Community perceptions of bloody diarrhoea in an urban slum in South Asia: implications for introduction of aShigellavaccine

Abstract

Understanding local perceptions of disease causation could help public health officials improve strategies to prevent bloody diarrhoea. A cross-sectional survey was conducted in Dhaka, Bangladesh to elicit community beliefs about the causes of and prevention strategies for bloody diarrhoea. Between March and June 2003, we interviewed 541 randomly selected respondents. Overall, 507 (93%) respondents perceived that a vaccine could prevent bloody diarrhoea. If a vaccine provided lifetime protection, 445 (83%) respondents stated that they would opt to get the vaccine and would pay a median of $0·05 (range U.S.$0·01-0·15) for it, equivalent to <1% of their median weekly income. There was almost universal perception that an effective vaccine to prevent bloody diarrhoea was highly beneficial and acceptable. While respondents valued a vaccine for prevention of bloody diarrhoea, they were only willing to pay minimally for it. Therefore, achieving a high rate of Shigella vaccine coverage may require subsidy of vaccine purchase.

Social and cultural determinants of anticipated acceptance of an oral cholera vaccine prior to a mass vaccination campaign in Zanzibar

“…Anticipated acceptance of the free OCV was at the upper end of the range of 60-99% reported by studies that have assessed people's intention to receive vaccines for shigellosis, other dysentery and typhoid fever in several Asian countries. [27][28][29] High levels of intention to receive free vaccination against cholera in Zanzibar may be explained by high levels of reported severity and fatality in the sample. 23 The fact that 60% of respondents…”

A Focused Ethnographic Study of Sri Lankan Government Field Veterinarians’ Decision Making about Diagnostic Laboratory Submissions and Perceptions of Surveillance

“…Qualitative research methods are being increasingly used in low-resource settings to identify factors that impact the uptake and application of health-related ideas, technologies, and practices [27]–[31]. They have also been employed in the human health field to explore the use of health data in public health practice, as well as factors that act to facilitate or hinder use of these data [32]–[34].…”

Social and cultural determinants of oral cholera vaccine uptake in Zanzibar

“…[15][16][17] Because cholera was almost universally reported in both communities as "very serious" (97%) and "usually or sometimes fatal without treatment" (96%) (not shown), the influence of illness-related severity and fatality could not directly be analyzed as potential determinants of OCV uptake. Perceptions regarding severity and potential fatality were nevertheless related to vaccine acceptance in these communities because unconsciousness, a feature of dehydration and thus an advanced stage of cholera, was not only reported as one of the most prominent somatic problems, 33 but it was also identified as positive determinant of OCV uptake.…”

“…14 Recently published studies addressing the relationship between local perceptions of severe enteric diarrheal illness and willingness or desire to receive vaccines have mainly focused on shigellosis and typhoid fever. [15][16][17][18][19][20][21] Studies on cholera have assessed social factors of vaccine acceptance 22 or have considered policymakers' views, 23 but empirical study of cultural factors of cholera and how they affect OCV uptake is lacking.…”