-
Brucellosis remains an important public health problem in most low-income and middle-income countries (1–3). 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.
Questions Having awareness Infected Uninfected Total Awareness rate (%) Seroprevalence (%) P-value All 62 2,322 2,384 2.60 Have you heard of brucellosis? Yes 60 2,248 2,308 96.81 2.60 1.000 ¶ No 2 74 76 2.63 What behaviors may cause a person to contract brucellosis? *,† Yes 29 1,165 1,194 50.08 2.43 0.597 No 33 1,157 1,190 2.77 Can brucellosis be prevented? * Yes 35 1,623 1,658 69.55 2.11 0.023 ** No 27 699 726 3.72 What are the symptoms of brucellosis? *,† Yes 27 1,207 1,234 51.76 2.19 0.190 No 35 1,115 1,150 3.04 Which domestic animals can transmit brucellosis? *,† Yes 13 747 760 31.88 1.71 0.062 No 49 1,575 1,624 3.02 Awareness § Yes 8 415 423 17.74 1.89 0.312 No 54 1,907 1,961 2.75 * 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.
Questions Utilization Infected Uninfected Total Utilization Rate (%) Seroprevalence (%) P-value All 62 2,322 2,384 2.60 Do you wear gloves when you work? * Yes 17 895 912 38.26 1.86 0.075 No 45 1,427 1,472 3.06 Do you wear a facemask when you work? * Yes 17 741 758 31.80 2.24 0.453 No 45 1,581 1,626 2.77 Do you wear boots when you work? * Yes 14 749 763 32.01 1.83 0.107 No 48 1,573 1,621 2.96 Do you wear overalls when you work? * Yes 13 723 736 30.87 1.77 0.087 No 49 1,599 1,648 2.97 Protection † Yes 9 471 480 20.13 1.88 0.264 No 53 1,851 1,904 2.78 * 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.
HTML
Citation: |