cancer Registry plays a crucial role in cancer control through identifying cancer incidence, mortality, pattern and trends over time in a particular population. The registry is in a very infancy stage in Nepal. During the process of establishing Population Based Cancer Registry in Nepal, the major challenges include adequate coverage of the cases, high cost of registration, sustainability along with expansion of the registry to other regions and non-linkage of Hospital Based Cancer Registry with Population Based Cancer Registry. However, the approach of mobilization of field enumerators at the end of year once had increased coverage of the cases. Similarly, the linkage of Population Based Cancer Registry with the existing Health Management and Information System will help in developing sustainable Population Based Cancer Registry and also provides an opportunity to increase coverage and expand it to other districts as well. Keywords: Challenges; Nepal; population based cancer registry; way forward.

SAT-223 Identifying Major Non Communicable Diseases (NCD) and Associated Risk Factors Prevailing in Rural Community: Primary Results from an ongoing Systematic Survey in Bangladesh

Hypertension, diabetes and kidney disease are the major contributors of non communicable diseases (NCD). Systematic data on these and their associated risk factors are lacking in Bangladesh. In this survey a well defined rural area (union) was selected. Listing of all households and the number of residents in that area was listed. A number of field enumerators (FE), visitors (FV), supervisors (SV) and coordinators (CO) were recruited and trained for data collection. Information on prevailing NCDs and related risk factor of all dwellers were collected on a short questionnaire by face-to-face interview. Definite history of hypertension, diabetes, and nephropathy diagnosed previously and/or on treatments was recorded. In 22354 subjects 14091 were adults and 8262 were of < 18years age category. The overall male female ratio was 49:51.In adults age was between 18-24 (21%), 25-54 (61%), 55-64 (10%) and > 65 yrs (8%). Among them 26% were tobacco user and 88% took added salt with food. Diagnosed cases of HTN was 10%, DM 6%, IHD 4%, CVA 2% and nephropathy in 1% subjects. Comparison between male and female showed female were less smoker (25% vs., 1%, p<0.001) but more smokeless tobacco user (10% vs. 14%. P<0.001); hypertensive (8% vs. 12%, p<0.001) and diabetic (5% vs. 7%, p<0.001). In <18yeras group 33% had no formal schooling; tobacco user <0.1% but 79% took added salt with food. Diagnosed cases of HTN, DM, and nephropathy seen in <0.1% subjects. In general salt intake is high in rural population. Also tobacco use is alarmingly high in adult population. The diagnosed disease burden of NCDs is high and women are more affected. The younger group is mostly free from NCDs but the education level is low. Further investigations for identifying undiagnosed NCD disease burden and their cardio-renal behavioral risk factors are warranted.

Patients Routinely Report More Symptoms to Experienced Field Enumerators than Physicians in Rural Côte d'Ivoire

Medical history-taking is among the most powerful diagnostic tools for healthcare professionals. However, its accuracy and reliability are underexplored areas. The present post-hoc study compares medical histories from 463 people in a rural part of Côte d'Ivoire. The medical histories of the same individuals were taken by physicians and experienced field enumerators who were blinded to the results of the others. Kappa (κ) statistics for 14 symptoms revealed only poor-to-moderate agreement between physicians and field enumerators (κ = 0.01-0.54). Participants reported consistently more symptoms to field enumerators than physicians. Only 33 (7.1%) participants gave no discordant statement at all. The average number of discordant statements per participant was 3.7. Poisson regression revealed no significant association between the number of discordant statements and participants' age, sex, educational attainment, occupation, or socioeconomic status. Operational research should further explore best practices to obtain reliable medical histories in resource-constrained settings.

A state-level study of Kentucky’s equine industry: the 2012 Kentucky Equine Survey

s / Journal of Equine Veterinary Science 33 (2013) 321-399 365 [5] Seyedabadi HR, Banabazi MH, Afraz F, Asadzadeh N, Javanmard A, Aliabad AJ. J Anim Vet Adv 2011;10(7):865-7. [6] Shin EK, Perryman LE, Meek K. J Immunol 1997;158(8):3565-9. [7] Terry RR, Gholewinski C, Cothran EG. J Appl Genet 1999;40(1):39-41. Production and Management: Oral Presentations A state-level study of Kentucky’s equine industry: the 2012 Kentucky Equine Survey R.J. Coleman , M.G. Rossano , C.J. Stowe , A.E. Jarrett , G. Grulke , L. Brown , and S. Clark 4 1 Department of Animal and Food Sciences, 2 Department of Agricultural Economics, University of Kentucky, Lexington, KY, 40546, 3 Kentucky Horse Council, Lexington, KY 40511, USDA-NASS, Louisville, KY, 20102-1120 The 2012 Kentucky Equine Survey was conducted by the Kentucky Field Office of the National Agricultural Statistics Service (NASS), with direction and assistance from the University of Kentucky, College of Agriculture and the Kentucky Horse Council. The objective of the Kentucky Equine Survey was to obtain an estimate of the inventory of all breeds of equine (horses, ponies, donkeys, and mules) as well as estimates of equine-related assets, sales and income, and expenditures. To develop a data base of names and addresses, the research team from UK contacted numerous breed and activity associations for their support and their mailing lists. In addition, a series of 34 public engagement meetings and extension programs were conducted across the state to reach horse owners who may not belong to a previously identified organization. These names were added to an existing data base of agricultural operations with equine maintained by NASS, resulting in a data base with over 31,000 names. This list frame was augmented by area frames, both in areas known to have agriculture and in additional areas considered Agri-urban fringe, where horse operations are frequently located but missed by traditional agricultural sampling approaches. From this data base a sample of 15,000 equine operations stratified by operation size and geographic location, received questionnaires. Data were collected June – October 2012. Non responders were contacted by telephone enumerators or by field enumerators in area segments being extensively sampled. The overall response rate was 71.4%.State-level estimates suggest that there are 242,400 horses in Kentucky, residing on 35,000 equine operations. The most prevalent breed was the Thoroughbred (54,000), followed by Quarter Horses (42,000), Tennessee Walking Horses (36,000) American Saddlebred Horses (14,000), and donkeys and mules (14,000). The total value of Kentucky’s equine and equine-related assets was $23.4 billion. The total of all equine sales and income from services provided for equine operations in 2011 was about $1.1 billion, and total equine-related expenditures by equine operations in 2011 were about $1.2 billion. Funding for the project was provided by the Kentucky Agriculture Development Fund, the University of Kentucky College Of Agriculture, the Kentucky Horse Council and numerous industry organizations and horse owners. Daily horse behavior patterns depend on management S.S. King, K.L. Jones, M. Schwarm, and E.L. Oberhaus Southern Illinois University, Carbondale, IL As human populations increasingly divorce from their agrarian roots, their intimate connection with the essential nature of the horse is being lost. Confined human lifestyles translate into increased confinement management of horses. We hypothesized that natural behavior patterns are altered as horses spend increasing amounts of time in confinement. This study compared 24-hour behavior patterns of horses between several confined states and unconfined pasture. A 24-hour time budget was constructed for 35 different horses observed for 24 consecutive hours. Horses were managed under zero confinement (24P), daytime confinement/night turnout (12CD), daytime turnout/night confinement (12CN), or 24h/day confinement (24C). The 24P group was considered the “control”. All horses had ad libitum access to roughage. Behavioral observations were made 10 times/h for 24h. Each 24h period was divided into 3h segments for analysis of time/treatment interactions. The 93 possible behaviors were ultimately grouped into 5 categories representing >91% of all behaviors (ingestion, movement, inactivity, socialization, investigative) for statistical evaluation. Percent time spent in each behavior was compared by confinement type and time of day using multiple ANOVA. The 24P time budget consisted of 44.9% ingestion, 24.2% movement, 21% inactivity, 3.4% socializing and 3.0 investigative. By comparison, the most frequent behavior of the 24C groups was inactivity (42.2%); ingestion (30.9%) and movement (11.3%) were all changed (P 0.05) in ingestion frequency between time periods. The highest frequency of ingestion occurred during 06:00-21:00h and was lowest at 03:0006:00h in 24C horses. Ingestion was highly influenced by time of pasture access in partially confined horses; lowest ingestion was 18:00-06:00h in 12CN and 06:00-18:00h in 12CD. The greatest compensatory ingestion occurred in

Wildlife crop depredation in the Luangwa Valley, eastern Zambia

Wildlife crop raiding was assessed in six chiefdoms of the Luangwa Valley, eastern Zambia between 2004 and 2008 to establish nature and extent of wildlife crop degredation and examine the impact of existing mitigation measures being implemented to deter wildlife crop raiding. Crop damage assessments, involving crop quality, stage of growth and proportion of crop damage, were conducted using six trained field enumerators. Structured questionnaires were administered randomly to local farmers that were inflicted by wildlife crop raiders to elucidate on-farm deterrence measures. Eleven species of wildlife were identified as ‘problem animals’: African elephant (Loxodonta africana), Hippopotamus(Hippopotamus amphibius), Bushpig (Potamochoerus larvatus), Yellow baboon (Papio cynocephalus), Porcupine (Hystrix africaeaustralis), African civet (Civetta civetta), Roan antelope (Hippotragus equinus), Lesser kudu (Tragelaphus strepsiceros), Eland(Taurotragus oryx), Cape buffalo (Syncerus caffer) and Warthog (Phacochoerus africanus). Results showed that African elephant caused the most damage, 67.82 and 98.41% of total wet and dry farming crop raiding incidences respectively, which occurred at crop maturity between February and April. Maize (Zea mays) and cotton (Gossypium hirsutum) were the most affected crops by problem animals, associated with 71.38 and 42.86% of the total crop raids in wet and dry farming seasons respectively. Frequency and extent of damages depended on deterrence measure applied on the crop fields. Of the six chiefdoms, in Malama chiefdom where solar powered electric fences and Capsicum fences were implemented, there were few and less intensive incursions. Based on the findings, we suggest development of capacity for local farmers in effective wildlife crop mitigation measures, particularly against African elephants. Future research would require determining uptake by local farmers and efficacy of novel counter-measures. Key words: Wildlife crop raiding, conservation, Luangwa Valley