Group D:ADVOCACY

Title of Study

Knowledge, Attitudes and Practices of the Community concerning the Prevention and Control of Leptospirosis in the National Capital Region, Philippines

Team

  • Project leaders
    • Prof. Jonathan Guevarra
    • Dr. Maridel Borja
    • Dr. Jun Fujii(KU)
  • Research Assistants
    • Ms. Elaina Al-Qaseer
    • Ms. Ma. Leonora Angelica Casas
    • Mr. Darwin Cagang

General Objectives

To determine the knowledge, attitudes and practices of the community concerning the prevention and control of Leptospirosis

To enhance advocacy activities regarding prevention and control of leptospirosis

Specific Objective

To determine the knowledge of the community in terms of modes of transmission, signs and symptoms, prevention, control and treatment

To determine the attitudes of the community in terms of prevention and control of leptospirosis

To determine the practices of the community in terms of prevention and control of leptospirosis

To develop materials on the prevention and control of leptospirosis

To disseminate information on leptospirosis to the public



Knowledge, Attitudes and Practices of the Community concerning the Prevention and Control of Leptospirosis in the National Capital Region (NCR), Philippines1

Jonathan P. Guevarra, RN, RM, MAN 2 and Maridel P. Borja, MSc, MSPH, Ph.D. 3

1A Project conducted by the College of Public Health, University of the Philippines Manila
in collaboration with
Kyushu University, Japan International Cooperation Agency, World Health Organization and the
Department of Science and Technology (Philippines)

2Assistant Professor, Department of Health Promotion and Education, College of Public Health, University of the Philippines Manila

3Professor, Department of Epidemiology and Biostatistics, College of Public Health,
University of the Philippines Manila


ABSTRACT


Introduction: Leptospirosis is a zoonotic disease that brings about a diverse array of clinical manifestations ranging from sub-clinical to undifferentiated febrile illness to jaundice, renal failure and life-threatening severe pulmonary hemorrhagic syndrome. While it occurs in many parts of the world, it is endemic mainly in countries with humid subtropical and tropical climates. It has a great epidemic potential in the Southeast Asian Region including the Philippines particularly during the rainy season when many areas are flooded.

Objective: This study determined the knowledge, attitudes and practices of the community concerning the prevention and control of Leptospirosis in the National Capital Region, Philippines.

Materials and Methods: The cross sectional study design was used in this study. A total of 413 respondents were included in the study. The mother or any responsible adult served as the respondent for the household questionnaire which yielded data on the knowledge, attitudes and domestic practices for the prevention and control of Leptospirosis. If the household respondent was not at home, at least two callbacks were made before recruiting the substitute household respondent as replacement. Research assistants who collected the data were trained. To minimize variability, the data collection instrument was standardized, pre-tested, made culturally sensitive, translated to Filipino and back-translated from Filipino to English. All interviewers were provided with a field manual for their reference. Field editing was also done by the interviewers and their supervisor. At least two persons edited the accomplished data collection forms and a coding manual was provided to the coders to serve as guide. Encoding was done using EPI INFO Version 6. Descriptive statistics were generated through Microsoft Excel.

Results: Ninety one percent (91%) identified that bacteria causes leptospirosis; however, 88% also said that leptospirosis is caused by virus. Eighty nine percent (89%) correctly identified that the disease is caused by the urine of infected rats (89%) and not by rat bites (84%). Majority of the respondents knew that leptospirosis can be transmitted through abrasions in the skin (71%) and through the mucous membrane (57%). However, 51% also mentioned that the disease can be transmitted through closed wounds. Respondents were also able to identify the signs and symptoms of the disease such as acute febrile illness with myalgia (87%) and difficulty of breathing and decreased urine output (72%). Majority (67 – 99%) identified the prevention and control measures for leptospirosis correctly. Respondents also answered that a person with leptospirosis should be treated in a health facility (99%) and that antibiotics are given to patients with the disease. In addition, respondents mentioned that incense (68%) and herbal medicines (49%) cannot cure the disease.

Majority of the respondents believe on the importance of following health advisories (99%), early detection (99%) and bringing the sick member of the family to the nearest health facility (94%). In terms of vulnerability, respondents also believe that wading in flood waters (93%), walking barefoot (85%) and cleaning or conducting clearing activities after flood (63%) makes a person vulnerable to leptospirosis. Furthermore, respondents also believe that wearing boots (99%) can prevent the disease and that medicines can treat (93%) leptospirosis.

In terms of domestic practices, respondents usually clean their surroundings/backyard (37%), do not wade in floodwaters (25%) and wear boots (21%) to protect themselves from acquiring leptospirosis. The primary sources of information on leptospirosis were the mass media (46%), health workers (17%) and the health facilities (14%). Only less than ten percent have read information on leptospirosis from flyers (9%), posters (9%), and leaflets (7%).

Conclusions: The respondents knew that the urine of infected rats causes leptospirosis. However, there seems to be confusion as to whether the disease is caused by bacteria or virus. In addition, there also is a concern regarding the understanding of the respondents in terms of the mode of transmission of the disease. Majority of the respondents were knowledgeable on the prevention, control and treatment of leptospirosis. Majority of the respondents believe that certain activities make them vulnerable to the disease and that there are preventive measures and medical treatment for the disease. Although respondents engage in practices (cleaning surroundings, not wading in floodwaters and wearing boots) to avoid contracting the disease, there is still a need to intensify campaign to practice these preventive measures.

In general, the majority of the respondents were knowledgeable on the prevention and control measures against leptospirosis. At the same time time, they have favorable attitudes regarding the prevention and control measures against leptospirosis. However, still less than 40% of them practice these preventive and control measures at home.

Keywords: Leptospirosis; Knowledge, Attitudes and Practices; Prevention and Control