title: Integrated health messaging for multiple neglected zoonoses: Approaches, challenges and opportunities in Morocco.
abstract: Integrating the control of multiple neglected zoonoses at the community-level holds great potential, but critical data is missing to inform the design and implementation of different interventions. In this paper we present an evaluation of an integrated health messaging intervention, using powerpoint presentations, for five bacterial (brucellosis and bovine tuberculosis) and dog-associated (rabies, cystic echinococcosis and leishmaniasis) zoonotic diseases in Sidi Kacem Province, northwest Morocco. Conducted by veterinary and epidemiology students between 2013 and 2014, this followed a process-based approach that encouraged sequential adaptation of images, key messages, and delivery strategies using auto-evaluation and end-user feedback. We describe the challenges and opportunities of this approach, reflecting on who was targeted, how education was conducted, and what tools and approaches were used. Our results showed that: (1) replacing words with local pictures and using "hands-on" activities improved receptivity; (2) information "overload" easily occurred when disease transmission pathways did not overlap; (3) access and receptivity at schools was greater than at the community-level; and (4) piggy-backing on high-priority diseases like rabies offered an important avenue to increase knowledge of other zoonoses. We conclude by discussing the merits of incorporating our validated education approach into the school curriculum in order to influence long-term behaviour change.
authors: Division of Infection and Pathway Medicine, Centre for Infectious Diseases, School of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, United Kingdom. Electronic address: Marie.Ducrotoy@ed.ac.uk.
authors: M J
authors: MJ
authors: Ducrotoy
authors: Institut Agronomique et Vétérinaire Hassan II, BP : 6202, Rabat-Instituts, Morocco; Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland.
authors: H
authors: H
authors: Yahyaoui Azami
authors: Institut Agronomique et Vétérinaire Hassan II, BP : 6202, Rabat-Instituts, Morocco.
authors: I
authors: I
authors: El Berbri
authors: Institut Agronomique et Vétérinaire Hassan II, BP : 6202, Rabat-Instituts, Morocco.
authors: M
authors: M
authors: Bouslikhane
authors: Institut Agronomique et Vétérinaire Hassan II, BP : 6202, Rabat-Instituts, Morocco.
authors: O
authors: O
authors: Fassi Fihri
authors: ANSES, Laboratoire de la rage et de la faunes auvagede Nancy, Unité de Surveillance Eco-épidémiologique des Animaux Sauvages, Laboratoire national de référence pour Echinococcusspp, 54220 Malzéville cedex, France.
authors: F
authors: F
authors: Boué
authors: Department of Parasitology and Medical Mycology, Lyon 1 University, 8 Avenue Rochefeller, 69373 Lyon Cedex 08, France.
authors: A F
authors: AF
authors: Petavy
authors: Institut Agronomique et Vétérinaire Hassan II, BP : 6202, Rabat-Instituts, Morocco.
authors: A
authors: A
authors: Dakkak
authors: Division of Infection and Pathway Medicine, Centre for Infectious Diseases, School of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, United Kingdom.
authors: S
authors: S
authors: Welburn
authors: Division of Infection and Pathway Medicine, Centre for Infectious Diseases, School of Biomedical Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Chancellor's Building, 49 Little France Crescent, Edinburgh EH16 4SB, United Kingdom; Emerging Pathogens Institute, University of Florida, Gainesville, USA.
authors: K L
authors: KL
authors: Bardosh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001296:Audiovisual Aids; D002006:Brucellosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D002417:Cattle; D002648:Child; D003479:Curriculum; D004285:Dogs; D004443:Echinococcosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D006266:Health Education / Q000379:methods*; D006282:Health Personnel / Q000193:education; D006801:Humans; D033181:Information Dissemination / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009018:Morocco / Q000453:epidemiology; D058069:Neglected Diseases / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D010290:Parents / Q000193:education; D011818:Rabies / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D012574:Schools; D013334:Students; D014380:Tuberculosis, Bovine / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D055815:Young Adult; D015047:Zoonoses / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology
keywords: Community-based; Health Education; Integrated Intervention; Morocco; Neglected Zoonotic Diseases (NZDs); Schoolchildren