Preventive Practices of Hantavirus in a Rural Community in Panama: An Explanatory Sequential Mixed Methods Study

INTRODUCTION

Preventive care practices are a challenge in community care. This study examined hantavirus preventive practices and their relationship with personal and social factors, lifestyle, and cultural beliefs.

METHOD

An explanatory sequential mixed methods design, guided by Leininger's Theory of Culture Care Diversity and Universality, was used in two phases: (a) a cross-sectional relational design (n = 109) and (b) ethnonursing research (n = 30), in an endemic community in Panama. Univariate and bivariate analyses were used to analyze the quantitative data, whereas the Leininger's analysis model was used to analyze the qualitative data.

RESULTS

In the quantitative phase, the most frequent preventive practice was household hygiene, and the least frequent was vector control. Two of the eight preventive practices were associated with personal factors and two were associated with social factors. In the qualitative phase, lifestyle, beliefs, and context were found to influence the adoption of hantavirus preventive practices and help explain the quantitative findings.

DISCUSSION

Knowledge and understanding of the social and cultural contexts are essential for hantavirus prevention.

Striving for long term sustainability - is it time we changed our approach to animal health in low- and middle-income countries?

Animal health and agricultural productivity in low- and middle-income countries have been the focus of research for development (R4D) projects for decades, with varying levels of success when considering the long-term sustainability of interventions. Many of these projects have been funded, designed and implemented by researchers from high income countries, and therefore risk neglecting the cultural nuances and complex country histories that can influence their success. This opinion piece suggests three broad recommendations: (1) implementing culturally congruent practices to improve disease control and prevention practices at the village level; (2) promoting public-private partnerships to improve control of transboundary animal diseases; and (3) improving national animal health and veterinary services and their governance to improve disease surveillance, control and prevention. Development researchers need to consider implementing these approaches in future projects to improve the suitability and sustainability of interventions and acknowledging the current technical capacity of host countries. Foreign donor organisations need to ensure their funding guidelines and reporting requirements allow for these recommendations to be adequately implemented.

Leaving no one behind: targeting mobile and migrant populations with health interventions for disease elimination-a descriptive systematic review

BACKGROUND

Mobile and migrant populations (MMPs) pose a unique challenge to disease elimination campaigns as they are often hard to survey and reach with treatment. While some elimination efforts have had success reaching MMPs, other campaigns are struggling to do so, which may be affecting progress towards disease control and elimination. Therefore, this paper reviews the literature on elimination campaigns targeting MMPs across a selection of elimination diseases-neglected tropical diseases, malaria, trypanosomiasis, polio, smallpox, and rinderpest.

METHODS

Through a systematic review process following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a three-person review team identified papers from databases, conference records, and citation searches using inclusion/exclusion criteria. Papers were divided into three key outcome domains during the synthetization process: (1) MMP movement patterns in East Africa including reasons for movement and consequences in terms of health outcomes and healthcare access; (2) MMP contribution to the transmission of disease across all geographies; (3) surveillance methods and treatment interventions used to implement programming in MMPs across all geographies. Experts in the field also provided supplemental information and gray literature to support this review.

RESULTS

The review identified 103 records which were descriptively analyzed using the outcome domains. The results indicate that in East Africa, there are various motivations for migration from economic opportunity to political unrest to natural disasters. Regardless of motivation, mobile lifestyles affect health service access such that MMPs in East Africa report barriers in accessing healthcare and have limited health knowledge. Often lower service delivery to these populations has resulted in higher disease prevalence. A minority of articles suggest MMPs do not pose challenges to reaching disease control and elimination thresholds. Finally, the literature highlighted surveillance methods (e.g., using satellite imagery or mobile phone data to track movement, participatory mapping, snowball sampling) and intervention strategies (e.g., integration with animal health campaigns, cross-border coordination, alternative mass drug administration [MDA] methods) to implement health interventions in MMPs.

CONCLUSIONS

Ultimately, the literature reviewed here can inform programmatic decisions as the community attempts to reach these never treated populations.

SYSTEMATIC REVIEW REGISTRATION

The protocol for this manuscript was registered with the International Prospective Registry of Systematic Reviews (PROSPERO) (No. CRD42021214743).

Leininger's Theory of Culture Care Diversity and Universality: An Overview With a Historical Retrospective and a View Toward the Future

An historical overview of Leininger's Theory of Culture Care Diversity and Universality also known as the Culture Care Theory (CCT) and evolution of the Sunrise Enabler are presented along with descriptions of the theory purpose, goal, tenets, basic assumptions, major core constructs, and orientational definitions. Recent articles, books, and book chapters provide relevant exemplars to enhance scholarly understanding and application of theory constructs. Proposed future directions encompass using the CCT to guide research of discovery and translational research projects for evidenced-based nursing practice; develop nursing courses and curricula to prepare culturally competent nurses; guide future culturally competent administrative and leadership policies and procedures; inform public policy related to cultural diversity and underserved populations; promote grant writing initiatives to enhance cultural diversity in hiring nursing staff, supervisors, and faculty; and promote admission of nursing students from underserved and/or diverse backgrounds.

Addressing the Challenges of Conducting Research in Developing Countries

PURPOSE

To explore the unique challenges that occur when conducting research in developing countries so the reader can consider approaches for providing ethically and culturally appropriate research strategies applicable for the context of the host country.

ORGANIZING CONSTRUCT

This article presents an overview of the challenges, which are organized based on the phases of the research period: pre-enrollment, enrollment, and post-enrollment. At each stage, examples of adaptation to meet the challenges are presented and recommendations are posited.

CONCLUSIONS

Strategies for research should protect the rights of the most vulnerable and disadvantaged populations while balancing the needs of society at large, provide culturally relevant ethical informed consent while balancing institutional review board requirements, and conduct research in a culturally appropriate manner for the host country while balancing the principles of ethical research established by developed countries.

CLINICAL RELEVANCE

Researchers are implored to focus on the ethical and cultural appropriateness of each aspect of the study process to afford the highest level of research credibility and validity.