title: Knowledge and perceptions of Chagas disease in a rural Honduran community.
abstract: BACKGROUND
  Honduras has a high prevalence of Trypanosomacruzi infection. The purpose of this study was to assess the knowledge and attitudes of Chagas disease in 17 geographically proximal rural Honduran communities. These communities are under the same local health ministry and are served by yearly medical relief efforts. La Hicaca (LH), although impoverished, is wealthier than the surrounding villages (SV).
  
  
  METHODS
  A 15-item, interviewer-administered, convenience sample questionnaire was employed on adult patients attending a brigade clinic in LH and SV. Pearson χ² and Fisher's exact tests were used to compare knowledge and attitudes of Chagas disease, environmental risks, and access to treatment between LH and SV.
  
  
  RESULTS
  One hundred and seventy-seven questionnaires were completed. The majority of respondents were aware of Chagas disease (90%, n=159). Only a minority of respondents understood disease transmission (2%, n=3). There was no significant difference in self-reported presence of the reduviid bug in homes in SV or LH (76% (n=85) vs 65% (n=42), p=0.11). In SV, 77% (n=74) of people had never been tested for Chagas, compared to 67% (n=42) in LH, p=0.90. Likewise, no significant difference was observed in perceived access to treatment between SV and LH (54% (n=50) vs 44% (n=24), p=0.23). Participants from SV perceived a higher risk of contracting Chagas disease than did people from LH (38% (n=40) vs 23% (n=23), p=0.05). Nearly all participants were interested in being tested for Chagas disease (90%, n=159) and in implementing preventative measures (98%, n=170).
  
  
  CONCLUSIONS
  Prior studies reported differences in healthcare access across these communities. In contrast, these findings suggest that knowledge of Chagas disease and environmental risk factors are similar between communities, although SV respondents perceived a higher risk of disease transmission. These findings have implications for future education and prevention campaigns in the area.
authors.affiliation: Virginia Commonwealth University, Richmond, Virginia, USA. sdonovan@mcvh-vcu.edu.
authors.forename: Summer D
authors.initials: SD
authors.lastname: Donovan
authors.affiliation: Virginia Commonwealth University Medical Center, Richmond, Virginia, USA. mstevens@mcvh-vcu.edu.
authors.forename: Michael
authors.initials: M
authors.lastname: Stevens
authors.affiliation: Health Systems Infection Prevention Program North Hospital, Virginia Commonwealth University, Richmond, Virginia, USA. ksanogo@mcvh-vcu.edu.
authors.forename: Kakotan
authors.initials: K
authors.lastname: Sanogo
authors.affiliation: Infection Prevention Program North Hospital, Rm 2-100 VCU Health System. nmasroor@mcvh-vcu.edu.
authors.forename: Nadia
authors.initials: N
authors.lastname: Masroor
authors.affiliation: Virginia Commonwealth University Medical Center, Richmond, Virginia, USA. gbearman@mcvh-vcu.edu.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Bearman
mesh_terms: D001364:Awareness; D014355:Chagas Disease / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006721:Honduras / Q000453:epidemiology; D006801:Humans; D010465:Perception; D012307:Risk Factors; D012424:Rural Population
keywords: Community Participation; Education; Environmental Health; Epidemiology; Health Needs Assessment; Infectious Disease; Medical; North America; Public Health