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COMMUNITY KNOWLEDGE, PERCEPTIONS AND PRACTICES ABOUT ANTHRAX IN KASESE AND RUBIRIZI DISTRICTS, SW UGANDA UVA and UMA One Health Conference, 15 February 2013 . Conservation Through Public Health Steven Rubanga, Joseph Byonaneby e , Dr. Gladys Kalema Zikusoka,

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Presentation Transcript
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COMMUNITY KNOWLEDGE, PERCEPTIONS AND PRACTICES ABOUT ANTHRAX IN KASESE AND RUBIRIZI DISTRICTS, SW UGANDAUVA and UMA One Health Conference, 15 February 2013

Conservation Through Public Health

Steven Rubanga, Joseph Byonanebye, Dr. Gladys Kalema Zikusoka,

Lawrence Zikusoka, Wilson Kagoro (QEPA CCW)

presentation outline
Presentation Outline
  • Background
  • Participatory epidemiology study
  • Community involvement in reducing negative impact of anthrax outbreak
background
Background
  • Queen Elizabeth Protected Area (QEPA) reported an unusually high mortality of hippos June 11, 2010
  • National Anthrax Task Force developing out break response strategies including community mobilisation
  • The objectives of the taskforce - containment of the outbreak, prevention of transmission to other animals and humans, and building capacity for outbreak response.
  • Members: UWA, MAAIF, MOH, MTWH,CDC, USAID RESPOND , AFENET, CTPH, WHO and FAO.
participatory epidemiology study
Participatory Epidemiology Study
  • A Participatory Epidemiology (PE) and Participatory Disease Surveillance (PDS) study was carried out in Kyambura, Katunguru and Kasenyi areas in Kasese and Rubirizi districts
  • To determine knowledge, perceptions and practices about anthrax and the preferred channel of information regarding anthrax
  • Information generated from this rapid assessment used for implementation of Information Education and Communication for Behavior Change regarding anthrax
materials and methods
Materials and Methods
  • 7 villages were purposefully and conveniently selected
  • One semi-structured interview involving 10 – 15 participants was held with each community/village
  • key informant interviews involving local leaders and animal health service providers were conducted before and after the group sessions
  • PE techniques: participatory mapping, simple ranking, proportional pilling/morbidity and mortality, seasonal calendars, transect walk, disease matrix impact scoring, and pair wise ranking
materials and methods1
Materials and Methods
  • Study area – Queen Elizabeth National Park in areas surrounding Kazinga channel and Lakes George and Edward
  • Sampling of villages = 7: Kyenzaza , Mirarigye, Kafuro, Kashaka, Kyambura , Kasenyi, Katunguru
  • Data collection- involvement in the study through the local mobilisers/leaders
  • Participants were asked
    • knowledge of community about anthrax
    • list of the diseases they thought could be acquired by wildlife, livestock and humans and to rank them
    • health seeking practices
    • preferred channel of information about anthrax
    • impact of nomadic pastoralists/grazing, hunting, crop farming on occurrence of anthrax
    • Seasonality of anthrax
    • Community-UWA relationships
results
Results
  • The common animal-human diseases problems
    • Anthrax, Worms, Foot & mouth Sleeping sickness, Big head, TB, Brucellosis and “others”
    • Anthrax was relatively more common and was of importance in all the villages visited than any other disease followed by “other diseases”
    • Anthrax was in particular perceived to be more important especially in the villages of Kafuro, Kashaka and Kasenyi.
    • The reasons given for relative frequency and importance of anthrax
      • Hippos come out of water and graze with their animals;
      • They use water in which sick animals die
      • More difficult to treat than malaria.
results1
Results
  • The perception of community about anthrax
  • Women perceived themselves to be at risk of anthrax from their spouses as they are hunters and pastoralists
  • The practices of community about anthrax
  • significant shift in preference towards the formal health services as opposed to the traditional healers
  • Severity was a factor associated with seeking immediate care
preferred source of health information
Preferred source of health information
  • Most preferred channels of communication: social mobilization, social institutions and radio
community uwa relationships
Community-UWA relationships
  • Consensus in Kasenyi, Kahaka and Kafuru- community were not happy with the UWA.
  • UWA mind about “their” animals and not them, the human beings; they harass them, and do not mobilize and educate them in case of anthrax outbreaks.
  • “the park officials brought anthrax,… just as they brought for us crocodiles. For example, some respondents do not want to participate when it came to community-UWA issues, when they realize UWA personnel was present”. KI Kashaka vilage
conclusion
Conclusion
  • Level of knowledge, perception, and practices about anthrax varied according to proximity to the park
  • Social mobilization, institutions and radio were the preferred method for behaviour change communication messages
follow up
Follow Up
  • Facilitated formation of 30 community conservation health volunteers to collect data and educate communities:
  • Consumption of bush meat from unknown sources and Poaching
  • Better health seeking behaviour

- Hygiene and sanitation

- Drinking water from the lake

- Cattle sharing drinking sources with wildlife

- Cattle grazing with wildlife

ctph communication strategy
CTPH Communication Strategy
  • Disease outbreaks website - www.diseaseoutbreaks.ug
  • Toll free hotline (0800200300)
  • Sms short code (6969).
  • Over 10,000 people called the toll free hotline in 5months
  • Program was hosted on national TV.
  • CCHWs visited 3,170 households
  • CCHWS gave 1,094 village health talks
  • 278 households were shown sms disease alerts
  • 1,541 listened to radio talk shows about anthrax.
  • The positive impact - all suspected cases investigated
  • No cases of people or cattle that have died of anthrax.
  • Runners Up in 2010 Health Category of Annual Uganda Communications Commission Award
recommendations
Recommendations
  • Reinforce community knowledge about anthrax
  • Strengthen community/local surveillance network for future disease outbreaks
  • Explore the use of mobile phones to continue to collect data and link with other projects in QEPA such as PREDICT animal mortality monitoring
acknowledgements
Acknowledgements
  • National Anthrax Task Force
  • MAAIF
  • MOH
  • MTTI/UWA/QEPA
  • Kasese and Rubirizi Districts
  • CDC
  • AFENET
  • WHO
  • Donors
  • MacArthur Foundation
  • USAID
  • Emerging Pandemic Threats/RESPOND
  • Uganda Communications Commission