Strengthening anthrax outbreak response and preparedness: simulation and stakeholder education in Namisindwa district, Uganda.

IF 2.3 2区 农林科学 Q1 VETERINARY SCIENCES
Abel W Walekhwa, Lydia N Namakula, Solomon T Wafula, Ashley W Nakawuki, Edwinah Atusingwize, Winnifred K Kansiime, Brenda Nakazibwe, Robert Mwebe, Herbert K Isabirye, Margerat I Ndagire, Noah S Kiwanuka, Valentina Ndolo, Harriet Kusiima, Richard Ssekitoleko, Alex R Ario, Lawrence Mugisha
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引用次数: 0

Abstract

Background: Anthrax is a zoonotic disease caused by Bacillus anthracis that poses a significant threat to both human health and livestock. Effective preparedness and response to anthrax outbreak at the district level is essential to mitigate the devastating impact of the disease to humans and animals. The current diseaae surveillance in animals and humans uses two different infrastructure systems with online platform supported by established diagnostic facilities. The differences in surveillance systems affect timely outbreak response especially for zoonotic diseases like anthrax. We therefore aimed to assess the feasibility of implementing a simulation exercise for a potential anthrax outbreak in a local government setting and to raise the suspicion index of different district stakeholders for a potential anthrax outbreak in Namisindwa District, Uganda.

Methods: We conducted a field-based simulation exercise and a health education intervention using quantitative data collection methods. The study participants mainly members of the District Taskforce (DTF) were purposively selected given their role(s) in disease surveillance and response at the sub-national level. We combined 26 variables (all dichotomized) assessing knowledge on anthrax and knowledge on appropriate outbreak response measures into an additive composite index. We then dichotomized overall score based on the 80% blooms cutoff i.e. we considered those scoring at least 80% to have high knowledge, otherwise low. We then assessed the factors associated with knowledge using binary logistic regression with time as a proxy for the intervention effect. Odds ratios (ORs) and 95% Confidence intervals (95%CI) have been reported.

Results: The overall district readiness score was 35.0% (24/69) and was deficient in the following domains: coordination and resource mobilization (5/16), surveillance (5/11), laboratory capacity (3/10), case management (4/7), risk communications (4/12), and control measures (4/13). The overall community readiness score was 7 out of 32 (22.0%). We noted poor scores of readiness in all domains except for case management (2/2). The knowledge training did not have an effect on the overall readiness score, but improved specific domains such as control measures. Instead tertiary education was the only independent predictor of higher knowledge on anthrax and how to respond to it (OR = 1.57, 95% CI = 1.07-2.31). Training did not have a significant association with overall knowledge improvement but had an effect on several individual knowledge aspects.

Conclusion: We found that the district's preparedness to respond to a potential anthrax outbreak was inadequate, especially in coordination and mobilisation, surveillance, case management, risk communication and control measures. The health education training intervention showed increased knowledge levels compared to the pre-test and post-test an indicator that the health education sessions could increase the index of suspicion. The low preparedness underscores the urgency to strengthen anthrax preparedness in the district and could have implications for other districts. We deduce that trainings of a similar nature conducted regularly and extensively would have better effects. This study's insights are valuable for improving anthrax readiness and safeguarding public and animal health in similar settings.

加强炭疽疫情应对和准备工作:乌干达纳米辛德瓦地区的模拟和利益相关者教育。
背景:炭疽是一种由炭疽杆菌引起的人畜共患疾病,对人类健康和牲畜都构成严重威胁。为减轻炭疽病对人类和动物的破坏性影响,在地区一级有效防备和应对炭疽病爆发至关重要。目前对动物和人类的炭疽疫情监测使用两种不同的基础设施系统,在线平台由已建立的诊断设施提供支持。监测系统的差异影响了疫情的及时应对,尤其是像炭疽这样的人畜共患疾病。因此,我们旨在评估在地方政府环境中针对潜在炭疽疫情实施模拟演练的可行性,并提高不同地区利益相关者对乌干达纳米辛德瓦地区潜在炭疽疫情的怀疑指数:我们采用定量数据收集方法进行了实地模拟演练和健康教育干预。研究参与者主要是地区工作组(DTF)的成员,鉴于他们在国家以下一级的疾病监测和应对中扮演的角色,我们有目的地选择了他们。我们将评估炭疽知识和适当疫情应对措施知识的 26 个变量(均为二分法)合并为一个加法综合指数。然后,我们根据 80% Blooms 临界值对总分进行了二分法处理,即我们认为得分至少达到 80% 的人具有较高的知识水平,反之则较低。然后,我们使用二元逻辑回归评估了与知识相关的因素,并将时间作为干预效果的替代变量。报告了比率(ORs)和 95% 置信区间(95%CI):地区准备就绪总体得分率为 35.0% (24/69),在以下领域存在不足:协调和资源动员 (5/16)、监测 (5/11)、实验室能力 (3/10)、病例管理 (4/7)、风险沟通 (4/12) 和控制措施 (4/13)。在 32 项评分中,社区准备度的总得分为 7 分(22.0%)。我们注意到,除病例管理(2/2)外,所有领域的准备度得分都很低。知识培训对总体准备度得分没有影响,但改善了特定领域,如控制措施。高等教育反而是唯一能预测对炭疽病和如何应对炭疽病有更多了解的独立因素(OR = 1.57,95% CI = 1.07-2.31)。培训与整体知识水平的提高没有明显的关联,但对几个单项知识方面有影响:我们发现,该地区应对潜在炭疽疫情的准备不足,尤其是在协调和动员、监测、病例管理、风险沟通和控制措施方面。健康教育培训干预措施显示,与测试前和测试后相比,知识水平有所提高,这表明健康教育课程可以提高怀疑指数。准备不足突出了该地区加强炭疽病准备工作的紧迫性,并可能对其他地区产生影响。我们推断,定期、广泛地开展类似性质的培训会取得更好的效果。这项研究的启示对于在类似情况下提高炭疽病防备能力、保障公众和动物健康很有价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BMC Veterinary Research
BMC Veterinary Research VETERINARY SCIENCES-
CiteScore
4.80
自引率
3.80%
发文量
420
审稿时长
3-6 weeks
期刊介绍: BMC Veterinary Research is an open access, peer-reviewed journal that considers articles on all aspects of veterinary science and medicine, including the epidemiology, diagnosis, prevention and treatment of medical conditions of domestic, companion, farm and wild animals, as well as the biomedical processes that underlie their health.
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