Avaliação do nível de conhecimento que populações residentes em áreas endêmicas têm sobre leishmaniose visceral, Estado do Maranhão, Brasil

Cutaneous leishmaniasis in Kutaber District, Ethiopia: Prevalence, sand fly fauna and community knowledge, attitude and practices

Background

Cutaneous leishmaniasis (CL) affects 25% of the population living in the highlands of Ethiopia. CL intervention has not decreased the number of leishmaniasis patients. A cross-sectional study was conducted to determine CL prevalence, community's knowledge, attitude and practices (KAP), and the sand fly fauna in Kutaber district, northeast Ethiopia.

Methods

A retrospective, community-based cross-sectional study was conducted in Boru Meda Hospital from December 2014-March 2021 to study CL prevalence of Kutaber district. A Pre-tested, well-structured questionnaire was used to collect data on the participants' socio-demographic characteristics, KAP towards CL and knowledge about sand fly vectors. Chi-square test and logistic regression analysis were used in the study, and data were analyzed using SPSS version 23 (p < 0.05).

Results

A total of 10,002 (14.02%), of which 71,325 samples were confirmed as positive for CL. The infection rate of CL in females (7.1%) was a little bit higher than males (7.0%). More cases were recorded among 15-29 age category. The study also revealed that 77.1% of the respondents had poor knowledge about CL treatment, prevention, clinical presentation and disease transmission. Farmers tended to have poorer knowledge about sand flies than non-workers and students (32.7 vs. 35 and 44.1%; P = 0.049). Housewives had poorer knowledge about sand flies than farmers and workers (22.2 vs. 32.7 and 33.3%; P = 0.023). Phlebotomus longipes comprised the highest composition (80%) of the sand fly species identified in Kutaber district.

Conclusions

The data showed that the community had poor knowledge about CL, vector, and transmission mode. CL preventive measures were prevalent, implying the need to raise CL awareness. Phlebotomus longipes was identified as the most dominant sand fly species which accounted for CL. The findings can be used in developing an effective control strategy to reduce CL transmission in the study area and elsewhere in Ethiopia.

Knowledge and attitude towards cutaneous leishmaniasis among rural endemic communities in Shara'b district, Taiz, southwestern Yemen

Background

Cutaneous leishmaniasis (CL), a neglected tropical disease, represents a significant public health problem in many endemic countries including Yemen. The ongoing armed conflict that started in March 2015 has had a negative impact on the entire healthcare system as well as on infectious disease control programmes. Therefore, this cross-sectional study aimed to assess knowledge and attitude towards CL among rural endemic communities in southwestern Yemen.

Methods

Five hundred households in five areas of Shara’b district of Taiz governorate were randomly selected to participate in a quantitative survey. A pretested structured questionnaire was used to collect data on the sociodemographic characteristics of the participants, their knowledge and attitude towards CL and their knowledge on the sand fly vector.

Results

The analysis was conducted on a final sample of 466 individuals (62.7% males and 37.3% females) aged between 18 and 70 years. Among the participants, 21.5% were non-educated while 39.7 and 20.8% had completed secondary school and tertiary education, respectively. Although the participants were aware of CL, about three quarters (77.7%) of them had poor overall knowledge about disease transmission, clinical presentation, treatment, and prevention. Interestingly, approximately half of the participants (49.1%) were able to differentiate sand flies from other flies and mosquitoes. However, only 14.8% of the participants knew about the role of the phlebotomine sand fly in the transmission of CL. Only 36.6% believed that CL can be prevented and 49.6% had a negative attitude towards the disease. Univariate and multivariate analyses showed that age and gender were the significant determinants of knowledge about CL and the sand fly vector among the studied population.

Conclusion

A poor level of knowledge about the different epidemiological aspects of CL was found among rural CL-endemic communities in Taiz. This factor, together with the major collapse of the healthcare infrastructure due to the ongoing civil war in Yemen, may be contributing to the continued endemicity of CL in the governorate. It is therefore recommended that health education on CL transmission and prevention should be provided to the targeted communities.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12879-021-05965-4.

Level of Knowledge and Risk Factors for Visceral Leishmaniasis in a Mining Area of Minas Gerais State, Brazil

Aiming to optimize and adjust leishmaniasis prevention and control measures for the resident population of Pains, state of Minas Gerais, Brazil, a structured questionnaire containing conceptual questions and questions about household characteristics was used to evaluate knowledge level and exposure risk. A total of 396 individuals were interviewed revealing unscientific and fragmented knowledge about the subject for most of the studied population. The female population was found to have 1.68 times more chance of knowing about the disease than the male population, while highly educated individuals were found to have 2.92 times more chances of knowing about leishmaniasis compared to basic educated individuals. All of the respondents reported the presence of, at least, one risk factor, while ages ≥40 years were considered a protective factor compared to younger ages, indicating that older individuals are more likely to recognize risks and protect themselves against leishmaniasis. These results will contribute to the production of didactic materials for the population with respect to their previous knowledge and will provide a basis for control and prophylactic measures.

Peridomiciliary risk factors and knowledge concerning visceral leishmaniasis in the population of formiga, Minas Gerais, Brazil

INTRODUCTION

Leishmaniasis represents an important burden of diseases in tropical countries, with significant levels of morbidity and mortality where they occur, including in Brazil. In this context, popular participation in prophylactic actions can be decisive for the success of the control strategies.

OBJECTIVE

For this reason, this study aimed at investigating the population's knowledge concerning leishmaniasis and the occurrence of peridomiciliary risk factors associated with the population of Formiga, Minas Gerais.

METHODS

A household questionnaire with a sample of 427 individuals was conducted between May and July 2011.

RESULTS

Only 7.5% of the residents presented knowledge regarding leishmaniasis, most of them being women (OR = 3.15; 95%CI 1.30 - 7.65). The prevalence of peridomiciliary risks was 95%. A statistically significant association was found between higher education levels and less peridomiciliary risk factors (OR = 0.45; 95%CI 0.28 - 0.72) and between the place of residence and a higher number of risk factors (OR = 0.84; 95%CI 1.19 - 2.85).

CONCLUSION

The results demonstrate that the population has low levels of knowledge about leishmaniasis. Moreover, the majority of respondents are subject to some peridomiciliary risk factor, which may contribute to the maintenance of the disease cycle in the city.

Perceptions of the population and health professionals regarding visceral leishmaniasis

Based on theoretical qualitative research reference methodology, this study sought to investigate the perception of visceral leishmaniasis (VL) by social actors directly involved in the prevention and control of the disease. Thirty-eight semi-structured interviews were conducted with residents, focus groups were staged with 18 health workers in an endemic VL area and depositions were collected, which after being processed by content analysis revealed shortcomings and challenges. The population associated VL with dogs, acknowledged their co-responsibility in tackling the disease and demanded information. Health workers identified environmental sanitation as an essential factor for VL prevention. Among the shortcomings, the lack of information about the disease and culpability of the individual because of non-adherence to prevention measures were observed, especially environmental management. Probably, approaches emphasizing the role of the environment as a health promotion agent and the timely definition of specific environmental measures against VL, constitute a prospect for overcoming these shortcomings. The consensus is that the main challenge for enhancing the prevention and control might be the participatory and dialogical construction of these approaches between health professionals and the population.

Conhecimentos de estudantes sobre Leishmaniose Visceral em escolas públicas de Caxias, Maranhão, Brasil

Trata-se de um inquérito amostral (743 questionários), realizado nos meses de abril a novembro de 2009 em dez escolas públicas municipais, previamente sorteadas e localizadas em oito bairros da cidade de Caxias. Avaliou-se por meio da aplicação de questionários fechados, o conhecimento dos estudantes sobre a Leishmaniose Visceral (LV), seu vetor e prevenção. Os resultados mostraram mudanças com maior percentual de acertos quanto às respostas sobre a transmissão da doença e quanto aos sintomas da LV no homem e no cão após as campanhas. Contudo, as campanhas educativas são necessárias como medidas para fortalecer a participação da população no combate à LV, pois antes do trabalho educativo a maioria dos estudantes disse que se prevenia da doença evitando contato com cães doentes, entretanto, após as campanhas os mesmos disseram evitar acúmulo de lixo. A pesquisa pode servir como subsídio para orientar novas ações educativas das equipes locais de controle da LV.

[Perception of the zoonosis and responsible pet care by the parents from public schools kindergarten located at metropolitan region of Recife, northeast of Brazil]

The goal of this research was to examine parents' perception of the zoonosis and responsible pet care, observing their level of knowledge and awareness about the theme. A convenience sample of 64 parents from two kindergarten schools located at Metropolitan Region of Recife, Pernambuco State, was surveyed using a perception questionnaire. Findings indicate that 71.8 % didn't know the meaning of the term zoonosis, but 16% recognize at least one type of the disease. Diseases transmitted from animals to humans were associated to the way of transmission, as physical contact between animal and man, bite wound disease, fecal contamination of water, food with cysts or eggs of nematodes, skin penetration of nematodes, and also the arthropod borne disease. The major pet health care reported was rabies vaccine (92.2%), anthelmintic therapy (76.6%), and pet care provide by a veterinarian (82.8%). However, 23.4% of the parents had some knowledge about the zoonotic infections transmitted by dogs and cats feces. The parent's awareness not only about the risks about the diseases transmitted from animals to humans but also the responsible pet care, constitute a important tool to reduce risk of zoonosis transmission.

[Assessment of knowledge and preventive attitudes concerning visceral leishmaniasis in Belo Horizonte, Minas Gerais State, Brazil]

The main objective of this study was to evaluate knowledge concerning visceral leishmaniasis and attitudes used to prevent the disease in Belo Horizonte, Minas Gerais State, Brazil, in 2006. A case-control study was conducted, with home visits and a questionnaire. The odds ratio was calculated, comparing 82 cases of human visceral leishmaniasis in 2004 and 164 controls (neighbors of cases). The disease was more frequent in children (OR=109.77). Visceral leishmaniasis was 2.57 times more likely in males than in females. Overall schooling level was low (68.3% of subjects had not completed secondary school). Half of the cases did not know what visceral leishmaniasis was, and only 1.2% could identify the vector. Having basic knowledge of visceral leishmaniasis reduced the odds of acquiring the disease by 2.24 times. Keeping the house clean and taking pet dogs to the veterinarian reduced the risk by 1.94 times. In Belo Horizonte, the population's level of knowledge on visceral leishmaniasis is superficial, and preventive attitudes are inaccurate.

Atendimento de pacientes com leishmaniose tegumentar americana: avaliação nos serviços de saúde de municípios do noroeste do Estado do Paraná, Brasil

Avalia-se o atendimento ambulatorial oferecido aos pacientes com leishmaniose tegumentar americana, de 2001 a 2004, antes e após a descentralização, em municípios do noroeste do Estado do Paraná, Brasil. Foram analisados 229 prontuários de pacientes com leishmaniose tegumentar americana. Observou-se que no atendimento centralizado a avaliação clínica e os registros médicos foram mais completos e criteriosos; o tratamento iniciou-se mais prontamente; o acompanhamento do desfecho em 95% dos pacientes e em 100% dos casos tratados com duas séries de tratamento foi avaliado. Foram observados os critérios recomendados pelo Manual de Controle da Leishmaniose Tegumentar Americana. Após a descentralização, o rigor no atendimento aos pacientes diminuiu: 32% dos pacientes foram tratados com duas séries de antimoniato N-metil glucamina, sem observação dos critérios recomendados. Detectou-se que 72,6% do acompanhamento dos pacientes foi inadequado e 84% da avaliação clínica não foram realizadas. A falta de registro dos prontuários constituiu importante obstáculo para a avaliação das atividades. O presente estudo não evidenciou benefícios significativos com a descentralização.

Children and adolescents victimized by sexual abuse in the city of Rio de Janeiro: An appraisal of cases

Physical and/or sexual abuse, negligence, and psychological abuse against children and adolescents, constitute a socially important syndrome, demanding preventive public policies and rules for its eradication. Sexual abuse, as a troublesome occurrence, or even its mere presumption, does not regularly undergo official notification. We have examined legal investigative registers at the Instituto Médico-Legal do Rio de Janeiro - Sede set up from January to March 2000, including women, children and adolescents, with medico-legal histories suggestive of sexual assault. From a sample of 1419 cases, we selected those involving vaginal coitus or other libidinous practices, with an upper age limit of 17 years, reducing our sample to 44 subjects. 84.09% of the assaults occurred between ages 0 and 14 years. In 62.36% of the studied cases there was no mention about perpetrators. Material for laboratory researches had not been collected in 84.09% of the cases. There is any lesions in 70.45% of the sample.

[Prevalence of infection by Leishmania chagasi using ELISA (rK39 and CRUDE) and the Montenegro skin test in an endemic leishmaniasis area of Maranhão, Brazil]

A prospective study was undertaken in 1,520 children less than 15 years of age in São José de Ribamar, Maranhão, Brazil, from June 1994 to January 1995, to evaluate the prevalence and characteristics (socioeconomic, environmental, and behavioral) associated with infection by Leishmania chagasi. Montenegro skin test (MST) and enzyme-linked immunosorbent assay (ELISA-rK39 and CRUDE) test were used to detect infection. The statistical analysis used the chi2 test with Yates correction and a p value less than 0.05 was considered statistically significant. Prevalence of infection was 61.7% as measured by MST, 19.4% according to ELISA (rK39), and 19.7% by ELISA (CRUDE). Association was detected between leishmaniasis in the family, water supply, application of insecticide, and infection by L. chagasi using MST. No association with infection by L. chagasi was detected using ELISA rK39 or CRUDE. More effective control measures are needed to reduce prevalence and to detect asymptomatic cases in this high percentage of infected children.

Evaluation of a pamphlet on visceral leishmaniasis as a tool for providing disease information to healthcare professionals and laypersons

Although educational materials are frequently produced and used as part of control programs in Brazil, little is known about the efficacy of this type of information. This study evaluated the potential for disseminating information on visceral leishmaniasis using a pamphlet. The sample consisted of 551 healthcare workers and 379 laypeople from a metropolitan area located in southeast Brazil. Both before and after reading the pamphlet, subjects completed a multiple-choice questionnaire. Overall baseline knowledge of the disease was estimated by the proportion of correct answers before reading the pamphlet. Although specific knowledge among zoonosis control workers was higher (90.0% on average), overall baseline knowledge of the disease varied from 45.0% to 77.0%. After reading the pamphlet, the levels increased to 71.0% and 96.0%, respectively. Before reading, the lowest proportion of correct answers in all groups related to the disease symptoms. Analysis of incorrect answers showed that visceral leishmaniasis is mainly confused with leptospirosis. The increased proportion of correct answers after reading the pamphlet is evidence of its potential as an educational tool.

[Health education: teaching about American tegumentary leishmaniasis]

Knowledge on the circulation of American tegumentary leishmaniasis (ATL) and perception by the local population are highly relevant for developing a control program, since they mobilize the community for effective health measures. This work aimed to orient primary school teachers and pupils (grades 1 through 4) in the public school system in Maricá, Rio de Janeiro State, Brazil, on ATL, using talks, posters, and leaflets with an interactive approach. Talks were given in seven municipal schools, and activities were held with 1,314 pupils and 56 teachers. Leaflets were distributed to the pupils with activities to help consolidate the content. Two months later one school was chosen for post-evaluation. Of the 213 pupils who had attended the talk, 198 answered a questionnaire, of whom 178 (89.9%) could remember the disease and 125 (63.1%) provided correct answers on transmission. Thus, informed children and teachers can function as information disseminators in health within their community and are therefore capable of contributing to control of endemic diseases.

Evaluation of informative materials on leishmaniasis distributed in Brazil: criteria and basis for the production and improvement of health education materials

Based on categories related to structure, content, language, and illustrations, the present study provides an evaluation of the quality of educational materials on leishmaniasis available to health services in Brazil. The 18 publications evaluated consisted of four handbooks, four guided studies, four booklets, and six leaflets. Of the total publications assessed, nine were produced by the Brazilian National Health Foundation (FUNASA), five by State and Municipal Health Departments jointly with FUNASA, and one by the Pan-American Health Organization. The evaluations were also performed by three professionals: a physician specialized in leishmaniasis, a parasitologist, and an information/communications expert. The publications failed to specify key items such as target public, objective, and bibliography. The illustrations, especially in the booklets and leaflets, failed to clarify the text, portrayed biased concepts, and omitted credits and scale. According to this study, informative materials on leishmaniasis distributed in Brazil present major limitations which jeopardize the quality of information they contain.

[knowledge level about of American tegumentary leishmaniasis (ATL) and use of alternative therapies in an endemic area in the Amazon Region in the State of Maranhão, Brazil]

The level of knowledge concerning American tegumentary leishmaniasis (ATL) and use of alternative therapies was evaluated in five rural communities in Buriticupu, Maranhão State, Brazil. The study lasted from September 1997 to January 1998. Local inhabitants answered an interview on housing conditions, epidemiological aspects, prevention, standard clinical treatment, and alternative therapies. The study population was 378 (19%) out of a total of 1,980 inhabitants, from Sexta Vicinal (35), Quinta Vicinal (63), Trilha 410 (96), Vila União (85), and Buritizinho (99). Of the interviewees, 72% had little knowledge of ATL transmission, 96% had heard something about the disease from friends, and 60.7% knew ATL by the local term "lésh". Glucantime was the most familiar drug for treatment, while 29.6% referred to use of herbal remedies on the ulcers. Citrus limon (lemon) was the plant most frequently used, and 15.4% of the interviewees used it as a powder spread on the wound. We conclude that the population had little correct knowledge of ATL in the five areas studied, especially with regard to prevention and treatment.

[Socioeconomic factors and attitudes towards household prevention of American cutaneous leishmaniasis in an endemic area in Southern Bahia, Brazil]

A survey was conducted to identify socioeconomic conditions and attitudes towards household prevention of American cutaneous leishmaniasis in Corte de Pedra, located in the county of Tancredo Neves, an endemic region in southern Bahia, Brazil. A questionnaire was applied in July 1997, focusing on social and economic variables, habits, and attitudes towards prevention of arthropod bites. All families (100%) living in the study area were surveyed, comprising 168 households with 851 individuals. Approximately 66.7% of the families earned up to one minimum wage, supporting an average of 5.1 residents per household. Most (57.2%) of the families did not use any type of protection against bites. Fumigation by burning various types of materials was the most customary form of prevention. Individual protection measures were rarely used. Since there was evidence of household and peridomiciliary transmission in the study area, use of impregnated bed nets is an alternative for intradomiciliary protection.