Influence of Sociospatial determinants on knowledge, attitudes and practices related to the plague in a population living in endemic areas in the central highlands, Madagascar

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Abstract

Background

Plague is endemic to the central highlands of Madagascar. Sporadic human cases or outbreaks can occur annually in these areas. In Madagascar, the associations between endemicity and the knowledge, attitudes and practices (KAP) of the population with regard to this disease remain poorly documented. The aim of this study was to assess KAP related to plague among the population living in the central highlands.

Methods

A cross-sectional survey was conducted in the general population from June to August 2017. Based on the reported cases of plague between 2006 and 2015 in two central highland districts, a KAP questionnaire was administered in the population. Based on the proportion of correct answers provided by respondents, KAP scores were classified into three KAP categories: low (< Mean - SD), medium (Mean ± SD) and good (> Mean + SD). Multivariate analyses were performed to determine the associations between population KAP scores related to plague and sociodemographic and epidemiological factors. In addition, individual interviews and focus groups with health professionals were conducted to assess plague perception.

Results

A total of 597 individuals participated in the survey; 20% ( n = 119) had a good KAP score, 62% ( n = 370) a medium KAP score and 18% ( n = 108) a low KAP score. Among the 119 respondents with good KAP scores, 80% ( n = 95) resided in Ambositra district, and 20% ( n = 24) resided in Tsiroanomandidy district. According to the health professionals in the two districts, populations in endemic areas are well aware of the plague. There were significant associations ( p < 0.05) of not owning a mobile phone, having no contact with a former plague case, and living in Tsiroanomandidy district with a lower KAP score.

Conclusion

The results of the study showed the need to adapt plague control interventions to the local context to allow a better allocation of human and financial resources. Doing so would minimize delays in patient management care and increase community resilience to plague epidemics.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11101-3.

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Most cited references 25

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Modelling the influence of human behaviour on the spread of infectious diseases: a review.

Sebastian Funk, Marcel Salathé, Vincent A. A. Jansen (2010)

Human behaviour plays an important role in the spread of infectious diseases, and understanding the influence of behaviour on the spread of diseases can be key to improving control efforts. While behavioural responses to the spread of a disease have often been reported anecdotally, there has been relatively little systematic investigation into how behavioural changes can affect disease dynamics. Mathematical models for the spread of infectious diseases are an important tool for investigating and quantifying such effects, not least because the spread of a disease among humans is not amenable to direct experimental study. Here, we review recent efforts to incorporate human behaviour into disease models, and propose that such models can be broadly classified according to the type and source of information which individuals are assumed to base their behaviour on, and according to the assumed effects of such behaviour. We highlight recent advances as well as gaps in our understanding of the interplay between infectious disease dynamics and human behaviour, and suggest what kind of data taking efforts would be helpful in filling these gaps.

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Plague dynamics are driven by climate variation.

N Stenseth, N. Samia, H Viljugrein … (2006)

The bacterium Yersinia pestis causes bubonic plague. In Central Asia, where human plague is still reported regularly, the bacterium is common in natural populations of great gerbils. By using field data from 1949-1995 and previously undescribed statistical techniques, we show that Y. pestis prevalence in gerbils increases with warmer springs and wetter summers: A 1 degrees C increase in spring is predicted to lead to a >50% increase in prevalence. Climatic conditions favoring plague apparently existed in this region at the onset of the Black Death as well as when the most recent plague pandemic arose in the same region, and they are expected to continue or become more favorable as a result of climate change. Threats of outbreaks may thus be increasing where humans live in close contact with rodents and fleas (or other wildlife) harboring endemic plague.

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Understanding the Persistence of Plague Foci in Madagascar

Voahangy Andrianaivoarimanana, Katharina Kreppel, Nohal Elissa … (2013)

Plague, a zoonosis caused by Yersinia pestis, is still found in Africa, Asia, and the Americas. Madagascar reports almost one third of the cases worldwide. Y. pestis can be encountered in three very different types of foci: urban, rural, and sylvatic. Flea vector and wild rodent host population dynamics are tightly correlated with modulation of climatic conditions, an association that could be crucial for both the maintenance of foci and human plague epidemics. The black rat Rattus rattus, the main host of Y. pestis in Madagascar, is found to exhibit high resistance to plague in endemic areas, opposing the concept of high mortality rates among rats exposed to the infection. Also, endemic fleas could play an essential role in maintenance of the foci. This review discusses recent advances in the understanding of the role of these factors as well as human behavior in the persistence of plague in Madagascar.

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Author and article information

Contributors

Sitraka Rakotosamimanana:

ORCID: http://orcid.org/0000-0002-1028-0427

raksitraka@pasteur.mg

Journal

Journal ID (nlm-ta): BMC Public Health

Journal ID (iso-abbrev): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2458

Publication date (Electronic): 9 June 2021

Publication date PMC-release: 9 June 2021

Publication date Collection: 2021

Volume: 21

Electronic Location Identifier: 1102

Affiliations

[1 ]GRID grid.418511.8, ISNI 0000 0004 0552 7303, Institut Pasteur de Madagascar, ; 101 Antananarivo, Madagascar

[2 ]GRID grid.440419.c, ISNI 0000 0001 2165 5629, Université d’Antananarivo, ; 101 Antananarivo, Madagascar

[3 ]Université de La Réunion, Saint-Denis, France

[4 ]ACCESS Health Program, Management Sciences for Health, Antananarivo, Madagascar

[5 ]UMR Prodig, Paris, France

Author information

Sitraka Rakotosamimanana http://orcid.org/0000-0002-1028-0427

Article

Publisher ID: 11101

DOI: 10.1186/s12889-021-11101-3

PMC ID: 8191115

PubMed ID: 34107908

SO-VID: bdfc0d2a-83aa-44af-8c04-a97482972fb0

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 3 November 2020

Date accepted : 19 May 2021

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ScienceOpen disciplines: Public health

Keywords: plague,madagascar,central highlands,kap scores,sociospatial determinants

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ScienceOpen disciplines: Public health

Keywords: plague, madagascar, central highlands, kap scores, sociospatial determinants

Influence of Sociospatial determinants on knowledge, attitudes and practices related to the plague in a population living in endemic areas in the central highlands, Madagascar

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Background

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IEEE: COVID-19 related research

Most cited references 25

Modelling the influence of human behaviour on the spread of infectious diseases: a review.

Plague dynamics are driven by climate variation.

Understanding the Persistence of Plague Foci in Madagascar

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