Advanced Search

Preplanned Studies: Brucellosis Knowledge and Personal Protective Equipment Usage Among High-Risk Populations in Brucellosis-Endemic Areas — China, 2019−2020

View author affiliations
  • Summary

    What is already known about this topic?

    According to the National Brucellosis Prevention and Control Plan (2016–2020) (NBPCP), the awareness rate of high-risk populations in brucellosis-endemic areas should reach 90% by 2020. But the updated results have not been reported.

    What is added by this report?

    This report determined the awareness rate of brucellosis (17.74%), utilization of personal protective equipment (PPE) (20.13%), and their relationship with seroprevalence, which provides evidence for the effectiveness of the implementation of NBPCP.

    What are the implications for public health practice?

    The results suggest that health education should be conducted for high-risk populations to improve their brucellosis and protection knowledge.

  • loading...
  • [1] Franco MP, Mulder M, Gilman RH, Smits HL. Human brucellosis. Lancet Infect Dis 2007;7(12):775 − 86. http://dx.doi.org/10.1016/S1473-3099(07)70286-4CrossRef
    [2] Rubach MP, Halliday JEB, Cleaveland S, Crump JA. Brucellosis in low-income and middle-income countries. Curr Opin Infect Dis 2013;26(5):404 − 12. http://dx.doi.org/10.1097/QCO.0b013e3283638104CrossRef
    [3] Pappas G, Papadimitriou P, Akritidis N, Christou L, Tsianos EV. The new global map of human brucellosis. Lancet Infect Dis 2006;6(2):91 − 9. http://dx.doi.org/10.1016/S1473-3099(06)70382-6CrossRef
    [4] Lai SJ, Zhou H, Xiong WY, Gilbert M, Huang ZJ, Yu JX, et al. Changing epidemiology of human brucellosis, China, 1955–2014. Emerg Infect Dis 2017;23(2):184 − 94. http://dx.doi.org/10.3201/eid2302.151710CrossRef
    [5] Ministry of Agriculture and Rural Affairs of the People’s Republic of China and National Health Commission of the People’s Republic of China and National brucellosis prevention and control plan (2016–2020). http://www.moa.gov.cn/govpublic/SYJ/201609/t20160909_5270524.htm.[2021-1-10]. (In Chinese). http://www.moa.gov.cn/govpublic/SYJ/201609/t20160909_5270524.htm
    [6] Lin SH, Wang Z, Liu XR, Yu AZ, Hasan M, Bayidawulieti J, et al. Serological prevalence survey among the high-risk population of brucellosis-endemic areas — China, 2019–2020, China. China CDC Wkly 2021;3(6):101 − 5. http://dx.doi.org/10.46234/ccdcw2021.027CrossRef
    [7] Zhang N, Zhou H, Huang DS, Guan P. Brucellosis awareness and knowledge in communities worldwide: a systematic review and meta-analysis of 79 observational studies. PLoS Negl Trop Dis 2019;13(5):e0007366. http://dx.doi.org/10.1371/journal.pntd.0007366CrossRef
    [8] Zeng JY, Ciren DJ, Yundan DZ, Pu Q, Gongjue CW, Jiumei DJ, et al. A study of the knowledge, attitudes and practices of Tibetan yak herders with respect to brucellosis. Int Health 2018;10(4):294 − 301. http://dx.doi.org/10.1093/inthealth/ihx076CrossRef
    [9] Awah-Ndukum J, Mouiche MMM, Kouonmo-Ngnoyum L, Bayang HN, Manchang TK, Poueme RSN, et al. Seroprevalence and risk factors of brucellosis among slaughtered indigenous cattle, abattoir personnel and pregnant women in Ngaoundéré, Cameroon. BMC Infect Dis 2018;18(1):611. http://dx.doi.org/10.1186/s12879-018-3522-xCrossRef
  • FIGURE 1.  The awareness rate of brucellosis knowledge and utilization rate of personal protective equipment (PPE) among high-risk populations in four counties, 2019–2020.

    TABLE 1.  The awareness of brucellosis knowledge and the relationship between their seroprevalence among high-risk populations in Shanxi and Xinjiang from 2019 to 2020.

    QuestionsHaving awarenessInfectedUninfectedTotalAwareness rate (%)Seroprevalence (%)P-value
    All622,3222,3842.60
    Have you heard of brucellosis?Yes602,2482,30896.812.601.000
    No274762.63
    What behaviors may cause a person to contract brucellosis? *,†Yes291,1651,19450.082.430.597
    No331,1571,1902.77
    Can brucellosis be prevented? *Yes351,6231,65869.552.110.023 **
    No276997263.72
    What are the symptoms of brucellosis? *,†Yes271,2071,23451.762.190.190
    No351,1151,1503.04
    Which domestic animals can transmit brucellosis? *,†Yes1374776031.881.710.062
    No491,5751,6243.02
    Awareness §Yes841542317.741.890.312
    No541,9071,9612.75
    * The response was depended on those who answered “yes” for the first question.
    These were multiple-choice questions. The “yes” means who answered more than 70% of the questions correctly.
    § The “yes” means who answered all five questions correctly.
    Results from Fisher’s exact test.
    ** The seroprevalence difference was statistically significant (P<0.05).
    Download: CSV

    TABLE 2.  The utilization of PPE and the relationship between their seroprevalence among high-risk populations in Shanxi and Xinjiang from 2019 to 2020.

    QuestionsUtilizationInfectedUninfectedTotalUtilization Rate (%)Seroprevalence (%)P-value
    All622,3222,3842.60
    Do you wear gloves when you work? *Yes1789591238.261.860.075
    No451,4271,4723.06
    Do you wear a facemask when you work? *Yes1774175831.802.240.453
    No451,5811,6262.77
    Do you wear boots when you work? *Yes1474976332.011.830.107
    No481,5731,6212.96
    Do you wear overalls when you work? *Yes1372373630.871.770.087
    No491,5991,6482.97
    Protection Yes 947148020.131.880.264
    No531,8511,9042.78
    * The “yes” means who answered “often” or “occasionally”.
    The “yes” means who answered “often” or “occasionally” in all four aspects.
    Download: CSV

Citation:

通讯作者: 陈斌, bchen63@163.com
  • 1. 

    沈阳化工大学材料科学与工程学院 沈阳 110142

  1. 本站搜索
  2. 百度学术搜索
  3. 万方数据库搜索
  4. CNKI搜索
Turn off MathJax
Article Contents

Article Metrics

Article views(1205) PDF downloads(16) Cited by()

Share

Related

Brucellosis Knowledge and Personal Protective Equipment Usage Among High-Risk Populations in Brucellosis-Endemic Areas — China, 2019−2020

View author affiliations

Summary

What is already known about this topic?

According to the National Brucellosis Prevention and Control Plan (2016–2020) (NBPCP), the awareness rate of high-risk populations in brucellosis-endemic areas should reach 90% by 2020. But the updated results have not been reported.

What is added by this report?

This report determined the awareness rate of brucellosis (17.74%), utilization of personal protective equipment (PPE) (20.13%), and their relationship with seroprevalence, which provides evidence for the effectiveness of the implementation of NBPCP.

What are the implications for public health practice?

The results suggest that health education should be conducted for high-risk populations to improve their brucellosis and protection knowledge.

  • 1. Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
  • 2. Division of Infectious Disease, Key Laboratory of Surveillance and Early Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing China
  • 3. Datong Center for Disease Control and Prevention, Datong, Shanxi, China
  • 4. Huocheng Center for Disease Control and Prevention, Yili, Xinjiang, China
  • 5. Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, Urumqi, Xinjiang Uygur Autonomous Region, China
  • 6. Yili Kazakh Autonomous Prefecture Center for Disease Control and Prevention, Yili, Xinjiang, China
  • 7. Yanggao Center for Disease Control and Prevention, Datong, Shanxi, China
  • 8. Zuoyun Center for Disease Control and Prevention, Datong, Shanxi, China
  • 9. Hunyuan Center for Disease Control and Prevention, Datong, Shanxi, China
  • Corresponding author:

    Liping Wang, wanglp@chinacdc.cn

    Online Date: February 05 2021
    doi: 10.46234/ccdcw2021.028
  • Brucellosis remains an important public health problem in most low-income and middle-income countries (13). During the past decade, the incidence rate and the number of reported cases of brucellosis have dramatically increased in China (4). To control brucellosis effectively, the National Brucellosis Prevention and Control Plan (2016−2020) (NBPCP) was formulated by the Ministry of Agriculture of China and the National Health Commission. Based on NBPCP, the awareness rate of high-risk populations in brucellosis-endemic areas should reach 90% by 2020 (5). This study was designed and conducted to determine the populations at high risk for brucellosis in endemic areas to provide the evidence to evaluate the effects of the NBPCP. From 2019 to 2020, China CDC established a cross-sectional study with an interviewed-based survey in Shanxi Province and Xinjiang Uygur Autonomous Region, that with high incidences of brucellosis in China. Yanggao, Zuoyun, and Hunyuan counties in Shanxi Province and Huocheng county in Xinjiang Uygur Autonomous Region were selected. The local CDCs conducted face-to-face interviews. The results showed that the awareness rate and the utilization rate of personal protective equipment (PPE) in high-risk populations were relatively lower than the goals of the NBPCP. It is necessary to carry out targeted health education for high-risk groups.

    The study subjects, sample size estimation, and seropositivity definition were described elsewhere (6). Using a questionnaire, data on population knowledge of brucellosis and PPE utilization was collected. Brucellosis knowledge primarily included transmission routes, symptoms, and domestic animal hosts, etc. The variable “Awareness” was scored as “yes” if respondents answered all five questions correctly and “no” if any questions were answered incorrectly. The utilization of PPE primarily included gloves, masks, rubber boots, and overalls, and the variable “Protection” was defined as a respondent who answered “often” or “occasionally” in all four aspects. Statistical analysis were conducted in R software (version 4.0.2, R Foundation for Statistical Computing, Austria) and χ2 test with a significance level of α=0.05 to test the difference in the proportion.

    A total of 2,411 participants from 4 counties responded, and 2,384 of them met the requirements with a response rate of 98.88% (2,384/2,411). The crude awareness rate (i.e. “having awareness”) and utilization rate of PPE of brucellosis were 17.74% (423/2,384) and 20.13% (480/2,384), respectively. Figure 1 shows the awareness rate of brucellosis knowledge and utilization rate of PPE in different counties. The awareness rate of brucellosis knowledge and utilization rate of PPE in Huocheng County were the highest among the four counties. Table 1 demonstrated the correlation between the awareness rate of brucellosis knowledge in different aspects and seroprevalence. The proportion of respondents who heard of brucellosis was 96.81%, including those who knew of transmission (50.08%), prevention (69.55%), and symptoms (51.76%). However, only 31.88% of respondents knew about the species of domestic animal hosts that spread brucellosis. Although seroprevalence in the group that had awareness was lower than that in the group did not have awareness, no significant difference was found between them (P=0.312, >0.05) except “Can brucellosis be prevented?” (P=0.023, <0.05). Table 2 illustrated the association between the utilization rate of PPE in different ways and seroprevalence. About a third of the respondents utilized PPE, including gloves (38.26%), facemasks (31.80%), boots (32.01%), and overalls (30.87%), respectively. The seroprevalence of the protected population was lower than that in the unprotected population. However, the difference was not statistically significant (P=0.264, >0.05).

    Figure 1.  The awareness rate of brucellosis knowledge and utilization rate of personal protective equipment (PPE) among high-risk populations in four counties, 2019–2020.

    QuestionsHaving awarenessInfectedUninfectedTotalAwareness rate (%)Seroprevalence (%)P-value
    All622,3222,3842.60
    Have you heard of brucellosis?Yes602,2482,30896.812.601.000
    No274762.63
    What behaviors may cause a person to contract brucellosis? *,†Yes291,1651,19450.082.430.597
    No331,1571,1902.77
    Can brucellosis be prevented? *Yes351,6231,65869.552.110.023 **
    No276997263.72
    What are the symptoms of brucellosis? *,†Yes271,2071,23451.762.190.190
    No351,1151,1503.04
    Which domestic animals can transmit brucellosis? *,†Yes1374776031.881.710.062
    No491,5751,6243.02
    Awareness §Yes841542317.741.890.312
    No541,9071,9612.75
    * The response was depended on those who answered “yes” for the first question.
    These were multiple-choice questions. The “yes” means who answered more than 70% of the questions correctly.
    § The “yes” means who answered all five questions correctly.
    Results from Fisher’s exact test.
    ** The seroprevalence difference was statistically significant (P<0.05).

    Table 1.  The awareness of brucellosis knowledge and the relationship between their seroprevalence among high-risk populations in Shanxi and Xinjiang from 2019 to 2020.

    QuestionsUtilizationInfectedUninfectedTotalUtilization Rate (%)Seroprevalence (%)P-value
    All622,3222,3842.60
    Do you wear gloves when you work? *Yes1789591238.261.860.075
    No451,4271,4723.06
    Do you wear a facemask when you work? *Yes1774175831.802.240.453
    No451,5811,6262.77
    Do you wear boots when you work? *Yes1474976332.011.830.107
    No481,5731,6212.96
    Do you wear overalls when you work? *Yes1372373630.871.770.087
    No491,5991,6482.97
    Protection Yes 947148020.131.880.264
    No531,8511,9042.78
    * The “yes” means who answered “often” or “occasionally”.
    The “yes” means who answered “often” or “occasionally” in all four aspects.

    Table 2.  The utilization of PPE and the relationship between their seroprevalence among high-risk populations in Shanxi and Xinjiang from 2019 to 2020.

  • Since the 1990s, the incidence of brucellosis has been increasing and reaching a peak in 2014 and ranked among the top 10 Class A and Class B infectious diseases from 2008 to 2018 (4). The research group conducted a cross-sectional study in four counties in two provincial-level administrative divisions (PLADs) to acquire the awareness rate of brucellosis knowledge and utilization rate of PPE. This study showed evidence that awareness of brucellosis and utilization of PPE was insufficient. Since people who answered all awareness questions correctly were regarded as aware, the crude awareness rate of brucellosis knowledge was significantly lower than that of other studies (7). Most of the high-risk populations had heard of brucellosis. Nevertheless, most people did not know the animal hosts of brucellosis. The utilization of PPE was low with only about one-third of people in protection. Improving awareness of brucellosis knowledge and utilization of PPE are still vital to reduce the infection rate of brucellosis, but the methods may need to be improved through further research onto changing behaviors. According to other research, education level and household income were negatively correlated with brucellosis awareness, and elderly populations had lower brucellosis awareness than younger populations (8-9). Health education that focuses on high-risk and historically high prevalence PLADs need to be strengthened. The utilization of PPE needs to be further promoted. Different districts should communicate and exchange practical prevention and control experiences.

    This study was subject to some limitations. First, there was a possibility of recall bias because of the retrospective nature of the questionnaire survey method. Second, due to the influence of COVID-19, China CDC only conducted project training but did not carry out field quality control. The quality of the questionnaires was limited by the inability of the team to hand-check every survey while in the field.

    In summary, the results indicated that the awareness rate of brucellosis knowledge and the utilization rate of PPE were low in brucellosis-endemic areas in China. The goals set in the NBPCP are still far from being achieved. More effective health education should be carried out for high-risk populations to improve their knowledge of brucellosis and protection to reduce their risk of infection.

    Acknowledgements: Datong Center for Disease Control and Prevention, Xinjiang Uygur Autonomous Region Center for Disease Control and Prevention, and Yili Kazakh Autonomous Prefecture Center for Disease Control and Prevention; Yanggao Center for Disease Control and Prevention, Zuoyun Center for Disease Control and Prevention, Hunyuan Center for Disease Control and Prevention, and Huocheng Center for Disease Control and Prevention.

    Funding: The National Science and Technology Major Project of China (2018ZX10713001-001).

    Conflicts of interest: The authors who have taken part in this study declared that they did not have any other potential conflicts of interest.

    Ethical approval and consent to participate: The study design obtained ethical approval following a review by China CDC Institutional Review Board. Written informed consent has been obtained from the patients in accordance with the Declaration of Helsinki. The research group confirmed that the identification information of all participants (including patient names, ID numbers, home addresses and telephone numbers) would not be included in recordings, written descriptions or publications.

Reference (9)

Citation:

Catalog

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return