Background
Methods
Study design, sampling strategy and study population
Questionnaire and data collection
Data analysis and statistical tests
Ethics
Results
Demographic analyses and response rates of the study populations
Characteristics | Two study populations | p-value | ||||
---|---|---|---|---|---|---|
Live-poultry market workers | Community residents | |||||
N = 430 | % | N = 418 | % | |||
Age (Years) | 17-40 | 141 | 32.8 | 165 | 39.5 | 0.06 |
41-64 | 268 | 62.3 | 241 | 57.7 | ||
≥65 | 21 | 4.9 | 12 | 2.9 | ||
Gender | Male | 226 | 52.6 | 125 | 29.9 | <0.001* |
Female | 204 | 47.4 | 293 | 70.1 | ||
Geographical Areas | North | 195 | 45.3 | 193 | 46.2 | 0.97 |
Central | 104 | 24.2 | 100 | 23.9 | ||
South | 61 | 14.2 | 55 | 13.2 | ||
East | 70 | 16.3 | 70 | 16.7 | ||
Education | ≦Elementary | 89 | 20.7 | 50 | 12.0 | <0.001* |
Junior high | 133 | 30.9 | 95 | 22.8 | ||
Senior high | 169 | 39.3 | 157 | 37.6 | ||
≧College | 39 | 9.1 | 115 | 27.6 |
High risk§ | Moderate risk§ | Low risk§ | ||||||
---|---|---|---|---|---|---|---|---|
Variables | N = 73 | % | N = 113 | % | N = 244 | % | p-value | |
Age (Years) | 17–40 | 24 | 32.9 | 34 | 30.1 | 83 | 32.8 | 0.95 |
41–64 | 45 | 61.6 | 74 | 65.5 | 149 | 62.3 | ||
≧65 | 4 | 5.5 | 5 | 4.4 | 12 | 4.9 | ||
Gender | Male | 44 | 60.3 | 65 | 57.5 | 117 | 48.0 | 0.09 |
Female | 29 | 39.7 | 48 | 42.5 | 127 | 52.0 | ||
Geographical Areas | North | 33 | 45.2 | 40 | 35.4 | 122 | 50.0 | 0.01* |
Central | 16 | 21.9 | 38 | 33.6 | 50 | 20.5 | ||
South | 8 | 11.0 | 11 | 9.7 | 42 | 17.2 | ||
East | 16 | 21.9 | 24 | 21.2 | 30 | 12.3 | ||
Education | ≦Elementary | 22 | 30.1 | 20 | 17.7 | 47 | 19.3 | 0.27 |
Junior high | 16 | 21.9 | 40 | 35.4 | 77 | 31.6 | ||
Senior high | 30 | 41.1 | 44 | 38.9 | 95 | 38.9 | ||
≧College | 5 | 6.8 | 9 | 8.0 | 25 | 10.2 |
Factors associated with risk awareness, attitude and preventive measures of AI before the outbreaks of HPAI H5N2
5 Surveyed questions | Variables | ORs | 95 % CI |
---|---|---|---|
1. Taiwan will be affected by the outbreaks of influenza in China | Educational Status | 2.09 | 1.48–2.95 |
Oppose ban on live poultry slaughtering in traditional markets | 0.34 | 0.18–0.64 | |
2. Taiwan residents will become infected with avian influenza (AI) | Educational Status | 1.42 | 1.19–1.69 |
Believe outbreak of AI in China will affect Taiwan | 2.22 | 1.55–3.18 | |
Support ban on live poultry markets | 1.51 | 1.10–2.06 | |
Southern Taiwana | 3.27 | 2.01–5.31 | |
Central Taiwana | 0.59 | 0.41–0.84 | |
Ageb | 0.98 | 0.97–1.00 | |
3. Knowing new “Ten No’s, Five Needs” policy | Educational Status | 1.26 | 1.08–1.46 |
Central Taiwana | 3.37 | 2.42–4.70 | |
Eastern Taiwana | 3.87 | 2.63–5.71 | |
Believe Taiwan residents will not be infected with avian influenza | 0.58 | 0.36–0.91 | |
Oppose ban on live poultry slaughter in traditional markets | 0.76 | 0.56–1.01 | |
4. Willing to take self-protection measures against avian influenza viral infection | Live-poultry market workersc | 0.47 | 0.28–0.80 |
Believe AI cases will appear in Taiwan | 2.28 | 1.13–4.60 | |
Aware of new “10 No’s, 5 Needs” policy | 2.41 | 1.46–3.97 | |
Eastern Taiwana | 0.53 | 0.28–1.00 | |
Believe outbreaks of AI from Mainland China will not affect Taiwan | 0.14 | 0.07–0.28 | |
Have no opinions on banning birds from being slaughtered in traditional markets | 0.42 | 0.25–0.70 | |
5. The vaccine will provide effective protection against avian influenza viral infection | Live-poultry market workersc | 0.30 | 0.17–0.50 |
Believe AI from Mainland China will not affect Taiwan | 0.21 | 0.09–0.46 | |
Aware of “Ten No’s, Five Needs” policy | 0.52 | 0.31–0.88 | |
Believe it is unnecessary to protect oneself against AI viral infection | 0.19 | 0.10–0.35 | |
Central Taiwana | 0.10 | 0.01–0.83 | |
Eastern Taiwana | 0.05 | 0.01–0.39 | |
Northern Taiwana | 0.03 | 0.00–0.24 |
Factors associated with risk awareness, attitude and preventive measures after the outbreaks of HPAI H5N2
Variables | Two study populations | p-value | ||||
---|---|---|---|---|---|---|
Live-poultry market workers | Community residents | |||||
N = 73 | % | N = 152 | % | |||
Age (Years) | 11–40 | 18 | 24.7 | 106 | 69.7 | <0.001* |
41–64 | 46 | 63.0 | 41 | 27.0 | ||
≧65 | 9 | 12.3 | 1 | 3.3 | ||
Missing | 0 | 4 | ||||
Gender | Male | 28 | 38.4 | 48 | 36.4 | 0.78 |
Female | 45 | 61.6 | 84 | 63.6 | ||
Missing | 0 | 20 | ||||
Education | ≦Elementary | 21 | 28.8 | 2 | 1.4 | <0.001* |
Junior high | 16 | 21.9 | 11 | 7.7 | ||
Senior high | 22 | 30.1 | 44 | 31.0 | ||
≧College | 14 | 19.2 | 85 | 59.9 | ||
Missing | 0 | 10 | ||||
Acceptance of avian influenza vaccinea | Yes | 45 | 61.6 | 114 | 75.0 | 0.04* |
Questions | ORs | 95 % CI | |
---|---|---|---|
Variables | |||
1. Taiwan will be affected by the outbreaks of influenza in China | Believe Taiwan residents will become infected with AIVs | 25.51 | 4.24–153.66 |
Age | 0.85 | 0.78–0.93 | |
2. Taiwan residents will become infected with avian influenza (AI) | Believe influenza outbreaks in China will affect Taiwan | 6.83 | 2.10–22.26 |
Will take preventive measures against AI | 3.88 | 1.16–12.98 | |
3. Knowing new “Ten No’s, Five Needs” policya | Aware of the critical condition of the child in Hong Kong infected with H5N1 | 4.24 | 2.09–8.59 |
4. Willing to take self-protection measures against avian influenza viral infection | Aware of critical condition of the child in Hong Kong infected with H5N1 | 5.85 | 1.45–23.56 |
Believe people in Taiwan will be infected with AIVs | 4.09 | 1.15–14.62 | |
Know AI may cause serious diseases and death | 6.62 | 1.54–28.55 | |
5. Willing to receive avian influenza vaccination | Believe seasonal flu vaccines can reduce chance of getting human flu or AI | 5.51 | 1.97–15.42 |
Believe seasonal flu vaccines can reduce chance of getting human flu and AI | 7.65 | 2.61–22.43 | |
6. Know AI may cause serious illness and even death | Know the “Ten No’s, Five Needs” policy | 4.10 | 1.19–14.12 |
Community Residentsb | 3.64 | 1.03–12.86 | |
Will take preventive measures against AI | 4.38 | 1.08–17.76 |
Protection measuresa | Two study populations | p-value | |
---|---|---|---|
Live-poultry market workers | Community residents | ||
(n = 69b) | (n = 152) | ||
Wash hands frequently | 58(84.1 %) | 121(79.6 %) | 0.43 |
Wear facemasks | 50(72.5 %) | 116(76.3 %) | 0.54 |
Comply with government’s policy | 27(39.1 %) | 89(58.6 %) | <0.01** |
Do Exercise | 14(20.3 %) | 66(43.4 %) | <0.01** |
Obtain more information | 6(8.7 %) | 61(40.1 %) | <0.001*** |
Receive human flu vaccine | 17(24.6 %) | 49(32.2 %) | 0.25 |
Receive AI H5N1 vaccine | 8(11.6 %) | 53(34.9 %) | <0.01** |
Take Tamiflu | 3(4.3 %) | 12(7.9 %) | 0.33 |
Take Chinese herbs | 6(8.7 %) | 6(3.9 %) | 0.15 |
Stop going to LPMsc | - | 74(48.7 %) | - |
Stop buying poultry in LPMsc | - | 56(36.8 %) | - |
Differences in the factors associated with RAP after the outbreaks of these AI viruses with regards to low versus high pathogenicity
Perception changes | Live-poultry market workers | Community residents | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Before HPAI | After HPAI |
p
| Before HPAI | After HPAI |
p
| |||||
N
| % |
N
| % |
N
| % |
N
| % | |||
1. AI epidemics in China will affect Taiwan | 104 | 94.20 % | 73 | 69.9 % | <0.001* | 100 | 94.00 % | 150 | 99.3 % | 0.013* |
2. People in Taiwan will be infected by AIVs | 104 | 34.60 % | 64 | 65.6 % | <0.001* | 100 | 44.00 % | 149 | 76.5 % | <0.001* |
3. Respondents knew government (Ten No’s, Five Needs) policy | 104 | 58.70 % | 70 | 68.60 % | 0.186 | 100 | 66.00 % | 147 | 68.70 % | 0.656 |
4. Respondents will take self-protection measures against AIVs | 104 | 91.30 % | 72 | 81.90 % | 0.064 | 100 | 95.00 % | 152 | 96.70 % | 0.499 |
5. Vaccination can prevent human or avian influenza virus infection | 104 | 92.30 % | 73 | 68.5 % | <0.001* | 100 | 95.00 % | 152 | 94.70 % | 0.916 |
Sources of information regarding the 2012 outbreaks of HPAI in chickens in central Taiwan among live poultry market workers versus community residents
Aware of HPAI | Two study populations | p-value | |||
---|---|---|---|---|---|
Live-poultry market | Community | ||||
Workers (n = 64) | Residents (n = 119) | 0.03a,b | |||
Sources | n | % | n | % | |
Television | 58 | 90.6 | 101 | 84.9 | 0.28 |
Newspapers | 10 | 15.6 | 41 | 34.5 | <0.01 |
Internet | 7 | 10.9 | 44 | 37.0 | <0.001 |
Relatives or Friends | 5 | 7.8 | 18 | 15.1 | 0.16 |
Radio | 1 | 1.6 | 15 | 12.6 | <0.05 |
Other Market Workers | 4 | 6.3 | 3 | 2.5 | 0.21 |
Phone Calls/Messages | 0 | 0.0 | 1 | 0.8 | 0.48 |
Risk perceptions of LPAI H5N2, HPAI H5N2 and other important emerging infectious diseases
Infectious diseasesa | Two study populations | p-value | |
---|---|---|---|
Live-poultry market workers (N = 73) | Community residents (N = 152) | ||
Severe Acute Respiratory Syndrome (SARS) | 60 (82.2 %) | 112 (73.7 %) | 0.159 |
HPAI H5N2 | 47 (64.4 %) | 83 (54.6 %) | 0.164 |
2009 Pandemic H1N1 | 46 (63.0 %) | 101 (66.4 %) | 0.612 |
Enterovirus | 24 (32.9 %) | 86 (56.6 %) | 0.001* |
LPAI H5N2 | 23 (31.5 %) | 51 (33.6 %) | 0.760 |
Tuberculosis | 21 (28.8 %) | 76 (50 %) | 0.003* |