RESUMEN
Objective To investigate the changes in the awareness rate of Taenia solium taeniasis and cysticercosis control knowledge among medical professionals before and after training in Fangcheng County, a disease-elimination pilot area of Henan Province, so as to evaluate the effectiveness of the training. Methods Three townships in Fangcheng County were randomly selected as the study townships, including Dushu, Bowang and Yangji townships, while Erlangmiao, Yanglou and Xiaoshidian townships in the county were randomly selected as the control townships. The grassroots medical professionals in the study townships were given once training on T. solium taeniasis and cysticercosis control knowledge each year from 2016 to 2020, while those in the control townships were given no interventions. All village-level doctors and a part of township-level public health professionals were sampled from the study and control townships as intervention and control groups. The baseline and final assessments of the awareness of T. solium taeniasis and cysticercosis control knowledge were performed using questionnaire survey in intervention and control groups in 2016 and 2020, and the awareness of T. solium taeniasis and cysticercosis control knowledge was compared between the two groups. Results A total of 663 medical professionals were investigated in Fangcheng County from 2016 to 2020, including 474 participants in the intervention group and 189 participants in the control group. Results from the 2016 baseline survey showed that the awareness rate of T. solium taeniasis and cysticercosis control knowledge was 28.83% (47/163) among grassroots medical professionals in Fangcheng County, and there were no significant differences in the awareness between the intervention (32.47%, 25/77) and control groups (25.58%, 22/86) (χ2 = 0.939, P > 0.05), between men (30.50%, 43/141) and women (18.18%, 4/22) (χ2 = 1.406, P > 0.05) or between village- (31.39%, 43/137) and township-level medical professionals (15.38%, 4/26) (χ2 = 2.727, P > 0.05), while significant differences were found in the awareness rate of T. solium taeniasis and cysticercosis control knowledge among medical professionals in terms of education levels (χ2 = 8.190, P < 0.05) and duration of working experiences (χ2 = 12.617, P < 0.05), and the awareness rate of T. solium taeniasis and cysticercosis control knowledge increased with education levels among medical professionals (χ2 = 6.768, P < 0.05). Only 5.52% (9/163) of the medical professionals had a history of diagnosis and therapy of T. solium taeniasis or cysticercosis, and only 1.23% (2/163) received training on T. solium taeniasis and cysticercosis control knowledge during the past 5 years. Results from the 2020 questionnaire survey showed a higher awareness rate of T. solium taeniasis and cysticercosis control knowledge among medical professionals in the intervention group (93.55%, 116/124) than in the control group (46.60%, 48/103) (χ2 = 61.845, P < 0.05), and no significant differences were seen in the awareness rate of T. solium taeniasis and cysticercosis control knowledge among medical professionals in terms of gender, level of medical professionals, duration of working experiences or history of diagnosis/therapy of T. solium taeniasis and cysticercosis in the intervention group (χ2 = 1.089, 0.140, 0.081 and 0.453, all P values > 0.05), while there was a significant difference in the awareness rate among medical professionals with different education levels (χ2 = 36.338, P < 0.05). In addition, the awareness rate of T. solium taeniasis and cysticercosis control knowledge significantly increased among medical professionals with various chracteristics in 2020 than in 2016. Conclusions In the low-prevalence areas of T. solium taeniasis and cysticercosis, long-term and persistent training may improve the awareness of T. solium taeniasis and cysticercosis control knowledge among grassroots medical professionals, which facilitates the timely identification of T. solium taeniasis and cysticercosis and the establishment of a sensitive disease surveillance system.
RESUMEN
Objective To compare the changes of knowledge, attitude and practice (KAP) related to taeniasis and cysticercosis among primary school students before and after health education interventions in disease-elimination pilot areas of Henan Province, so as to evaluate the effectiveness of health education interventions. Methods A primary school was selected from each of Dushu, Bowang and Yangji townships, Fangcheng County, Henan Province from 2017 to 2019; then, 2 to 3 classes were randomly selected from grade 4 to 6 in each primary school, and finally, all students in these classes were enrolled as study subjects. A thematic health education lecture pertaining to taeniasis and cysticercosis was given once each year by means of “health education in class”. The KAP towards taeniasis and cysticercosis was investigated among primary school students using selffilled structured questionnaires, and the changes of awareness of taeniasis and cysticercosis control knowledge and percentage of healthy behaviors formation were compared in primary school students among years and following various frequencies of health education interventions. Results More than 10 thousand person-time primary school students received health education interventions during the period from 2017 to 2019, and a total of 1 223 person-time primary school students were investigated during the 3-year study period, including 633 person-time men and 590 person-time women and 88.55% of primary school students at ages of 10 to 12 years. The proportion of households raising pigs and using dry toiliets decreased from 5.30% (24/453) and 18.10% (82/453) in 2017 to 3.60% (13/361) and 11.08% (40/361) in 2019, respectively. The awareness rate of taeniasis and cysticercosis control knowledge increased significantly from 0.22% (1/453) in 2017 to 62.59% (256/409) in 2018 and 76.73% (277/361) in 2019 (χ2 = 567.60, P < 0.001), and the awareness rate was 85.25% (104/122) among primary school students attending the thematic special health education courses for successive three times. The awareness rates of taeniasis and cysticercosis control knowledge were 0.44% (1/225), 58.00% (116/200) and 71.63% (149/208) among male students and 0 (0/338), 66.99% (140/209) and 83.66% (128/153) among female students from 2017 to 2019, and there was a significant difference in the awareness of taeniasis and cysticercosis control knowledge between male and female students in 2019 (χ2 = 7.14, P = 0.01). On-site teaching by doctors was the students’ favorite way to receive health education interventions (70.07%, 857/1 223), followed by watching health education videos (58.63%, 717/1 223) and seeing parasite specimens (48.9%, 598/1 223). The proportion of students’ families who used cutting boards for raw and cooked food separately increased from 7.28% (33/453) in 2017 to 47.37% (171/361) in 2019, was 67.21% (82/122) among students attending the health education courses for successive three times. The proportion of students who frequently washed their hands before meals and after using toilet increased from 71.96% (324/453) in 2017 to 89.47% (319/361) in 2019 and was 95.90% (117/122) among students attending the health education courses for successive three times. In addition, the percentage of students washing hands frequently in families using dry toilets was significantly lower in those who did not use dry toilets (χ2 = 9.21, P = 0.002), and the proportion of students with a habit of eating raw or undercooked meat decreased significantly from 35.76% (162/453) in 2017 to 6.65% (24/361) in 2019 (χ2 = 69.11, P < 0.01). Conclusion The thematic health education activity of “health education in class” contributes greatly to the increase in the awareness of taeniasis and cysticercosis control knowledge and the rate of healthy behaviors formation among primary school students in diseaseelimination pilot areas of Henan Province.