Suntornsut, P; Chaowagul, W; Thongklang, W; Phosri, T; Day, NPJ; Michie, S; Limmathurotsakul, D; (2018) Feasibility and initial outcomes of a multifaceted prevention programme of melioidosis in diabetic patients in Ubon Ratchathani, northeast Thailand. PLoS Neglected Tropical Diseases , 12 (9) , Article e0006765. 10.1371/journal.pntd.0006765.

Preview

Text journal.pntd.0006765(2).pdf - Published Version Download (12MB) | Preview

Abstract

Background: Melioidosis is an infection caused by Burkholderia pseudomallei, a Gram-negative bacillus found in soil and water. Diabetes mellitus is the most important risk factor for melioidosis. The recommendations for disease prevention include avoiding direct contact with soil and water, and drinking only boiled or bottled water. Methods: A prospective intervention study was conducted to evaluate the feasibility and behavioural outcomes of a multifaceted prevention programme for melioidosis. Participants were diabetic adults in Ubon Ratchathani, northeast Thailand. Ten behavioural support groups consisting of 6 to 10 participants per group were conducted. Twelve behaviour change techniques were used: information about health consequences, credible source, adding objects to the environment, reconstructing the physical environment, instruction on how to perform a behaviour, demonstration of the behaviour, commitment, prompts/cues, self-monitoring of behaviour, goal setting, feedback on behaviour, and social support, and their feasibilities evaluated. Results: There were 70 participants, of median age 59 years and 52 (74%) were female. Participants found the intervention beneficial, interesting and engaging. Participants indicated that they liked to watch videos with information about melioidosis delivered by local doctors and patients who survived melioidosis, and videos showing use of over-the-knee boots by local farmers. Participants felt engaged in the sessions that trialed protective gear and that made calendars with individual photographs and self-pledges as a reminder tool. The proportions of participants reporting that they always wore boots while working in rice fields increased from 30% (10/33) to 77% (28/37, p = 0.04), and that they drank only boiled or bottle water increased from 43% (30/70) to 86% (59/69, p<0.001) at 6 months post intervention. Conclusion: The programme is highly acceptable to participants, and can support behaviour change. Policy makers should consider implementing the programme in areas where melioidosis is endemic. Making calendars with individual photographs and self-pledges as a reminder tool could be powerful in behaviour change interventions, and further research on this component is needed. Author summary: Melioidosis is a serious infectious disease caused by the Gram-negative environmental bacterium, Burkholderia pseudomallei. Infection in humans occurs following skin inoculation, inhalation or ingestion. The recommendations for melioidosis prevention include using protective gear such as rubber boots when in direct contact with soil and environmental water, and drinking only boiled or bottled water. A multifaceted prevention programme is recommended to achieve the desired behaviour changes. Here, we evaluated the feasibility and behavioural outcomes of a multifaceted prevention programme for melioidosis. Our study participants were diabetic adults in Ubon Ratchathani, northeast Thailand. We found that the multifaceted prevention programme was highly acceptable to participants, and could support behaviour change. A calendar with an individual photograph as a reminder tool engaged participants effectively. Our study also confirmed that commitment and action by the government are essential for the preventive interventions to be successful. We recommend that policy makers should consider implementing the programme in areas where melioidosis is endemic. Since cultures and barriers to adopting the recommended behaviours vary, the intervention strategies would need to be adapted to local contexts.

Download activity - last month

Export as CSVJSONXML

Download activity - last 12 months

Export as XMLJSONCSV

Downloads by country - last 12 months

Export as XMLJSONCSV

Archive Staff Only

View Item