Awareness of visceral leishmaniasis and its relationship to canine infection in riverside endemic areas in Northeastern Brazil

IntroductionAn awareness of visceral leishmaniasis (VL) is necessary to encourage the population to participate in prevention and control in collaboration with more efficient, centrally organized health programs. The aim of this study was to evaluate the awareness of the riverside population regarding VL and the association between awareness and the prevalence of canine visceral leishmaniasis (CVL).MethodsIn total, 71 people living in riverside areas in the City of Mossoró in State of Rio Grande do Norte participated of the study, and 71 dogs were tested for CVL by polymerase chain reaction (PCR). Association analysis of several variables related to knowledge of the riverside population regarding CVL positivity was performed, yielding odds ratios (OR) and 95% confidence intervals (CI), and significance was determined using chi-square (χ2) and Fisher's exact tests.ResultsAmong individuals whose dogs tested positive for CVL, 60% did not know the cure for CVL, and these subjects were three times more likely to have a dog test positive for CVL than those who were aware the cure for CVL. Knowledge of CVL cure was the only variable that remained in the logistic model after the successive removal of variables, with an adjusted OR of 3.11 (95%CI: 1.1-8,799; p=0.032).ConclusionsInsufficient awareness regarding VL in riverside areas with CVL-positive dogs was associated with increased rates of canine infection, which suggests that changes in habits and the adoption of attitudes and preventive practices may contribute to the control and prevention of this disease. This study reinforces the need to invest in better health education programs regarding VL.

引言
提高民众对内脏利什曼病（visceral leishmaniasis，VL）的认知，有助于推动民众参与疾病防控工作，并配合更高效的集中化卫生项目开展。本研究旨在评估沿河居民对内脏利什曼病的认知水平，以及该认知与犬内脏利什曼病（canine visceral leishmaniasis，CVL）流行率之间的关联。
方法
本研究共纳入巴西北大河州莫索罗市沿河地区的71名居民，并通过聚合酶链反应（polymerase chain reaction，PCR）对71只犬开展犬内脏利什曼病检测。针对沿河居民与犬内脏利什曼病检测阳性相关的多项认知变量开展关联分析，计算比值比（odds ratios，OR）与95%置信区间（confidence intervals，CI），并通过卡方检验（chi-square，χ²）与费希尔精确检验确定统计学显著性。
结果
在犬只犬内脏利什曼病检测呈阳性的居民中，60%的人群不了解该病的治疗方案；这类居民的犬只检测呈阳性的概率是知晓该病治疗方案人群的3倍。经逐步剔除变量后，仅对犬内脏利什曼病治疗方案的认知这一变量保留在logistic回归模型中，校正后的比值比为3.11（95%CI：1.1~8.799；p=0.032）。
结论
在存在犬内脏利什曼病阳性犬只的沿河地区，民众对内脏利什曼病的认知不足与犬只感染率升高存在关联，这提示改善生活习惯、树立正确认知并落实预防措施，有助于推动该病的防控工作。本研究进一步证明，需加大针对内脏利什曼病的健康教育项目投入。