Risks, trust and knowledge: determinants of pregnant women's decisions regarding participation in a future Q fever screening and treatment program during a large epidemic in The Netherlands

Breteler, Janna Klein; Oudhoff, Jurriaan P.; Munster, Janna M; Aarnoudse, Jan G.; Steenbergen, Jim E. van; Beaujean, Desirée

doi:10.1002/pd.2772

Cited by 5 publications

(3 citation statements)

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“…Studies on public perceptions and behavioral responses have been conducted during outbreaks of other zoonotic infections, including severe acute respiratory syndrome (SARS) and avian influenza [16][17][18][19][20][21][22][23]. However, studies on public perceptions and behaviors during Q fever outbreaks have been limited, and they were mainly directed at specific risk groups [13,24,25]. The aim of the present study was to identify trends over time (2009,2010, and 2012) and regional differences in public perceptions and behavioral responses, as well as predictors of preventive behavior, with regard to Q-fever.…”

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confidence: 99%

Q fever in the Netherlands: public perceptions and behavioral responses in three different epidemiological regions: a follow-up study

et al. 2014

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BackgroundOver the past years, Q fever has become a major public health problem in the Netherlands, with a peak of 2,357 human cases in 2009. In the first instance, Q fever was mainly a local problem of one province with a high density of large dairy goat farms, but in 2009 an alarming increase of Q fever cases was observed in adjacent provinces. The aim of this study was to identify trends over time and regional differences in public perceptions and behaviors, as well as predictors of preventive behavior regarding Q fever.MethodsOne cross-sectional survey (2009) and two follow-up surveys (2010, 2012) were performed. Adults, aged ≥18 years, that participated in a representative internet panel were invited (survey 1, n = 1347; survey 2, n = 1249; survey 3, n = 1030).ResultsOverall, public perceptions and behaviors regarding Q fever were consistent with the trends over time in the numbers of new human Q fever cases in different epidemiological regions and the amount of media attention focused on Q fever in the Netherlands. However, there were remarkably low levels of perceived vulnerability and perceived anxiety, particularly in the region of highest incidence, where three-quarters of the total cases occurred in 2009. Predictors of preventive behavior were being female, older aged, having Q fever themselves or someone in their household, more knowledge, and higher levels of perceived severity, anxiety and (self-) efficacy.ConclusionsDuring future outbreaks of (zoonotic) infectious diseases, it will be important to instil a realistic sense of vulnerability by providing the public with accurate information on the risk of becoming infected. This should be given in addition to information about the severity of the disease, the efficacy of measures, and instructions for minimising infection risk with appropriate, feasible preventative measures. Furthermore, public information should be adapted to regional circumstances.

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confidence: 99%

Q fever in the Netherlands: public perceptions and behavioral responses in three different epidemiological regions: a follow-up study

et al. 2014

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“…Although it's likely that this low percentage reflects a reluctance to take part in a randomised controlled trial, this might also indicate that the acceptance of such a preventive programme among this group might not be straightforward. From an earlier study on this topic we learned that women's appraisal of programme efficacy and convenience, their knowledge about the disease and perceived Q fever risk is crucial for their intended programme uptake [22].…”

Section: Discussionmentioning

confidence: 99%

Routine screening for Coxiella burnetii infection during pregnancy: a clustered randomised controlled trial during an outbreak, the Netherlands, 2010

et al. 2013

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“…A recent study on determinants for refusing participation on Q fever screening in pregnancy found a response rate of 56%. Approximately one quarter refused to participate because they had doubts about the side effects of the antibiotic treatment or were afraid of the consequences of participation [9]. Another reason for the low screening rate in Jena could have been the misconception that C. burnetii infection contracted during pregnancy would always be symptomatic.…”

Section: Discussionmentioning

confidence: 99%

Maternofetal consequences of Coxiella burnetii infection in pregnancy: a case series of two outbreaks

Boden¹,

Brueckmann²,

Wagner-Wiening³

et al. 2012

BMC Infect Dis

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BackgroundA high complication rate of Q fever in pregnancy is described on the basis of a limited number of cases. All pregnant women with proven Q fever regardless of clinical symptoms should therefore receive long-term cotrimoxazole therapy. But cotrimoxazole as a folic acid antagonist may cause harm to the fetus. We therefore investigated the Q fever outbreaks, Soest in 2003 and Jena in 2005, to determine the maternofetal consequences of Coxiella burnetii infection contracted during pregnancy.MethodsDifferent outbreak investigation strategies were employed at the two sides. Antibody screening was performed with an indirect immunofluorescence test. Medical history and clinical data were obtained and serological follow up performed at delivery. Available placental tissue, amniotic fluid and colostrum/milk were further investigated by polymerase chain reaction and by culture.Results11 pregnant women from Soest (screening rate: 49%) and 82 pregnant women from Jena (screening rate: 27%) participated in the outbreak investigation. 11 pregnant women with an acute C. burnetii infection were diagnosed. Three women had symptomatic disease.Three women, who were infected in the first trimester, were put on long-term therapy. The remaining women received cotrimoxazole to a lesser extent (n=3), were treated with macrolides for three weeks (n=1) or after delivery (n=1), were given no treatment at all (n=2) or received antibiotics ineffective for Q fever (n=1). One woman and her foetus died of an underlying disease not related to Q fever. One woman delivered prematurely (35th week) and one child was born with syndactyly. We found no obvious association between C. burnetii infection and negative pregnancy outcome.ConclusionsOur data do not support the general recommendation of long-term cotrimoxazole treatment for Q fever infection in pregnancy. Pregnant women with symptomatic C. burnetii infections and with chronic Q fever should be treated. The risk-benefit ratio of treatment in these patients, however, remains uncertain. If cotrimoxazole is administered, folinic acid has to be added.

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Risks, trust and knowledge: determinants of pregnant women's decisions regarding participation in a future Q fever screening and treatment program during a large epidemic in The Netherlands

Cited by 5 publications

References 28 publications

Q fever in the Netherlands: public perceptions and behavioral responses in three different epidemiological regions: a follow-up study

Q fever in the Netherlands: public perceptions and behavioral responses in three different epidemiological regions: a follow-up study

Routine screening for Coxiella burnetii infection during pregnancy: a clustered randomised controlled trial during an outbreak, the Netherlands, 2010

Maternofetal consequences of Coxiella burnetii infection in pregnancy: a case series of two outbreaks

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