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Community participation is the main strategy to sustainability of Chagas disease entomological surveillance. The purpose of this study was to evaluate the level of knowledge on triatomine insects and Chagas disease among the residents from eight localities of Diamantina, in Minas Gerais, with a view to observing any associations between their knowledge and infestations by triatomines.
In order to evaluate this knowledge, questionnaires were used containing both closed and open questions. They were applied to residents who were ten years old or over. To establish if they could recognize the triatomine insect, they were given samples to look at. The responses to the closed questions were analyzed with reference to any frequencies of and associations with infestations involving this insect.
The responses to the questions were organized into different thematic areas and were descriptively analyzed. We did not observe any associations between triatomine infestations and knowledge of Chagas disease. The results of this study can provide guidance on education that can be given by the health services to the community in order to encourage them to provide notifications of the triatomine insects.
Chagas disease represents an endemic and major problem for the American continent which principally affects vulnerable people that live in rural areas in substandard accommodation.
Vector-borne transmission of Trypanosoma cruzi Chagas is the principal route to the human infection 1 1. Lancet ; The insect-vectors are blood-sucking hemipteransand there are species of them. Mem Inst Oswaldo Cruz ; 6: Rev Pan-Amaz Saude ; 4 1: This advice was part of a national campaign launched in the s.
In the first phases, the actions carried out were vertical in nature whereby pest control officers visited houses in search of the insects and applied insecticide in areas hit by the endemic. In the entomological surveillance phase, due to the low rates of household infestations, the pest control officers did not detect many insects during this phase. This therefore did not justify pest control officers being placed in hard to reach areas searching for signs of the insect as it was not cost effective.
Teoria do Conhecimento
In this context, detections fell to the residents who, upon finding a suspected insect, gave it to a designated community member who was in charge of the local Triatomine insects Information Units PIT that were generally situated in schools, health centers or households.
From the PIT the insect would be sent to the health service to be identified and examined for trypanosomatides. If it was confirmed that the insect was a triatomine, a pest control officer would be sent to the household to search for further specimens. Where such were found,both the house in question, the furniture and the surrounding buildings would be sprayed with insecticides 5 5.
Moreno EC, Baracho L. Cad Saude Publica ; 16 Supl. Due to control and containment campaigns, the Chagas infection iscontrolledin Brazil 1 1.
In this context entomological surveillance with the participation of the community conhecijento as an effective and sustained way in preventing new infections, becoming more thanjust aPCDCh phase 7 7. It was also one of the first regions in the country to bring in pest control measures 7 7. Rev Soc Bras Med Trop ; 42 6: This was done by pest control officers who had been involved in the Eradication of Malaria Campaign 9 9.
Universidade Federal dos Vales do Jequitinhonha e Mucuri; Between and the region found itself under entomological surveillance directed by rural teachers to whom information was given concerning triatomine insects.
In the subsequent years, however, these combative measures were curtailed owing to the loss fonhecimento executive powers of the Regional Centers and low rates of compliance by the municipalities. As a result there were new outbreaks in households of the triatomine insects resulting in insect colonies. The majorspecies were the Panstrongylus megistus Burmeister and the Triatoma infestans Klug This situation provided the justification for restarting intensive combative actions against the triatomine insects in the s when SUCAM assumed d PCDCh in the region 7 7.
Since entomological surveillance actions against the disease in the country was the responsibility of municipalities. The procedures were for the residents to notify the pest support service based in health centers or conhecimenro of a suspected insect and in turn a pest control officers would visit the area where the insect was found. If dk insects were subsequently found, disinsectization would occur.
The participation of the community is fundamental in controlling triatomines in households. Even though the aforementioned dp actions were successful in reducing the Chagas disease, a new problem has emerged. Young people who were not around during the previous campaigns have been experiencing difficulties in recognizing and sending off suspected insects to be analyzed 12 Rev Soc Bras Med Trop ; 42 1: Cad Saude Publica ; 25 8: Health education needs to remain as an important measure to ensure continuous surveillance.
Armed with the requisite knowledge, the population will be in a better position to recognize and act upon any suspicious finding 14 Having this knowledge is just as important as having a relationship with individuals, but the people must believe in the cause, for any actions to be successful 15 Cad Saude Publica ; 12 1: One of the major challenges in the control and containment of diseases is trying to bridge the gap for institutions and individuals between what is known and what is actually done, known as the know-do gap 16 Bennett G, Jessani N, editors.
The knowledge translation toolkit: According to teoriia World Health Organization 17 Meeting on Knowledge Translation in Global Health. This will help to identify their yeoria points and gaps and in turn, the relevant scientific and technical knowledge can be passed to managers, service providers and health care users in a way so that it can be used in their daily lives 18 Lost in knowledge translation: J Contin Educ Health Prof ; 26 1: Surveillance on the part of the population in looking out for the Chagas disease is of paramount importance.
Under-notifications in areas that might be infested, is likely to occur where people do not have the requisite knowledge to identify the insect and to notify the health authorities who can then action the pest control officers. Having a better understand on what people know in relation to the triatomine insects and the Chagas disease may contribute to guiding actions in health care ddo a view to strengthening community participation around surveillance.
This study aimed to evaluate the level of knowledge of the residents in infested areas in Diamantina which is in the Alto Valley region of Jequitinhonha in Minas Gerais. This region is endemic with Chagas disease. The study took place in the urban and rural areas in the municipality of Diamantina situated in the Jequitinhonha Valley region in the northeast state of Minas Gerais. In it had an estimated population of 47, inhabitants covering an area of 3.
There were communities located in the other parts of the municipality rural conecimento. According to the National Serological Inquiry carried out in the s, the municipality of Diamantina was found to be serologically positive for T. In order to identify the areas to be studied, some criteria was developed in which all of the areas were grouped into four categories based of the number of triatomine insects that were captured in households through notifications given and personnel being sent to areas.
This covered to becausethe detailed entomological information during this period was available. Two localitiesfor each category were chosen.
One belonged to the urban nucleus in the main part of the municipality the main borough and the other was outside of this area in a rural area. This was based on the divisions identified by the National Health Foundation 21 Due to questions of logistics and access issues, random selections were done amongst the localities that met the criteria in being a maximum of 40 km from the city urban nucleus. They needed to have been similar with reference to grassland and vegetation about m above sea level and vegetation being predominate in rocky fields.
We opted to draw lots again in areas borderingother that had been randomly chosen before. The following were the chosen areas with their respective populations based on data from the Local Authority of Diamantina: The available data on the size of the populations dates back toowing to the lack of updates registered by the local authority.
Urban areas in this study were included because triatomine infestations have been occurring often at the headquarters of the municipality in Diamantina,mainly in the peripheral areas of the city. This was despite the fact that infestations were traditionally connected with semi-rural areas. Questionnaires were used based on the models of Silveira et al.
It had twelve multiple choice questions and two questions that required a written response. The multiple choice questions covered the following: In relation to the Chagas disease, the questions covered: The questions requiring written answers covered: We showed samples of Hemiptera an adult predator and an adult and one nymph P. The resident had to point out which insects were the triatomine insects.
When the person successfully pointed out which was the triatomine insect, we considered that to be the requisite knowledge in accordance with Villelaet al. The interviewees were adults and children from the age of ten years old and over.
They were interviewed by two interviewers that went from door to door in areas covering, objectively, the largest amount of houses possible in a given area in all of the houses where individuals wanted to participate in the study.
When a minor opened the door, they were only allowed to participate after consent was obtained from someone responsible for them, such as a parent. There was a significant sample of people from whom data was collected between December and Septemberwith a significance level of 0. We decided to include children as we noticed before that young people had difficulties in recognizing triatomine insects when compared with adults.
This may be due to a lack of general awareness in the scenario of controlled transmission of the Chagas disease 12 The residents got together to discuss the triatomine insects and its role in spreading the Chagas disease, after the questions were answered.
They also talked about the importance of participation in detecting and taking captured insects to the municipal health services.
Participation in the research was based on the condition of individuals signing a consent form. For those under 18 a signature was required from a parent or legal guardian.
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Centers for Disease Control and Prevention; The multiple choice questions were analyzed with conhefimento to the frequency of which the alternatives were chosen. They were analyzed in relation to associations with different categories of infestations in areas. The ability to recognize triatomine insects was also analyzed with reference to the age group of the participants and the residency zone.