Knowledge, attitudes and practices about human African trypanosomiasis and their implications in designing intervention strategies for Yei county, South Sudan

Background
A clear understanding of the knowledge, attitudes and practices (KAP) of a particular community is necessary in order to improve control of human African trypanosomiasis (HAT).New screening and diagnostic tools and strategies were introduced into South Sudan, as part of integrated delivery of primary healthcare. Knowledge and awareness on HAT, its new/improved screening and diagnostic tools, the places and processes of getting a confirmatory diagnosis and treatment are crucial to the success of this strategy.
Methodology
A KAP survey was carried out in Yei County, South Sudan, to identify gaps in community KAP and determine the preferred channels and sources of information on the disease. The cross-sectional KAP survey utilized questionnaires, complemented with key informant interviews and a focus group discussion to elicit communal as well as individual KAP on HAT.
Findings
Most (90%) of the respondents had general knowledge on HAT. Lower levels of education, gender and geographic locations without a history of HAT interventions were associated with incorrect knowledge and/or negative perceptions about the treatability of HAT. Symptoms appearing in the late stage were best known. A majority (97.2%) would seek treatment for HAT only in a health centre. However, qualitative data indicates that existing myths circulating in the popular imagination could influence people’s practices. Seventy-one percent of the respondents said they would offer social support to patients with HAT but qualitative data highlights that stigma still exists. Misconceptions and stigma can negatively influence the health seeking behaviour of HAT cases. In relation to communication, the top preferred and effective source of communication was radio (24%).
Conclusion
Gaps in relation to KAP on HAT still exist in the community. Perceptions on HAT, specifically myths and stigma, were key gaps that need to be bridged through effective education and communication strategies for HAT control alongside other interventions.

研究背景
若要提升非洲人类锥虫病（Human African Trypanosomiasis, HAT）的防控成效，需对特定社区的知识、态度与行为（Knowledge, Attitudes and Practices, KAP）形成清晰认知。作为初级卫生保健一体化服务的组成部分，南苏丹引入了新型筛查与诊断工具及策略。了解社区对HAT的认知与知晓情况、新型/改良型筛查与诊断工具、获取确诊诊断与治疗的场所及流程，对该防控策略的成功实施至关重要。

研究方法
本研究在南苏丹耶伊县开展了一项KAP调查，旨在明确社区KAP存在的缺口，并确定该疾病相关信息的首选传播渠道与信息来源。这项横断面KAP调查以调查问卷为主要工具，辅以关键知情人访谈与焦点小组讨论，以获取社区层面与个体层面的HAT相关KAP数据。

研究结果
绝大多数（90%）受访对象具备非洲人类锥虫病的基础认知。受教育程度较低、性别因素以及未开展过HAT干预措施的地区，与对HAT可治疗性的错误认知或负面态度显著相关。民众对该病晚期症状的认知最为充分。多数（97.2%）受访对象表示仅会前往医疗卫生机构接受HAT治疗。然而，定性数据显示，民众中流传的错误认知与谣言可能会影响人们的行为模式。71%的受访对象表示愿意为HAT患者提供社会支持，但定性数据同时表明污名化现象依然存在。错误认知与污名化会对HAT患者的就医行为产生负面影响。在信息传播方面，最受青睐且效果最佳的信息来源为广播（占比24%）。

研究结论
该社区在HAT相关KAP方面仍存在认知缺口。针对HAT的认知偏差，尤其是错误谣言与污名化问题，是亟需填补的核心缺口，需通过针对HAT防控的有效教育与传播策略，并结合其他干预措施予以解决。