背景:西尼罗河病毒(WNV)是一种蚊子传播的黄病毒。在人类中,80%的感染是无症状的,而大约20%的人出现流感样症状。不到1%的人发展为神经侵入性形式,可导致脑炎,脑膜炎,急性弛缓性麻痹,甚至死亡。该病毒在全球范围内传播到以前不存在该病毒的地区,这已成为人们日益关注的问题。自2000年以来,有许多疫情影响到世界各地的本地和旅行人口。由于缺乏疫苗,预防措施主要集中在监测上,矢量控制,以及个人防护行为(PPB)的使用。PPB的重要性是公共卫生建议的核心。然而,将这些信息转化为公众一致的行动可能具有挑战性,由于采取这些措施不可避免地会受到社会经济因素的影响,意识,知识,和风险感知。
方法:对EMBASE进行了基于PRISMA的系统研究,PubMed/MEDLINE,和WebofScience数据库。PROSPERO注册号CRD42023459714。使用横断面研究关键评估清单(CEBMa)评估最终阶段的研究质量。
结果:筛选了2963篇文章,17项研究被纳入最后一轮研究.在这些中,六个被认为是高质量的,十个中等质量,一个质量低。在几乎所有研究中,WNV传播的意识和知识都在90%以上,而对WNV的担忧从50%到80%不等。担心驱虫剂的安全性,不管有没有DEET,从27%到70%不等。实际使用驱虫剂的人比例从30%到75%不等,60岁以上(29%)和孕妇(33%)的使用率最低,在9-11岁的学生中最高(75%)。对西尼罗河病毒(WNV)的关注一直与采取预防措施的增加有关,包括使用驱虫剂,在整个研究中增加两到四倍。以学校为基础的干预措施有效地增加了去除积水(AOR=4.6;2.7-8.0)和穿着长衣(AOR=2.4;95CI:1.3-4.3)的做法,但对驱虫剂的使用没有显著影响。
结论:本系统综述提供了知识的概述,态度,WNV的实践(KAP)及其决定因素。虽然对西尼罗河病毒(WNV)及其影响的担忧可能是一个重要的动机,重要的是促进以证据为基础的个人防护行为(PPB),以对抗不必要的恐惧.例如,在最脆弱的年龄组中使用驱虫剂。鉴于WNV的地理扩张,有必要预防性地针对整个人口,包括那些难以到达和尚未流行的地区。这项调查的结果可能对公共卫生产生重大影响,并支持知情和有效的沟通策略和干预措施。
BACKGROUND: West Nile virus (WNV) is a mosquito-borne flavivirus. In humans, 80% of infections are asymptomatic, while approximately 20% experience influenza-like symptoms. Fewer than 1% develop the neuroinvasive form which can lead to encephalitis, meningitis, acute flaccid paralysis, and even death. The global spread of the virus to areas where it was not previously present has become a growing concern. Since the 2000 s, there have been numerous outbreaks affecting local and travelling populations worldwide. Given the lack of a vaccine, preventative measures are primarily focused on surveillance, vector control, and the use of personal protective behaviours (PPBs). The importance of PPBs is central to public health recommendations. However, translating these messages into coherent action by the public can prove challenging, as the uptake of such measures is inevitably influenced by socio-economic factors, awareness, knowledge, and risk perception.
METHODS: A PRISMA-based systematic research was conducted on EMBASE, PubMed/MEDLINE, and Web of Science databases. PROSPERO registration number CRD42023459714. Quality of studies included in the final stage was evaluated using the Critical Appraisal Checklist for Cross-Sectional Study (CEBMa).
RESULTS: 2963 articles were screened, and 17 studies were included in the final round. Out of these, six were deemed of high quality, ten were of medium quality, and one was of low quality. In almost all studies considered, both awareness and knowledge of WNV transmission were above 90%, while concern about WNV ranged from 50% to 80%. Concern about the safety of repellents, either with or without DEET, ranged from 27% to 70%. The percentage of people actually using repellents ranged from 30% to 75%, with the lowest usage reported among individuals over 60 years old (29%) and pregnant women (33%), and the highest among students aged 9-11 (75%). Concern for West Nile Virus (WNV) was consistently linked to an increase in taking preventative measures, including the use of repellents, by two to four times across studies. The school-based intervention was effective in increasing the practice of removing standing water (AOR=4.6; 2.7-8.0) and wearing long clothing (AOR=2.4; 95%CI: 1.3-4.3), but did not have a significant impact on the use of repellents.
CONCLUSIONS: The present systematic
review provides an overview of the knowledge, attitudes, and practices (KAP) of WNV and their determinants. While concern about West Nile Virus (WNV) and its effects can be a significant motivator, it is important to promote evidence-based personal protective behaviours (PPBs) to counter unwarranted fears. For example, the use of repellents among the most vulnerable age groups. Given the geographical expansion of WNV, it is necessary to target the entire population preventively, including those who are difficult to reach and areas not yet endemic. The findings of this investigation could have significant implications for public health and support well-informed and effective communication strategies and interventions.