Knowledge of, attitudes toward, and preventive practices relating to cholera and oral cholera vaccine among urban high-risk groups: findings of a cross-sectional study in Dhaka, Bangladesh

BMC Public Health

Jasim Uddin³  Firdausi Qadri¹  Alejandro Cravioto²  Ashraf Uddin Siddik¹  Ashraful Islam Khan¹  Amit Saha¹  Fahima Chowdhury¹  Farhana Khanam¹  Iqbal Ansary Khan¹  Nirod Chandra Saha¹  Sheikh Shah Tanvir Kaukab¹  Tasnuva Wahed¹ 

[1]Centre for Vaccine Sciences, icddr,b, Dhaka, Bangladesh

[2]International Vaccine Institute, Seoul, South Korea

[3]Centre for Equity and Health Systems, icddr,b, Dhaka, Bangladesh

关键词: Bangladesh;    Healthcare-seeking;    Perceptions;    Knowledge;    Oral cholera vaccine;    Cholera;   

Others  :  1162438
DOI  :  10.1186/1471-2458-13-242

 received in 2012-08-02, accepted in 2013-03-12,  发布年份 2013

【 摘 要 】

Background

In endemic countries such as Bangladesh, consequences of cholera place an enormous financial and social burden on patients and their families. Cholera vaccines not only provide health benefits to susceptible populations but also have effects on the earning capabilities and financial stability of the family. Community-based research and evaluations are necessary to understand perceptions about and practices of the community relating to cholera and oral cholera vaccines. This may help identify the ways in which such vaccines may be successfully introduced, and other preventive measures can be implemented. The present study assessed the knowledge of, attitudes toward, and preventive practices relating to cholera and oral cholera vaccine among an urban population residing in a high cholera-prone setting in Dhaka, Bangladesh.

Methods

This cross-sectional study was conducted in an area of high cholera prevalence in 15 randomly-selected clusters in Mirpur, Dhaka city. A study team collected data through a survey and in-depth interviews during December 2010–February 2011.

Results

Of 2,830 families included in the final analysis, 23% could recognize cholera as acute watery diarrhea and 16% had ever heard of oral cholera vaccine. About 54% of the respondents had poor knowledge about cholera-related issues while 97% had a positive attitude toward cholera and oral cholera vaccine. One-third showed poor practice relating to the prevention of cholera.

The findings showed a significant (p < 0.05) association between the respondents’ knowledge and sex, education, occupation, monthly overall household expenditure, attitudes and practice. In the adjusted model, male sex, having a lower monthly overall household expenditure, and having a less positive attitude toward cholera were the significant predictors to having poor knowledge.

Conclusions

The findings suggest the strengthening of health education activities to improve knowledge on cholera, its prevention and treatment and information on cholera vaccination among high-risk populations. The data also underscore the potential of mass cholera vaccination to prevent and control cholera.

【 授权许可】

   
2013 Wahed et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]World Health Organization: Global Health Observatory (GHO): Number of reported cholera cases. [http://www.who.int/gho/epidemic_diseases/cholera/cases_text/en/index.html webcite]
• [2]World Health Organization: Cholera, 2010. Wkly Epidemiol Rec 2011, 86(31):325-340.
• [3]Ali M, Lopez AL, You YA, Kim YE, Sah B, Maskery B, Clemens J: The global burden of cholera. Bull World Health Organ 2012, 90:209-218A.
• [4]World Health Organization: Cholera 2011. Wkly Epidemiol Rec 2012, 87(31–32):289-304.
• [5]International Centre for Diarrhoeal Disease Research, Bangladesh: Introduction of Cholera Vaccine in Bangladesh (ICVB)’ project disseminates progress with stakeholders. News ‘n’ Views 2011, 5(15):1.
• [6]Chowdhury F, Rahman MA, Begum YA, Khan AI, Faruque ASG, Saha NC, Baby NI, Malek MA, Kumar AR, Svennerholm A-M: Impact of rapid urbanization on the rates of infection by Vibrio cholerae O1 and enterotoxigenic Escherichia coli in Dhaka, Bangladesh. PLoS Negl Trop Dis 2011, 5(4):e999.
• [7]Griffith DC, Kelly-Hope LA, Miller MA: Review of reported cholera outbreaks worldwide, 1995–2005. Am J Trop Med Hyg 2006, 75(5):973-977.
• [8]Shultz A, Omollo JO, Burke H, Qassim M, Ochieng JB, Weinberg M, Feikin DR, Breiman RF: Cholera outbreak in Kenyan refugee camp: risk factors for illness and importance of sanitation. Am J Trop Med Hyg 2009, 80(4):640-645.
• [9]Njoh ME: The cholera epidemic and barriers to healthy hygiene and sanitation in Cameroon: a protocol study. PhD thesis. Umea University, Department of Epidemiology and Public Health; 2010. http://bvs.per.paho.org/texcom/colera/MENjoh.pdf webcite
• [10]Ali M, Emch M, Donnay J, Yunus M, Sack R: Identifying environmental risk factors for endemic cholera: a raster GIS approach. Health Place 2002, 8:201-210.
• [11]Huq A, Sack RB, Nizam A, Longini IM, Nair GB, Ali A, Morris JG, Khan MNH, Siddique AK, Yunus M: Critical factors influencing the occurrence of Vibrio cholerae in the environment of Bangladesh. Appl Environ Microbiol 2005, 71(8):4645-4654.
• [12]Chipare T: Strategies to cope with the impact of cholera on Zimbabwe from 2008 to 2009: a case study of Budiriro high density suburb, city of Harare. Master’s dissertation. University of The Free State, Disaster Management Training and Education Centre for Africa; 2010. http://natagri.ufs.ac.za/dl/userfiles/Documents/00002/2266_eng.pdf webcite
• [13]Poulos C, Riewpaiboon A, Stewart JF, Clemens J, Guh S, Agtini M, Sur D, Islam Z, Lucas M, Whittington D: Costs of illness due to endemic cholera. Epidemiol Infect 2011, 140(3):500-509.
• [14]Kirigia JM, Sambo LG, Yokouide A, Alley ES, Muthuri LK, Kirigia DG: Economic burden of cholera in the WHO African region. BMC Int Health Human Rights 2009, 9(8):1-14.
• [15]Schaetti C, Khatib AM, Ali SM, Hutubessy R, Chaignat C-L, Weiss MG: Social and cultural features of cholera and shigellosis in peri-urban and rural communities of Zanzibar. BMC Infect Dis 2010, 10(339):1-14.
• [16]World Health Organization: Cholera: mechanism for control and prevention. [http://www.who.int/cholera/technical/Resolution_CholeraA64_R15-en.pdf webcite]
• [17]World Health Organization: WHO Technical Working Group on creation of an oral cholera vaccine stockpile. Geneva; 2012. [http://apps.who.int/iris/bitstream/10665/75240/1/WHO_HSE_PED_2012_2_eng.pdf webcite]
• [18]World Health Organization: Cholera, 2009. Wkly Epidemiol Rec 2010, 85(31):293-308.
• [19]World Health Organization: Cholera vaccines: WHO position paper. Wkly Epidemiol Rec 2010, 85(13):117-128.
• [20]Quick RE, Gerber ML, Palacios AM, Beingoleat L, Vargas R, Mujica O, Moreno D, Seminario L, Smithwick EB, Tauxe RV: Using a knowledge, attitudes and practices survey to supplement findings of an outbreak investigation: cholera prevention measures during the 1991 epidemic in Peru. Int J Epidemiol 1996, 25(4):872-878.
• [21]Mpazi VM, Mnyika KS: Knowledge, attitudes and practices regarding cholera outbreaks in Ilala Municipality of Dar Es Salaam region, Tanznia. East Afr J Public Health Volume 2005, 2:6-11.
• [22]Chingayipe EM: Factors affecting cholera case detection by the communities in Chiradzulu district. Master’s dissertation. University of Malawi, College of Medicine, Environmental Health; 2008. http://www.medcol.mw/mph/dissertations/intake%202005/Elizabeth%20Chingayipe.pdf webcite
• [23]Maekawa M, Douangmala S, Sakisaka K, Takahashi K, Phathammavong O, Xeuatvongsa A, Kuroiwa C: Factors affecting routine immunization coverage among children aged 12–59 months in Lao PDR after regional polio eradication in Western Pacific Region. Bio Sci Trends 2007, 1(1):43-51.
• [24]Odusanya OO, Alufohai EF, Meurice FP, Ahonkhai VI: Determinants of vaccination coverage in rural Nigeria. BMC Public Health 2008, 8(381):1-8.
• [25]Journal of Pakistan Medical Association: Improving vaccination status of children under five through health education. JPMA 2004, 54:610.
• [26]IMMUNIZATION basics Project: Epidemiology of the unimmunized child: findings from the grey literature. Arlington, VA, USA; 2009. http://www.who.int/immunization/sage/ImmBasics_Epid_unimm_Final_v2.pdf webcite
• [27]Qidwai W, Ali SS, Ayub S, Ayub S: Knowledge, attitude and practice regarding immunization among family practice patients. JDUHS 2007, 1(1):15-19.
• [28]Rahman MM, Islam MA, Mahalanabis D: Mothers' knowledge about vaccine preventable diseases and immunization coverage of a population with high rate of illiteracy. J Trop Pediatr 1995, 41(6):376-378.
• [29]ICDDR,B opens a new urban treatment centre to cope with ongoing diarrhoeal disease demand. [http://www.icddrb.org/media-centre/news/2012-icddrb-opens-a-new-urban-treatment-centre-to-cope-with-ongoing-diarrhoeal-disease-demand webcite]
• [30]Saha A, Chowdhury MI, Khanam F, Bhuiyana S, Chowdhury F, Khan AI, Khan IA, Clemens J, Ali M, Cravioto A: Safety and immunogenicity study of a killed bivalent (O1 and O139) whole-cell oral cholera vaccine Shanchol, in Bangladeshi adults and children as young as 1 year of age. Vaccine 2011, 29:8285-8292.
• [31]Khan IA, Qadri F: Strategic guidelines for oral cholera vaccine delivery. Dhaka: icddr,b; 2011.
• [32]Reza S: Communicable diseases: gastrointestinal infections. In The essentials of community medicine. Edited by Reza S. Dhaka: Parash Publishers; 2002:112-114.
• [33]Pearson B: Coping with cholera: the importance of coordinated planning. Africa Health 2011, 18-24. http://www.africa-health.com/articles/january_2011/Cholera.pdf webcite
• [34]World Health Organization: Prevention and control of cholera outbreaks: WHO policy and recommendations. [http://www.who.int/cholera/technical/prevention/control/en/index.html webcite]
• [35]World Health Organization: Updated WHO position paper on cholera vaccines. Geneva; 2010. [http://www.who.int/immunization/cholera_PP_slides_20_Mar_2010.pdf webcite]
• [36]Yap J, Lee VJ, Yau TY, Ng TP, Tor P: Knowledge, attitudes and practices towards pandemic influenza among cases, close contacts, and healthcare workers in tropical Singapore: a cross-sectional survey. BMC Public Health 2010, 10(442):2-8.
• [37]Leung GM, Quah S, Ho L-M, Ho S-Y, Hedley AJ, Lee H-P, Lam T-H: A tale of two cities: community psychobehavioral surveillance and related impact on outbreak control in Hong Kong and Singapore during the severe acute respiratory syndrome epidemic. Infect Control Hosp Epidemiol 2004, 25(12):1033-1041.
• [38]Mascie CGN: Manual for Epidemiology, Biostatistics & use of SPSS for Windows. UK: University of Cambridge; 2005.
• [39]Blum LS, Nahar N: Cultural and social context of dysentery: implications for the introduction of a new vaccine. J Health Popul Nutr 2004, 22(2):159-169.
• [40]Mushtaque A, Chowdhury R, Kabir ZN: Folk terminology for diarrhea in rural Bangladesh. Clin Infect Dis 1991, 13(Supplement 4):S252-s254.
• [41]Communicating with Disaster Affected Communities: Baseline survey on the evaluation of the impact of the communication campaign on cholera (knowledge and perceptions of beneficiaries on information, prevention and treatments measures). Haiti: CDAC; 2010.
• [42]Rochars VEBD, Tipret J, Patrick M, Jacobson L, Barbour KE, Berendes D, Bensyl D, Frazier C, Domercant JW, Archer R: Knowledge, attitudes, and practices related to treatment and prevention of cholera, Haiti, 2010. Emerg Infect Dis 2011, 17(11):2158-2161.
• [43]Weil AA, Khan AI, Chowdhury F, LaRocque RC, Faruque ASG, Ryan ET, Calderwood SB, Qadri F, Harris JB: Clinical outcomes in household contacts of patients with cholera in Bangladesh. Clin Infect Dis 2009, 49:1473-1479.
• [44]UNICEF: Sanitation, hygiene and water supply in urban slums. Dhaka; 2008. [http://www.unicef.org/bangladesh/URBAN_Water_Sanitation_and_Hygiene.pdf webcite]
• [45]Nsungu M, Jonga M: Does a direct cholera threat necessarily improve the knowledge, attitude and practices on the disease? Cent Afr J Med 1996, 42(5):125-128.
• [46]Fening K, Edoh DA: The impact of socio-economic status and sanitation levels on the prevalence of diarrhoeal diseases in the Akim Oda area of Ghana. Internet J Epidemiol 2009, 6(2):10.
• [47]Wahed T, Moran AC, Iqbal M: The perspectives of clients and unqualified allopathic practitioners on the management of delivery care in urban slums, Dhaka, Bangladesh - a mixed method study. BMC Pregnancy Childbirth 2010, 10(1):50. BioMed Central Full Text
• [48]Bangladesh Health Watch: The state of health in Bangladesh 2007. Health workforce in Bangladesh: Who constitutes the healthcare system?. Dhaka: Center for Health System Studies, James P. Grant School of Public Health, BRAC University; 2008.