A community-based randomized trial for prevention and control of brucellosis among rural population: application of the PRECEDE planning model

Abstract

Background: Brucellosis is one of the most frequently-occurring zoonotic diseases of veterinary and public health in developing countries. It affects human and animal health and has measurable effects on productive and reproductive performance of livestock. Thus the main purpose of this study is to develop a community-based intervention program for prevention and control of brucellosis. The two-arm parallel cluster randomized controlled trial investigated the effectiveness of an integrated prevention program over six months on brucellosis in a rural population in Ahar, East Azerbaijan, Iran. Health houses were selected of villages and randomly allocated into the intervention and the control groups (16 Health Houses in all, eight per arm). Participants were recruited via household health records in the health houses presented in the villages. The PRECEDE-PROCEED model was used to design, implement and evaluate of brucellosis prevention and control program. The appropriate strategy and intervention were matched with the project priority changes according to policies, resources, and organizational situations. Social support, knowledge, attitudes, self-efficacy, behavioral and environmental factors were measured at the baseline and 6-months follow-up. Generalized mixed effects-model was used to analyze data. Results: A total of 400 individuals from the study answered the questions in the present study. The mean age (SD) of the respondents in the intervention and control groups were 35.9 (11.87) and 37.28 (11.04) years, respectively. There were significant differences between intervention and control group for Precede model-base variables after six month of intervention program adjusted for adjusted for education, history of brucellosis and family history of brucellosis. Conclusion: there is a need to consolidate collaborative efforts from the health and veterinary sectors, as well as to strengthen regular vaccination and financial resources to support farmers willing to compensate or offering slaughter facilities. This diagnostic study of educational and ecological factors influencing behaviors and environments related to brucellosis will identify where and how interventions can be most effective.