Knowledge, attitudes, and practices regarding the leishmaniases among inhabitants from a Paraguayan district in the border area between Argentina, Brazil, and Paraguay

  • Andrea Giménez-Ayala
  • Nilsa González-Brítez
  • Antonieta Rojas- de- Arias
  • Mónica Ruoti
Original Article
  • 26 Downloads

Abstract

Aims

Leishmaniasis is caused by parasites of the genus Leishmania sp. that differ in their geographical distribution, hosts, and vectors. Knowledge, attitudes, and practices (KAP) of the population are important to understand their relation to the disease. The aim of this study was to characterize KAP with regard to the leishmaniases in inhabitants of the triple border area Argentina–Brazil–Paraguay in specific neighborhoods where infected dogs were found and phlebotomine were captured, identifying a transmission focus.

Methods

This is an observational, descriptive design based on a quantitative transversal survey. Sixty-two surveys were applied in homes located in areas at risk. Surveys were carried out in households in the San Francisco and Santa Rosa neighborhoods where the presence of infected reservoirs (dogs) was confirmed and Lu. longipalpis had been previously identified and captured.

Results

Seventy-one percent of respondents stated that they had heard about the disease. Knowledge about types, mode of transmission, and symptoms of the disease was rare. Attitudes and practices were closely related to pet dogs, and confusion between human and canine cases was noticed. There was a major flaw in the public services responsible for the transfer of knowledge to the population.

Conclusion

These results suggest the necessity of conducting an educational intervention in these vulnerable populations, to improve conditions for prevention and control of leishmaniasis in the triple border where the flux of people is very intense and the chances of outbreaks are currently very high.

Graphical abstract

Keywords

Leishmaniasis, knowledge, attitudes, practices in health, border areas 

Notes

Acknowledgements

Researchers benefited from The National Program of Incentive to the Investigator (PRONII in Spanish) from the National Council of Science and Technology (CONACYT), Paraguay.

Authors contribution

AG, MR, and ARdA conceived and designed the protocol; NG, AG, and MR performed the surveys; AG and ArdA analyzed the data; AG and ARdA wrote the paper.

Compliance with ethical standards

Financial support

This work was partially supported by the International Development Research Centre (IDRC) (Grant no. 103696–009) and the Project Research, Education and Biotechnology applied to Health — FOCEM/MERCOSUR. COF 03/11.

Ethical statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.”

Informed consent

Informed consent was previously obtained from all individual participants included in the study.

Ethical approval

The Fundación Moisés Bertoni Ethical Committee approved the protocol of this study in July 2014.

Conflict of interest

Andrea Giménez-Ayala declares that she has no conflict of interest.

Nilsa González-Brítez declares that she has no conflict of interest.

Antonieta Rojas de Arias declares that she has no conflict of interest.

Mónica Ruoti declares that she has no conflict of interest.

References

  1. Acardi SA, Liotta DJ, Santini MS, Romagosa CM, Salomón OD (2010) Detection of Leishmania infantum in naturally infected Lutzomyia longipalpis (Diptera: Psychodidae: Phlebotominae) and Canis familiaris in Misiones, Argentina: the first report of a PCR-RFLP and sequencing-based confirmation assay. Mem Inst Oswaldo Cruz 105:796–799CrossRefPubMedGoogle Scholar
  2. Adamchak S, Reierson J, Liku J (2013) Integrating HIV/FP programs: opportunities for strategic communication (Chapter 9). In: Okigbo CC (ed) Strategic urban health communication. Springer, NY, pp 103–114Google Scholar
  3. Alemu A, Alemu A, Esmael N, Dessie Y, Hamdu K, Mathewos B, Birhan W (2013) Knowledge, attitude and practices related to visceral leishmaniasis among residents in Addis Zemen town, South Gondar, Northwest Ethiopia. BMC Public Health 13:382. Available from: http://www.biomedcentral.com/1471-2458/13/382
  4. Atencio V, José M (2006) Caracterización ecoepidemiológica del foco de leishmaniasis cutánea en Choroni, Estado Aragua 2005. Comunidad y Salud 4(1):10–21Google Scholar
  5. Bentosela M, Mustaca AE (2007) Comunicación entre perros domésticos (Canis familiaris) y hombres. Rev Latinoam Psicol 39(2):375–387Google Scholar
  6. Borges BKA, da Silva JA, Haddad JPA, Moreira ÉC, de Magalhães DF, Ribeiro LML (2008) Avaliação do nível de conhecimento e de atitudes preventivas da população sobre a leishmaniose visceral em Belo Horizonte, Minas Gerais, Brasil. Cad Saude Publica 24(4):777–784. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X2008000400007&lng=en&nrm=iso&tlng=pt
  7. Canese J (2010) Gran incremento de Leishmaniasis visceral humana en Paraguay. Pediatría (Asunción) 37:167–168Google Scholar
  8. Canese A, Maciel JD, Oddone R (2011) Manual de diagnóstico y tratamiento de las Leishmaniosis. Ministerio de Salud Pública y Bienestar Social, Asunción, Paraguay, pp 73Google Scholar
  9. Conrad P, Barker KK (2010) The social construction of illness: key insights and policy implications. J Health Soc Behav 51 Suppl(S):S67–S79CrossRefGoogle Scholar
  10. Cousiño B (2006) Vigilancia y control de la Leishmaniasis en Paraguay. In: Organización Panamericana de la Salud (ed) Informe final de la reunión de expertos OPS/OMS sobre Leishmaniasis visceral en las Américas. PANAFTOSA/OPS, Río de Janeiro, pp 34–36. Available from: http://bvs1.panaftosa.org.br/local/File/textoc/LEANES_Inf_final_leish_2005.pdf#page=38
  11. Dirección General de Estadística Encuestas y Censos (DGEEC) (2017) Available from: http://www.dgeec.gov.py/Publicaciones/Biblioteca/Atlas%20Censal%20del%20Paraguay/atlas_censal_paraguay.html
  12. dos Santos Lobo K, Trindade Bezerra JM, de Oliveira Brito LM, Soares da Silva J, Soares Pinheiro VC (2013) Conhecimentos de estudantes sobre Leishmaniose visceral em escolas públicas de Caxias, Maranhão, Brasil. Rev Ciência Saúde Coletiva 18(3):2295–2300. Available from: http://www.scielosp.org/pdf/csc/v18n8/13.pdf
  13. Fernández Z, Oviedo M, Vívenes MA, Maffei M, González A, Vásquez L (2011) Leishmaniasis visceral en Trujillo, Venezuela: conocimientos, actitudes, prácticas (CAP) y estrategias de prevención y control. Fermentum. Revista Venezolana de Sociología y Antropología 21(60): 45–64Google Scholar
  14. Garcez LM, Cardoso JF, Portela Chagas A, Correia Miranda JF, Rodrigues de Souza GC, Soares DC, Bezerra LM, Fraiha H, Shaw JJ, Goto H (2010) Vigilância da leishmaniose visceral em localidades epidemiologicamente distintas em Juruti, um município minerário do Estado do Pará, Brasil. Revista Pan-Amazônica de Saúde 1(1):107–116.  https://doi.org/10.5123/S2176-62232010000100016
  15. García B, Borges R, Salgado A (2004) La Etnografía: manual teórico-práctico para el diseño de iniciativas de educación y participación comunitaria en leishmaniasis. M.S.D.S.–U.C.V., Venezuela, p. 57Google Scholar
  16. Gimenez-Ayala A, González N, Ruoti M, Rojas de Arias A (2017) Situación epidemiológica de las leishmaniosis y percepción de actores claves en el departamento de Alto Paraná Paraguay. Mem Inst Investig Cienc Salud 15(2):85–96CrossRefGoogle Scholar
  17. González Ramírez MT, Hernández RL (2011) Diferencias en estrés percibido, salud mental y física de acuerdo al tipo de relación humano-perro. Rev Colomb Psicol 20(1):75–86Google Scholar
  18. Gould IT, Perner MS, Santini MS, Saavedra SB, Bezzi G, Maglianese MI, Ntman JG, Gutiérrez JA, Salomón OD (2013) Leishmaniasis visceral en la Argentina. Notificación y situación vectorial (2006/2012). Med (Buenos Aires) 73:104–110Google Scholar
  19. Instituto Brasileiro de Geografía e Estadistica (IBGE) (2017) Available from: https://www.ibge.gov.br/estatisticas-novoportal/sociais/populacao.html
  20. Instituto Nacional de Estadistica y Censos de la República Argentina (INDEC) (2017) Available from: https://www.indec.gob.ar
  21. Isaza DM, Nelly Restrepo B, Arboleda M, Casas E, Hinestroza H, Yurgaqui T (1999) La leishmaniasis: conocimientos y prácticas en poblaciones de la costa del Pacífico de Colombia. Rev Panam Salud Pública 6(3):1999CrossRefGoogle Scholar
  22. López-Perea N, Sordo L, Gadisa E, Cruz I, Hailu T, Moreno J (2014) Knowledge, attitudes and practices related to visceral leishmaniasis in rural communities of Amhara State: a longitudinal study in northwest Ethiopia. PLoS Negl Trop Dis 8(4):e2799. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3990515&tool=pmcentrez&rendertype=abstract
  23. Mastrangelo AV (2015) Derechos de humanos y no humanos: una reflexión basada en dos estudios de caso etnográficos. Cad Eletron Cienc Soc 3(1):35–53Google Scholar
  24. Moya SL, Giuliani MG, Manteca Acosta M, Salomón OD, Liotta DJ (2015) First description of Migonemyia migonei (França) and Nyssomyia whitmani (Antunes & Coutinho) (Psychodidae: Phlebotominae) natural infected by Leishmania infantum in Argentina. Acta Tropica; 152: 181–184.  https://doi.org/10.1016/j.actatropica.2015.09.015
  25. Munuera JM (2004) La dimensión social. In: Psicología para ciencias de la salud: estudio del comportamiento humano ante la enfermedad. McGraw–Hill, New York, p. 18. Available from: http://cataleg.upc.edu/record=b1445014~S1*cat
  26. Organización Panamericana de la Salud (OPS/OMS) (2017) Leishmaniasis. Informe Epidemiológico de las Américas. Informe Nro. 5 abril 2017. OPS/OMS, Washington, 8 ppGoogle Scholar
  27. Organización Mundial de la Salud (2012) Control de las leishmaniasis. Informe de una reunión del Comité de Expertos de la OMS sobre el control de las leishmaniasis, Ginebra, 22 a 26 de marzo de 2010. OMS, Washington (Serie de Informes Técnicos 949)Google Scholar
  28. Organización Panamericana de la Salud (2012) Salud en las Américas. Panorama regional y perfiles de pais. OPS, Washington (Publicación Científica y Técnica Nro. 636)Google Scholar
  29. Rodríguez LR (2007) La teoría de acción razonada: implicaciones para el estudio de las actitudes. Investig Educ Duranguense 7:66–77Google Scholar
  30. Romero Peñuela MH, Sánchez Valencia JA (2009) Evaluación de factores de riesgo de la leishmaniasis visceral en seis municipios endémicos colombianos. Hacia la Promoción la Sald 14(2):66–74Google Scholar
  31. Salomón OD, Quintana MG, Bruno MR, Quiriconi RV, Cabral V (2009) Visceral leishmaniasis in border areas: clustered distribution of phlebotomine sand flies in Clorinda, Argentina. Mem Inst Oswaldo Cruz 104(August):801–804CrossRefPubMedGoogle Scholar
  32. Sandman P (2003) The four kinds of risk communication. Disponible en: http://www.psandman.com/col/4kind-1.htm
  33. Salomón OD, Mastrángelo AV, Santini MS, Liotta DJ, Yadón ZE (2016) La eco-epidemiología retrospectiva como herramienta aplicada a la vigilancia de la leishmaniasis en Misiones, Argentina, 1920-2014. Rev Panam Salud Publica 40(1). Available from: http://www.scielosp.org/pdf/rpsp/v40n1/1020-4989-RPSP-40-01-029.pdf
  34. Trench FJP, Ritt AG, Gewehr TA, De Souza Leandro A, Chiyo L, Rittgewehr M, Ripoli M, Bisetto A, Pozzolo EM, Soccol VT (2016) First report of autochthonous visceral leishmaniosis in humans in Foz do Iguaçu, Paraná state, southern Brazil. Ann Clin Cytol Pathol 2(6):2–5. Available from: https://www.jscimedcentral.com/ClinicalCytology/clinicalcytology-2-1041.pdf
  35. Wilcox B, Jessop H (2010) Ecology and environmental health. In: Frumkin H (ed) Environmental health; from global to local, 2nd ed. John Wiley & Sons, New York, pp 3–47Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Medical Research Center (CIM)Faculty of Health Sciences, UNEAlto ParanáParaguay
  2. 2.Department of Tropical MedicineInstitute of Research in Health Sciences–UNASan LorenzoParaguay
  3. 3.Center for the Development of Scientific Research (CEDIC) (FMB/Díaz Gill Laboratory Medicine)AsunciónParaguay

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