Sociocultural determinants of adoption of preventive practices for hantavirus: A knowledge, attitudes, and practices survey in Tonosí, Panama

PLoS Negl Trop Dis. 2020 Feb 27;14(2):e0008111. doi: 10.1371/journal.pntd.0008111. eCollection 2020 Feb.

Abstract

Introduction: Hantaviruses are a group of single-stranded RNA viruses carried by small rodent reservoirs, transmitted to humans through inhalation of aerosolized particles of rodent feces, urine, or saliva. In Panama, the Choclo orthohantavirus has been associated with Hantavirus Pulmonary Syndrome (n = 54) and Hantavirus Fever (n = 53). In 2018, there were 107 cases of hantavirus diseases, the majority in the Tonosí district, and 4 deaths. As there is no vaccine or treatment for hantavirus, proper prevention measures by community members is key to stopping outbreaks.

Methodology and principal findings: We investigated hantavirus knowledge, attitudes, and practices in one corregimiento of Tonosí, Panama to determine what factors influence uptake of prevention practices and high level of knowledge. We conducted a cross-sectional survey with 124 residents covering hantavirus knowledge, attitudes based in the Health Belief Model (perceived severity, perceived susceptibility, perceived obstacles, perceived benefits, and cues to action) and prevention practices. There was an overall high level of knowledge (median score: 4/6), though 20% did not know the route of transmission. The mean number of reported practices performed per person was 8.4 (range: 4-12). Most people had heard of hantavirus through other community members. In linear regression, lower perceived obstacles predicted higher preventive practice score. Reported obstacles to preventive practices included physical restrictions, such as age and health state. In ordinal logistic regression, higher education level and knowing more people who had previously been sick with hantavirus contributed to higher knowledge score.

Conclusions: Future interventions should focus on removing barriers to performing preventive practices. As most people learned of hantavirus through community members, interventions should be community-based and involve those who have experienced the disease. Any future education materials should address confusions about route of transmission and be targeted at those with a lower education level.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cross-Sectional Studies
  • Female
  • Hantavirus Infections / epidemiology
  • Hantavirus Infections / prevention & control*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Middle Aged
  • Panama / epidemiology
  • Young Adult

Grants and funding

The work was financed by the Department of Research in Emerging and Zoonotic Diseases and by the project 111130150.501 (BA) from the Ministry of Economy and Finance of Panama. CH was supported by a Fulbright grant from the Fulbright U.S. Student Program, sponsored by the United States Department of State. BA (DI-UIP63380000) is supported by Research Direction, Universidad Interamericana de Panama. BA is a member of the SNI (Sistema Nacional de Investigación from SENACYT of Panamá). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.