背景:在Kitgum地区发生了戊型肝炎感染的流行,2009年乌干达北部。在这种流行病中,超过10422人被感染,超过166人死亡。基特古姆地区健康管理信息系统(HMIS)显示,尽管在两个社区采取了类似的流行病控制措施,但穆克韦尼的戊型肝炎病例继续比基特古姆·马蒂迪县的病例多。Mucwini县的病毒坚韧性尚不清楚。本研究旨在评估社区对乌干达北部两个县KitgumMatidi和Mucwini的戊型肝炎患病率差异的看法和观点。
方法:采用定性和定量方法的混合研究。与各村卫生队进行了四次焦点小组讨论和六次主要线人访谈,地方委员会主席,卫生工作者,和社区成员。这些参与者是有目的地选择的,因为他们在社区卫生服务方面的专业知识和经验。进行了面对面的访谈指南,以获取有关与两个县的戊型肝炎发生差异有关的因素的详细信息。这项研究得到了当地IRB和乌干达国家科学技术委员会(UNCS&T)的批准。
结果:最重要的发现是两个社区在预防和控制实践方面的差异。Mucwini的居民对感染的依从性较低,预防,和控制指南,Mucwini的地方议员和村卫生队之间在津贴方面存在分歧,导致执行不力和不遵守社区控制流行病的准则。
结论:Mucwini的戊型肝炎患病率高于KitgumMatidi的患病率,原因是Mucwini居民的个人和社区卫生状况差,以及Mucwini居民与KitgumMatidi居民相比,不遵守行为改变沟通。作者建议通过确保受影响社区采取适当的感染预防和控制指南的意愿,采取更积极主动的方法来管理流行病。此外,利益相关者之间的分歧应迅速解决,以便所有社区成员遵守控制措施。
BACKGROUND: An epidemic of Hepatitis E infection occurred in Kitgum district, northern Uganda in 2009. In that epidemic, more than 10,422 people were infected, and over 166 deaths were registered. Kitgum District Health Management Information Systems (HMIS) showed that Hepatitis E cases continued to occur in Mucwini more than in Kitgum Matidi sub-county despite instituting similar epidemic control measures in the two communities. The tenacity of the virus in Mucwini sub-county had remained unclear. This study aimed to assess communities\' views and perspectives on the differential prevalence of Hepatitis E in the two sub-counties of Kitgum Matidi and Mucwini in northern Uganda.
METHODS: A mixed study using qualitative and quantitative methods was used. Four Focus group discussions and six key informant interviews were conducted with the village health teams, local council chairpersons, health workers, and community members. These participants were chosen purposively because of their expertise and experience in community health services. Face-to-face interview guides were administered to obtain detailed information on factors associated with the differential occurrence of Hepatitis E in the two sub-counties. This study was approved by a local IRB and the Uganda National Council of Science and Technology (UNCS&T).
RESULTS: The most substantial findings were the differences in prevention and control practices in the two communities. Residents of Mucwini were less compliant with infection, prevention, and control guidelines, and disagreements between local councilors and village health teams in Mucwini over allowances led to poor implementation and non-adherence to guidelines on community control of the epidemic.
CONCLUSIONS: A differentially higher prevalence of Hepatitis E in Mucwini than in Kitgum Matidi resulted from poor personal and community hygiene and non-adherence to behavior change communication among residents of Mucwini than their counterparts in Kitgum Matidi. The authors recommend a more proactive approach to managing an epidemic by securing the willingness of the affected community to adopt appropriate infection prevention and control guidelines. In addition, disagreements among stakeholders should be resolved quickly so that all community members adhere to control measures.