Leptospirosis Risk Perception and Associated Behavior in a Region of High Seroprevalence in Iquitos, Peru

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dc.contributor.advisorHigashi, Robin T.en
dc.contributor.committeeMemberNiwagaba, Lilianen
dc.contributor.committeeMemberSouthern, Paulen
dc.creatorGutierrez, Carolina Paolaen
dc.creator.orcid0000-0002-7925-2395
dc.date.accessioned2019-08-02T19:22:57Z
dc.date.available2019-08-02T19:22:57Z
dc.date.created2016-05
dc.date.issued2016-04-01
dc.date.submittedMay 2016
dc.date.updated2019-08-02T19:22:57Z
dc.descriptionThe general metadata -- e.g., title, author, abstract, subject headings, etc. -- is publicly available, but access to the submitted files is restricted to UT Southwestern campus access and/or authorized UT Southwestern users.en
dc.description.abstractBACKGROUND: Iquitos has an ideal environment for Leptospira transmission leading up to endemic leptospirosis. Studies in Belen, an urban slum in Iquitos, indicate seroprevalence as high as 28% with rates higher in flooding and non-flooding areas, and pathogenic Leptospira in floodwater. Public health education efforts to date have failed to reduce prevalence and transmission rates. OBJECTIVE: Assess the community environment, residents' beliefs and behaviors, and social networks for information exchange to identify opportunities for enhancing public health strategies. METHODS: The primary researcher collected qualitative data from site observation (approximately 12 hours), 51 interviews, and 4 focus group interviews (n=27). All audio recordings were transcribed verbatim, translated to English, then analyzed and interpreted using NVivo 9.0 (QSR Australia). RESULTS: Roughly half (47%) of participants were familiar with the term "Leptospirosis" or "la enfermedad de la rata" (the rat's disease), but few could report on disease presentation or prevention. Although limited knowledge uptake has hampered prevention efforts, results also demonstrate that high-risk behaviors are closely aligned with environmental conditions, daily living practices, and cultural values, beliefs, and priorities. CONCLUSION: Complex and interconnected social, economical, and cultural conditions make Belen an ideal environment for transmission of leptospirosis. Public health strategies and funding to reduce transmission should target community trash disposal techniques, knowledge of water-borne illness, and modification of education modalities and distribution to leverage community-oriented values and priorities.en
dc.format.mimetypeapplication/pdfen
dc.identifier.oclc1111291701
dc.identifier.urihttps://hdl.handle.net/2152.5/7074
dc.language.isoenen
dc.subjectEnvironmental Exposureen
dc.subjectLeptospiraen
dc.subjectLeptospirosisen
dc.subjectPeruen
dc.subjectRatsen
dc.subjectSocioeconomic Factorsen
dc.titleLeptospirosis Risk Perception and Associated Behavior in a Region of High Seroprevalence in Iquitos, Peruen
dc.typeThesisen
dc.type.materialtexten
thesis.degree.departmentUT Southwestern Medical Schoolen
thesis.degree.disciplineGlobal Healthen
thesis.degree.grantorUT Southwestern Medical Centeren
thesis.degree.levelDoctoralen
thesis.degree.nameM.D. with Distinctionen

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