Sociocultural descriptions of febrile syndromes in rural areas of Urabá, Colombia: An exploration of “tick fever”

VÉLEZ, JUAN CARLOS QUINTERO; MIGNONE, JAVIER; QUINTERO, LISARDO OSORIO; ARBELÁEZ, CARLOS ROJAS

doi:10.1590/S0103-73312019290319

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OTHER THEMES • Physis 29 (03) • 2019 • https://doi.org/10.1590/S0103-73312019290319 copy

Sociocultural descriptions of febrile syndromes in rural areas of Urabá, Colombia: An exploration of “tick fever”

Descrição sociocultural de síndromes febris em áreas rurais de Antioquia Urabá: um olhar sobre a "febre do carrapato"

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction:

In 2006 and 2008 there were two lethal outbreaks of rickettsioses in the rural areas of Urabá, characterized by the lack of immediate diagnosis and antibiotic treatment.

Objective:

Describe sociocultural aspects about knowledge, attitudes and practices in relation to febrile syndromes and “tick fever” in rural areas of Urabá.

Materials and methods:

We conducted an exploratory study using knowledge, attitudes, and practices questionnaires and semi-structured interviews about febrile syndromes and “tick fever”. We surveyed 246 heads of households and interviewed nine individuals.

Results:

We observed that people tended to identify febrile syndromes with signs and clinical symptoms of dengue, malaria, leptospirosis and rickettsioses. A considerable proportion of individuals (32.93%) knew very little about “tick fever”, thinking that is was transmitted by mosquitos. They mentioned intestinal parasitoids, malaria, dengue, and “evil eye” among the causes of febrile syndromes. “Tick fever” is linked by its name to the bite of the tick. Furthermore, the treatments for febrile syndromes mentioned by interviewees are associated to those commonly used in western medicine and medicinal plants.

Conclusions:

There is a need for educational programs in rural areas, to raise awareness about these potential lethal conditions that can be effectively treated.

Keywords:
KAP survey; rickettsioses; tick fever; reservoir

	Age (years)	Sex	Occupation	Time of residence in the area (years)	Residence
Interviewee 1	28	Female	University student	28	Alto de Mulatos
Interviewee 2	63	Male	Farmer	36	Alto de Mulatos
Interviewee 3	62	Male	Farmer	13	Alto de Mulatos
Interviewee 4	42	Female	Nurse aid	4	Alto de Mulatos
Interviewee 5	64	Male	Farmer	18	Alto de Mulatos
Interviewee 6	54	Male	Farmer	54	Alto de Mulatos
Interviewee 7	53	Female	Pharmacy assistant	10	Alto de Mulatos
Interviewee 8	-	Male	Farmer	20	Alto de Mulatos
Interviewee 9	65	Female	Home maker	-	Las Changas

PHYSIS - Revista de Saúde Coletiva Instituto de Medicina Social Hesio Cordeiro - UERJ, Rua São Francisco Xavier, 524 - sala 6013-E- Maracanã. 20550-013 - Rio de Janeiro - RJ - Brasil, Tel.: (21) 2334-0504 - ramal 268, Web: https://www.ims.uerj.br/publicacoes/physis/ - Rio de Janeiro - RJ - Brazil
E-mail: publicacoes@ims.uerj.br

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[TFN1] Source: Interview about knowledge and perceptions related to tick fever in Las Changas and Alto de Mulatos, Urabá region, 2016.

Sociodemographic Characteristics	%(n=244)
Sex
Female	75.4
Ethnia
Mestizo	92.2
Caucasian	6.2
Afro	0.8
Indigenous	0.8
Education
Elementary school complete	18.4
Elementary school incomplete	38.9
Secondary school complete	12.7
Secondary incomplete	17.2
Technical postsecondary	1.6
Tecnology postsecondary	0.4
University	1.2
No formal education	9.4
Ocupation
Outside	31.6
Inside	68.4
Age in years (Median and IQR)	43.9 (34.1-55.8)
Time of residence in area, years (Median and IQR)	15.0 (7.0-29.0)

Survey	% (n=246)
1. Have you heard about tick fever?	86.9
Yes	13.4
No
2. Do you consider tick fever a problem?
Yes	97.2
No	2.4
Don’t know	0.4
3. Who should prevent tick fever?
Family
Yes	30.9
No	69.1
Government
Yes	45.9
No	54.1
Community
Yes	26.8
No	73.2
Medical center of the region
Yes	90.2
No	9.8
Don’t know	1.6
4. How do you think tick fever hits you?
Water
Yes	0.4
No	99.6
Air
Yes	0.4
No	99.6
Person to person
Yes	3.3
No	96.7
Rat bite
Yes	8.1
No	91.9
Contaminated food
Yes	15.5
No	84.5
Mosquito bite
Yes	32.9
No	67.1
Tick bite
Yes	94.7
No	2.0
Missing data	3.3
Don’t know	1.6
5. What discomfort does tick fever cause?
Fever
Yes	98.0
No	2.0
Headache
Yes	89.4
No	10.6
Muscle and bone pain
Yes	91.1
No	8.9
Chills
Yes	89.0
No	11.0
Weakness and fatigue
Yes	80.5
No	19.5
Vomits and diarrhea
Yes	44.3
No	55.7
Don’t know	2.4
6. How is tick fever cured?
Taking the pills provided by mosquito control personnel
Yes	7.3
No	92.7
Taking aspirin
Yes	2.8
No	97.2
Taking medicine prescribed by the pharmacy
Yes	14.2
No	85.8
Attending the health center
Yes	78.9
No	21.1
Attending a shaman or healer
Yes	0
No	100
Don’t know	17.5
7. Has any member of the community died from tick fever?
Yes	8.9
No	91.1
8. How many people have died from tick fever in their community?
Boys (0-17 years)	≤2
Girls (0-17 years)	2
Young adults (18-40 years)	≤4
Older adults (older than 40 years)	0
9. Did you have any test to see if you have tick fever?
Yes	11.8
No	88.2
10. What tests did you do?
Urine sample (N=29)
Yes	6.9
No	93.1
Blood sample (N=29)
Yes	96.6
No	3.4
Physical test (N=29)
Yes	6.9
No	93.1
Vision test (N=29)
Yes	3.5
No	96.5

Survey	% (n=246)
1. Where do you go when you have fever?
Farmacy
Yes	32.1
No	67.9
Shaman or healer
Yes	0.4
No	99.6
Medical center
Yes	76.4
No	23.6
Hospital
Yes	29.3
No	70.7
2. Do you take the pills against the tick fever that the health staff gives you?
Yes	93.5
No	6.5
3. Do you agree with the insecticide spraying in your home?
Yes	99.2
No	0.8
4. Do you agree with the visit of health personnel to attend a fever?
Yes	4.5
No	95.5
5. Are there people in the community who cure tick fever and other diseases?
Yes	4.5
No	95.5
6. How do you take care not to get sick with tick fever?
Filling the puddles around your home with dirt or sand
Yes	48.8
No	51.2
Organizing clean-up days in the community
Yes	48.0
No	52.0
Using insect repellents
Yes	18.3
No	81.7
Personal protection (use of clothing that protects against stings, long-sleeved shirt and long pants)
Yes	41.1
No	58.9
Spraying the house with poison (spray)
Yes	71.5
No	28.5
Don’t know	13.4
7. Do you think ticks are dangerous?
Yes	97.2
No	2.8
8. What can ticks do to you?
Absolutly nothing
Yes	0.41
No	99.6
It causes an itch
Yes	1.6
No	98.4
It produces a welt
Yes	57.3
No	42.7
Its transmits deseases
Yes	91.5
No	8.5
They sting and then fall
Yes	3.3
No	96.7
Don’t know	0.41
9. Who gets ticks?
Animals
Yes	1.6
No	98.4
People
Yes	2.0
No	98.0
Animals and people
Yes	99.6
No	0.4
Nobody
Yes	0
No	100

Survey	% (n=246)
1. Do you keep the channels and ditches clean around your house?
Yes	77.2
No	22.8
2. Do you use insecticides around your house?
Yes	88.6
No	11.4
3. Do you use insect repellents?
Yes	17.5
No	82.5
4. Do you bathe your dogs with flea and tick poison?
Yes	36.6
No	62.2
Don’t know	1.2
5. How often do your pets bathe with flea and tick poison?
Weaks (n=48)
1 week	64.6
2 weeks	33.3
3 weeka	2.1
Months (n=40)
1 month	62.5
2 months	22.5
3 months	12.5
6 months	2.5
Year (n=2)
1 year	100
6. Do you wear white or light clothing when you work outdoors?
Yes	28.5
No	71.5
7. Do you wear long-sleeved shirts when you go work outdoors?
Yes	72.8
No	27.2
8. Do you check that you don’t have any ticks on your body after working outdoors?
Yes	51.2
No	48.8
9. Do you take care of the environment around you?
Yes	74.8
No	25.2
10. Do you plant crops in natural forests?
Yes	58.1
No	41.9
11. Do you use any measure of protection against rodents?
Yes	57.7
No	42.3
12. Which protection measure?
Poison
Yes	25.6
No	33.3
Other	41.1
13. Do you hunt forest animals?
Yes	4.5
No	95.5
14. Why do you hunt?
Eating (n=11)
Yes	45.5
No	54.5
Sport (n=11)
Yes	0
No	100
To defend domestic animals (n=11)
Yes	45.5
No	54.5
Sell (N=11)
Yes	9.1
No	90.9