https://doi.org/10.52973/rcfcv-e34475
Received: 25/06/2024 Accepted: 05/08/2024 Published: 05/12/2024
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Revista Científica, FCV-LUZ / Vol. XXXIV, rcfcv-e34475
ABSTRACT
It is estimated that 60% of infectious diseases, and up to 75% of
emerging and reemerging diseases are zoonotic. Inhabitants of
tropical rural areas are the most affected by zoonotic diseases.
However, knowledge of these inhabitants in vulnerable areas about
zoonotic diseases is rarely known and taken into consideration
for prevention programs and disease control. Semi–structured
questionnaires were applied to 96 inhabitants of Mayan communities
from the state of Yucatán, Mexico, to investigate their knowledge and
risk perception of rabies, taeniasis/cysticercosis complex, trichinosis,
toxoplasmosis, rickettsiosis, Chagas disease, leishmaniasis,
leptospirosis and brucellosis. Rabies (88.5%) and Chagas disease
(35.4%) were the most well–known diseases while taeniasis/
cysticercosis complex (7.5%), brucellosis (3.1%), toxoplasmosis (1%)
and trichinosis (1%) were the lesser–known diseases. None of the
interviewees mentioned knowing rickettsiosis, leishmaniasis or
leptospirosis. Of the inhabitants who had knowledge about rabies,
98.7% mentioned that the disease is spread by the bite of an animal,
60% indicated that the vaccination of animals prevents the disease,
and 65% considered that this disease represents a high risk for health.
Of the people who recognized Chagas disease, 93.7% mentioned
that the disease is acquired through the bite of blood–sucking bugs,
commonly referred to as “pics” in the Mayan language. In general,
Chagas disease prevention measures were varied and infrequent,
such as not touching “pics” (11.8%). Informative talks (46.9%) and
television (29.2%) were the means through which they would like
to receive information about diseases. Due to the inhabitants of
tropical rural communities living with multiple socioeconomic and
environmental conditions that increase the risk of exposure and
transmission of zoonotic diseases, it is necessary to implement
educational programs for control and prevention of zoonosis for
short–, medium–, long–term that consider the knowledge, perceptions
and necessities of the communities.
Key words: Diseases prevention; one health; rural areas; zoonotic
diseases
RESUMEN
Se estima que el 60 % de las enfermedades infecciosas y hasta un 75 %
de las enfermedades emergentes y re–emergentes son zoonóticas.
Los habitantes de las áreas rurales tropicales son más afectados por
las enfermedades zoonóticas. Sin embargo, el conocimiento sobre
las zoonosis por parte de los habitantes de áreas vulnerables es poco
conocido y tomado en consideración en los programas prevención y
control de enfermedades. Cuestionarios semi–estructurados fueron
aplicados a 96 habitantes de comunidades mayas del estado de
Yucatán, México, para investigar su conocimiento y percepción de
riesgo sobre la rabia, el complejo teniasis/cisticercosis, la triquinosis,
la toxoplasmosis, las rickettsiosis, la enfermedad de Chagas, la
leishmaniasis, la leptospirosis y la brucelosis. Los resultados indicaron
que la rabia con 88.5 % y la enfermedad de Chagas con un 35.4 %,
respectivamente, fueron las enfermedades más reconocidas, mientras
que teniasis/cisticercosis (7.5 %), brucelosis (3.1 %), toxoplasmosis
(1 %) y triquinosis (1 %) fueron poco conocidas. Ninguno de los
encuestados reconoció la rickettsiosis, leishmaniasis o leptospirosis.
De los entrevistados que reconocieron la rabia, el 98.7 % mencionó
que es transmitida por la mordida de un animal, el 60 % indicó que
la vacunación de los animales la previene y el 65 % consideró que
representa un riesgo alto para la salud. Entre las personas que
reconocieron la enfermedad de Chagas, el 93.7 % mencionó que es
adquirida a través de chinches hematófagas llamadas “pics” en lengua
Maya. En general, las medidas de prevención de esta enfermedad
fueron variadas e infrecuentes, como no tocar a los “pics” (11.8 %). Así
mismo, se conoció que las charlas informativas (46.9 %) y la televisión
(29.2 %) fueron los medios a través de los cuales los entrevistados
les gustaría recibir información sobre enfermedades. Debido a que
los habitantes de comunidades rurales tropicales viven en múltiples
condiciones socioeconómicas y ambientales que incrementan el riesgo
de exposición y transmisión de las zoonosis, es necesario implementar
programas de educación, control y prevención de zoonosis a corto,
mediano y largo plazo que consideren el conocimiento, percepción y
necesidades de las comunidades.
Palabras clave: Áreas rurales; enfermedades zoonóticas; prevención
de enfermedades; una salud
Knowledge and perceptions on zoonoses in Mayan communities from the
state of Yucatán, Mexico
Conocimiento y percepciones sobre zoonosis en comunidades mayas del estado de Yucatán, México
Alejandra Duarte–Jiménez
1
, Roberto Carlos Barrientos–Medina
2
, Jesús Alonso Panti–May
2
*
1
Universidad Autónoma de Yucatán, Facultad de Medicina Veterinaria y Zootecnia. Mérida, Yucatán, México.
2
Universidad Autónoma de Yucatán,
Centro de Investigaciones Regionales “Dr. Hideyo Noguchi”, Mérida, Yucatán, México.
*Corresponding author: alonso.panti@correo.uady.mx
FIGURE 1. Location of the Mayan communities. a) Location of the state of Yucatán,
in the Mexican republic (blue square). b) Location of the city of Merida (blue
square) in the state of Yucatán. c) Location of the communities (blue squares) in
relation to the municipality of Merida
Knowledge and perceptions on zoonoses in Mayan communities / Duarte-Jiménez et al. __________________________________________
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INTRODUCTION
Zoonotic diseases are caused by pathogens transmitted between
vertebrate animals and humans [1]. These pathogens can be
transmitted to humans through direct contact with secretions from
any vertebrate animal, consumption of animal meet or they can be
indirectly transmitted through biological vectors [2]. It is estimated
that 60% of infectious diseases, and up to 75% of emerging and
reemerging diseases are zoonotic [3] and that every year there are up
to 2.5 billion cases affecting humans and 2.7 million deaths associated
with zoonotic diseases [4].
Zoonotic diseases have a signicantly greater impact on less
developed countries and regions. This is due to the presence of
risk factors such as elevated population growth, lack of healthcare
systems and programs to deal with the spur of diseases, along with
a high prevalence of immunocompromised people who have HIV or
parasitic infections [5]. In this sense, Latin America and the Caribbean
are regions where 48.6% and 22.5% of the population living in rural
areas are in poverty and extreme poverty, respectively, despite poverty
decreasing over the last decade [6].
The emergence of zoonotic diseases originating from wildlife,
such as COVID–19 from SARS–CoV2, demonstrates the necessity
for future research on activities that put animals and humans in
close proximity [7]. People in rural areas typically live with multiple
socioeconomic and environmental factors that increase their risk
of exposure and transmission of zoonotic diseases, such as contact
with livestock and wildlife [8, 9]. With the use of wildlife being a vital
part of daily activity in rural Mexico, whether through food, pets,
traditional medicine [10], the risk for the emergence of zoonotic
diseases is heightened in these areas.
The complexity of implementing and designing effective zoonotic
disease prevention strategies makes them especially dicult to be
successful in rural areas [8]. It is necessary to create an intervention
based on studies that thoroughly consider the knowledge, perceptions,
practices and habits of the target population to establish preventive
measures of zoonotic diseases in both rural and urban areas, as
considering these social factors can increase motivation and overall
participation of the residents [11, 12]. Furthermore, understanding
why people participate in activities that increase zoonotic disease
transmission is important for developing disease control [8, 12].
Essentially, the purpose of this research was to investigate the
knowledge and perceptions on zoonotic diseases of national and
local importance in the residents of four Mayan communities in the
state of Yucatán, Mexico.
MATERIALS AND METHODS
Ethical statement
The present study was approved by the Bioethics Committee of
the Campus de Ciencias Biológicas y Agropecuarias, Universidad
Autónoma de Yucatán (Protocol Approval No. CB–CCBA–L–2021–001).
Study areas, design and populations
A cross sectional descriptive study was carried out in the
communities of Dzoyaxché (20°47'20" N, 89°35'23" W), San Ignacio
Tesip (20°50'31.92" N, 89°36'42.12" W), Hunxectamán (20°52'54" N,
89°33'28" W) and Yaxnic (20°47'24" N, 89°37'10.92" W), all belonging to
the municipality of Mérida, in the state of Yucatán (FIG. 1). The rst
three mentioned communities are found inside the Cuxtal Natural
Reserve, in a natural protected area consisting of 10,757 ha, located
in the south of the municipality of Mérida, while Yaxnic borders
the natural reserve. In general, the communities have fewer than
1,000 inhabitants who live with levels of marginalization and social
deprivation [13, 14, 15] (TABLE I).
TABLE I
Characteristics of the studied communities
Community Population Mayan people
Inhabited
dwellings
Marginalization
index
Social deprivation
index
Yaxnic 907 825 254 Low Low
Dzoyaxché 533 503 145 Low Low
San Ignacio Tesip 405 359 113 Very low Low
Hunxectamán 177 160 47 Low Low
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The vegetation of the Cuxtal Natural Reserve is low deciduous forest
and secondary vegetation, with 242 species of plants, including native
and introduced species in patios, parks and gardens [16]. The fauna
includes 53 species of mammals, 168 species of birds, 55 species of
reptiles, 12 species of amphibians and 410 species of invertebrates
[16]. The region’s climate is warm and subhumid with precipitation
in the summer from June to October, with an average precipitation
of 1,100 mm annually. The annual average temperature is 26°C with
a maximum of 36°C in May and a minimum of 16°C in January.
Data collection
To collect the socioeconomic data, along with the knowledge,
attitude and risk perceptions of zoonotic diseases, a non–probability
convenience sample was used due to the low participation from the
inhabitants of a community in the Cuxtal Natural Reserve in a pilot
study during the COVID–19 pandemic. Between June and July 2021,
the chosen communities were visited and with the help of a map,
street blocks were visited house by house to explain the objective
and methodology of the project. The inclusion criteria of the people
interviewed were the following: a) currently inhabiting the house,
b) inhabitants 18 years of age or older and c) signing the informed
consent. The exclusion criteria were: a) not currently residing in the
house, b) being under 18 years of age and c) not signing the informed
consent. In the case of the inclusion criteria being met, we proceeded
with the interview. Due to health concerns caused by the COVID–19
pandemic, it was decided to only interview one member of the
household as to not have proximity with several people. In addition,
sanitary measures, such as the use of face masks, antibacterial gels
and a safety distance of at least 3 m between the interviewer and the
interviewed, were used during the interview.
A semi–structured questionnaire was created ad hoc to obtain
socioeconomic information from the participants, as well as their
knowledge of the term zoonosis and their knowledge and risk
perception of rabies, taeniasis/cysticercosis complex, trichinosis,
toxoplasmosis, rickettsiosis, Chagas disease, leishmaniasis,
leptospirosis and brucellosis. The selection of zoonotic diseases was
based on both the diseases included in the Epidemiological Bulletin
of the National Epidemiological Surveillance System and those of
importance in Yucatan [17]. In order to collect the socioeconomic
information of the participants, aspects such as age, gender,
income, and education of the participants were asked during the
interviews. Also, the contact with animals, whether by possession,
consumption, or visits to the residence, was also investigated. To
explore the information of the inhabitant’s knowledge of zoonotic
diseases, they were asked about their ideas and knowledge on
the term zoonotic disease and what animals transmit diseases to
humans, as well as the transmission routes and what prevention
measures are used for the zoonotic diseases selected. To obtain
information on the risk perception, we asked whether the diseases
represent a risk – understood as a danger which harms or affects
their health – classifying them as high, medium or low risk. The survey
was created by consulting relevant literature related to the region’s
topics [18, 19, 20]. To check the clarity, duplicity and interpretation
of the information and questions, a rst version of the survey was
applied to ve residents of the community of San Ignacio Tesip [21].
To create the nal version, the feedback from this assessment was
used to make the modications needed.
Data analysis
A database was constructed to store the information collected.
To compare the socioeconomic characteristics of the inhabitants
interviewed between the four communities, the Chi square test
for homogeneity was used with R software version 1.3.959 with a
level of signicance of P< 0.05. As the four communities had similar
socioeconomic characteristics, data were pooled into rural. For
quantitative variables (e.g., age), the mean, standard deviation and
range are presented. For qualitative variables (e.g., knowledge of
the term zoonosis) frequencies and percentages are presented [22].
RESULTS AND DISCUSSION
Demographic and socio–economic characteristics of participants
A total of 96 inhabitants were interviewed in the study, of which 26
were from Dzoyaxché, 26 from San Ignacio Tesip, 26 from Yaxnic and
18 from Hunxectamán. The majority of those interviewed were female
(79.2%), housewives (66.7%), with an average age of 43.6 years, with basic
education (75%) and with an average family income of less than or equal
to USD 216.8 (TABLE II). The majority (88.5%) had or raised animals, most
commonly dogs and chickens or turkeys. The most widely consumed
meats by the interviewed inhabitants were chicken or turkey (100%),
pork (97.9%) and beef (97.9%), while from the wild animals, venison
(52.1%) was commonly consumed. The wild animals the interviewed
inhabitants observed most frequently in their yards or near their homes
were opossums (68.7%), rats/mice (61.5%) and skunks (54.2%) (TABLE III).
Knowledge and perceptions on zoonoses of participants
The majority of those interviewed (97.9%) did not know of the term
zoonosis (TABLE IV). However, 78.1% of them did recognize which
animals can transmit diseases to humans. Dogs (51%) and cats (29.2%)
were the most mentioned animals as disease transmitters. The
most well–known diseases were rabies (88.5%) and Chagas disease
(35.4%), meanwhile the least known were taeniasis/cysticercosis
(7.5%), brucellosis (3.1%), toxoplasmosis (1%) and trichinosis (1%).
TABLE II
Socioeconomic characteristics of the respondents from Dzoyaxché (DZO), Hunxectamán (HUN), San Ignacio Tesip (SIT), and Yaxnic (YAX)
Variable Category
DZO
n (%)
HUN
n (%)
SIT
n (%)
YAX
n (%)
Total
n (%)
Gender
Female 21 (80.8) 15 (83.3) 20 (76.9) 20 (76.9) 76 (79.2)
Male 5 (19.2) 3 (16.7) 6 (23.1) 6 (23.1) 20 (20.8)
Age (years) Mean ± SD 39 ± 16.1 46.7 ± 18.0 46.2 ± 15.8 43.6 ± 18.9 43.6 ± 17.2
Education
Level
None 2 (7.7) 0 (0) 2 (7.7) 2 (7.7) 6 (6.3)
Primary school 17 (65.4) 17 (94.1) 20 (76.9) 18 (69.2) 72 (75)
Secondary school 6 (23.1) 1 (5.6) 4 (15.4) 5 (19.2) 16 (16.7)
University 1 (3.8) 0 (0) 0 (0) 1 (3.8) 2 (2.1)
Occupation
Housewife 17 (57.7) 14 (77.8) 18 (69.2) 15 (57.7) 64 (66.7)
Employee 2 (26.9) 2 (11.1) 4 (15.4) 7 (26.9) 20 (20.8)
Student 2 (7.7) 0 (0) 2 (7.7) 4 (15.4) 8 (8.3)
Retiree 0 (0) 1 (5.5) 2 (7.7) 0 (0) 3 (3.1)
Unemployed 0 (0) 1 (5.5) 0 (0) 0 (0) 1 (1)
Monthly
Family
Income
≤ US$216.8 11 (42.3) 8 (44.4) 10 (38.5) 6 (23.1) 35 (55.3)
> US$216.8 13 (50) 10 (55.6) 16 (61.5) 20 (76.9) 59 (31.9)
Do not answer 2 (7.7) 0 (0) 0 (0) 0 (0) 2 (2.1)
The comparison of the variables between the communities did not show statistical dierences (
P>0.05)
TABLE III
Animals with which the interviewees had contact, whether as pets, as source of meat or as peridomestic animals
Variable Categories Frequency (%)
Keep domestic animals
Yes 85 (88.5)
No 11 (11.5)
Kept animals
Dogs (
Canis lupus familiaris) 77 (80.2)
Chickens / turkeys (
Gallus gallus / Meleagris gallopavo) 47 (49)
Cats (
Felis catus) 29 (30.2)
Sheep / goats (
Ovis aries / Capra hircus) 12 (12.5)
Cattle (
Bos taurus / Bos indicus) 6 (6.4)
Rabbits (
Oryctolagus cuniculus) 4 (4.2)
Turtles (Testudines
) 2 (2.1)
Fishes 2 (2.1)
Pigs (
Sus scrofa domesticus) 1 (1.0)
Consumption of animals
Chicken / turkey 96 (100)
Pigs 94 (97.9)
Cattle 94 (97.9)
Deer (
Odocoileus virginianus) 50 (52.1)
Ocellated turkey (
Meleagris ocellata) 11 (11.5)
Armadillo (
Dasypus novemcinctus) 8 (8.3)
Peccary (
Pecari tajacu) 6 (6.2)
Rabbit 5 (5.2)
Wild small birds 4 (4.2)
Iguana (
Iguana iguana) 3 (3.1)
Peridomestic animals
Opossums (
Didelphis virginiana) 66 (68.7)
Rats / mice (
Rattus rattus / Mus musculus) 59 (61.5)
Skunks (
Spilogale yucatanensis) 52 (54.2)
Bats (Chiroptera) 21 (21.9)
Gray foxes (
Urocyon cinereoargenteus) 8 (8.3)
Raccoons (
Procyon lotor) 1 (1)
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TABLE IV
Knowledge about zoonoses of respondents from the Mayan communities
Variable n Category Frequency (%)
Do you know the term zoonosis?
96
Yes 2 (2.1)
No 94 (97.9)
Do animals can transmit diseases to people? 96
Yes 75 (78.1)
No 21 (21.9)
What animals do you think can
transmit diseases to people?
96
Dogs 49 (51.0)
Cats 28 (29.2)
Rats / mice 8 (8.3)
Opossums 6 (6.2)
Cattle 5 (5.2)
Pigs 5 (5.2)
Bats 5 (5.2)
Chickens / turkeys 5 (5.2)
Rabbits 1 (1.0)
Iguanas 1 (1.0)
All animals 4 (4.2)
What disease do you know? 96
Rabies 85 (88.5)
Chagas disease 34 (35.4)
Taeniasis/cysticercosis 7 (7.5)
Brucellosis 2 (2.1)
Trichinellosis 1 (1.0)
Toxoplasmosis 1 (1.0)
Rickettsiosis 0 (0.0)
Leishmaniasis 0 (0.0)
Leptospirosis 0 (0.0)
Sources of information for identied zoonoses 96
Television 31 (36.0)
Relatives 23 (26.7)
Acquaintances 12 (13.9)
Radio 10 (11.6)
Presentations/exhibitions 8 (9.6)
Government institutions 6 (7.0)
Social medias 6 (7.0)
Had the disease 5 (5.8)
School 2 (2.3)
Newspaper 4 (4.6)
Doctor 4 (4.6)
Internet 4 (4.6)
Veterinarian 3 (3.5)
Flyer 1 (1.2)
Book 1 (1.2)
Research project 1 (1.2)
Through what means would you prefer to
receive information about zoonoses?
96
Presentations/exhibitions 45 (46.9)
Television 28 (29.2)
Newspaper 17 (17.7)
Radio 16 (16.7)
Social medias 16 (16.7)
Posters 10 (10.4)
Internet 2 (2.1)
Cell phone messages 2 (2.1)
In what language would you prefer to
receive information about zoonoses?
96
Maya 7 (7.3)
Spanish 44 (45.8)
Maya or Spanish 44 (45.8)
Do not answer 1 (1.0)
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TABLE V
Knowledge and perception towards rabies
Variable n Categories Frequency (%)
Do you know how rabies spreads
to people and animals?
85
Yes 78 (91.8)
No 7 (8.2)
How rabies spreads to people and animals? 78
Animal bite 77 (98.7)
Contact with the saliva of an infected animal 10 (12.8)
Scratch from an infected animal 1 (1.3)
What animals can transmit rabies? 78
Dogs 65 (83.3)
Bats 8 (10.3)
Rats/mice 4 (5.1)
Cats 3 (3.8)
Opossums 3 (3.8)
Do you know the signs/symptoms
of rabies in animals/humans?
85
Excessive salivation 23 (27.1)
Aggressiveness 15 (17.6)
Sudden death 12 (14.2)
Fever 5 (5.9)
Thirst 3 (3.5)
Inappetence 2 (2.3)
Wound infection 2 (2.3)
Disorientation 2 (2.3)
Convulsion 1 (1.2)
Muscle pain 1 (1.2)
Headache 1 (1.2)
What measures prevent the rabies? 85
Vaccinate animals 51 (60)
Go to the doctor post–exposure 8 (9.4)
Prevent pets leaving from the dwelling 7 (8.2)
Use traditional cures 6 (7.1)
Avoid contact with animals 4 (4.7)
Take pets to the veterinarian 2 (2.3)
Kill suspicious rabid animals 2 (2.3)
Neuter dogs and cats 1 (1.2)
Isolate suspicious rabid animals 1 (1.2)
What level of risk does rabies
represent to your health?
85
High 56 (65.9)
Medium 8 (9.4)
Low 10 (11.8)
I don’t know 11 (12.9)
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None of the interviewees mentioned knowing about rickettsiosis,
leishmaniasis or leptospirosis. The interviewed inhabitants mentioned
their sources of knowledge on diseases were primarily television (36%)
and family members (26.7%). They said they would like to receive
information about diseases from informative talks and television. Of
the interviewed inhabitants, 45.8% stated they would prefer receiving
this information in Spanish due to their lack of prociency in the
Mayan language, while another 45.8% indicated they could receive the
information in either Mayan or Spanish because they were bilingual.
Although the majority of those interviewed (97.9%) did not know the
term zoonosis, or zoonotic disease; most were knowledgeable (78.1%)
of animals being able to transmit diseases to humans. Several studies
in Latin America have resulted in similar outcomes. Garaycochea etal.
[23] determined that 91.6% of the women attending in the Instituto
Nacional Materno Perinatal of Lima, Peru, did not know of the term
zoonosis, though 82.8% of them knew animals could transmit diseases
to humans. Tarabla et al. [24] found that 88.2% of the housewives
interviewed in Coronda, Santa Fe, Argentina, did not know of the term
zoonosis, however 80% did mention the transmission of diseases
from animals to humans. A different study by Ayala–Servín et al.
[25], found that 86.7% of the inhabitants interviewed at San Lorenzo,
Paraguay, claimed to know of the existence of diseases transmitted
from animals to humans. Therefore, though a high percentage of
the general population might be unfamiliar with the specic term
“zoonosis,” this does not seem to be problematic, as people are
generally aware that animals can transmit diseases to humans.
From the inhabitants who claimed to know about rabies (TABLEV),
91% of them mentioned knowing how the disease is spread. Of these
people, 98.7% of them mentioned that rabies is spread through the
bite of a rabid animal, with dogs being stated as the animal that
transmits rabies the most (83.3%). The signs and symptoms which
they most associated with animal or human rabies were excessive
TABLE VI
Knowledge and perceptions about Chagas disease
Variable n Categories Frequency (%)
Do you know how people
get Chagas disease?
34
Yes 32 (94.1)
No 2 (95.9)
How people get Chagas disease? 32
Bites of “pics” 30 (93.7)
Contact with feces of “pics” 2 (6.2)
Do you know the signs/symptoms
of Chagas disease?
34
Inammation/infection of the wound 15 (44.1)
Heart damage 9 (26.5)
Fever 2 (5.9)
Heart attack 2 (5.9)
Liver damage 1 (2.9)
Headache 1 (2.9)
What measures prevent Chagas disease? 34
Not touch “pics” 4 (11.8)
Fumigate the dwelling 3 (8.8)
Go to the doctor post–exposure 3 (8.8)
Keep the dwelling clean 2 (5.9)
Not accumulating useless objects 2 (5.9)
Use mosquito nets 1 (2.9)
Kill “pics” 1 (2.9)
Use ducks as biological control 1 (2.9)
What level of risk does Chagas disease
represents to your health?
34
High 29 (85.3)
I don’t know 5 (14.7)
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salivation (27.1%), aggressiveness (17.6%) and sudden death (14.2%).
The most frequently mentioned method of prevention against rabies
was animal vaccination (60%). Of the interviewed residents, 65% of
them considered rabies as a high health risk.
Although a high percentage (91.8%) of the interviewed adequately
recognized the sources of transmission of rabies (animal bites,
scratches or contact with contaminated saliva), only 9.6% of them
mentioned that wild mammals, such as bats, can carry and transmit
this disease. Furthermore, no person mentioned carnivores like
foxes or skunks. In the Americas, human rabies transmission by
dogs has been drastically reduced; however, transmission through
wild mammals (e.g., bats, foxes, skunks) has obtained greater
epidemiological importance [26, 27]. In 2019, Mexico was the rst
country to receive validation from the World Health Organization
for eliminating human rabies transmitted by dogs as a public health
issue [28]. Currently, wild mammals have taken a bigger role in the
epidemiology of human rabies, between 2007 and 2020, the Institute
of Epidemiological Diagnosis and Reference (InDRE) analyzed 407
cases of human exposure to the rabies virus, identifying positive
cases in primarily bats (63%) and skunks (28%), and with less
frequency (9%) foxes, coatis, felines, coyotes, deer and opossums
[29]. This highlights the need to modify human rabies prevention
strategies by considering the role of wild mammals and the contact
of rural community members with these animals, whether for meat
consumption (e.g., deer) or due to their presence in households (e.g.,
skunks, gray foxes, bats, opossums).
Within the people that recognized Chagas disease, 94.1% of them
mentioned understanding how this disease is transmitted to humans.
The main form of transmission mentioned (93.7%) was through the
bite of blood–sucking bugs (Triatoma dimidiata), commonly referred
to as “pics” in the Mayan language (TABLE VI). The most mentioned
effect related to Chagas disease by the interviewed inhabitants
were inammation and or infection at the site of the bite (44.1%).
The main prevention method mentioned was avoiding contact with
blood–sucking bugs (11.8%). Among the interviewed inhabitants, 85%
considered Chagas disease to be a high health risk.
Chagas disease is endemic to various Mexican states, including
Yucatán. According to the National Committee for Epidemiological
Surveillance, from 2010 to 2020, the cases of Chagas disease reported
annually in Yucatán ranged from 27 to 166 and from 391 to 980 in
the country [30]. However, these numbers may be lower due to the
amount of cases not reported to government agencies [31]. In this
study, Chagas disease was the second most recognized zoonotic
disease, though still with a low frequency (35.4%). All participants
who recognized the disease associated it with the bug “pic”; however,
only a few (6.2%) connected it to contact with the vector’s feces, and
none mentioned other transmission routes, such as blood transfusion
or congenital transmission. Additionally, the most associated signs
and symptoms were inammation or infection around the bitten area
(44.1%) and heart damage (26.5%). Overall, knowledge of transmission
methods among the interviewed residents was very limited. A
previous study in three rural communities in the state of Yucatán
showed that 50% of the interviewed residents recognized that the
“pic” insect could transmit the disease and how this insect causes
inammation and infection (61%) and affected the heart (38%) [32]. In
other countries such as Honduras and Bolivia, the acknowledgement
and identication of this zoonotic disease has had a higher frequency
(88–90%). However, the knowledge of transmission routes, in general,
was also low due to only 1.3–2% being able to recognize a different
transmission route other than the vector one [33, 34]. Since Chagas
disease is prevalent in Latin America, it is essential to enhance the
TABLE VII
Knowledge and perception about taeniasis / cysticercosis
Variable Category Frequency (%)
Do you know how people get
taeniasis / cysticercosis?
Yes 7 (100)
No 0 (0)
How people get taeniasis /cysticercosis?
Eat contaminated pork with worms 5 (71.4)
Eat raw or undercooked pork 2 (28.6)
Do you know the signs or symptoms
of the taeniasis / cysticercosis?
Brain damage by worms 2 (28.6)
Headache 1 (14.3)
Convulsion 1 (14.3)
Fainting 1 (14.3)
Inappetence 1 (14.3)
I don’t know 1 (14.3)
What measures prevent the
taeniasis / cysticercosis?
Not eat contaminated pork 3 (42.9)
Eat well–cooked pork 3 (42.9)
Wash fruits and vegetables 1 (14.3)
I don’t know 2 (28.6)
What level of risk does taeniasis /
cysticercosis represent to your health?
High 6 (85.7)
Low 1 (14.3)
Knowledge and perceptions on zoonoses in Mayan communities / Duarte-Jiménez et al. __________________________________________
8 of 10
communication methods that effectively disseminate information
about the disease to communities, so that it is long lasting and can
be reinforced through informal methods based on the experience of
rural communities [33].
Those interviewed who recognized the taeniasis/cysticercosis
complex considered it a disease purely spread by pigs. Everyone
stated knowing it is transmitted and acquired, by consuming pork
contaminated with worms (71.4%) or raw or undercooked (28.6%)
(TABLE VII). According to those interviewed, the people with this
disease can suffer from brain damage caused by the worms (28.6%)
and experience increased headaches, seizures, fainting and loss of
appetite (14.3%). To prevent this disease the main consensus was to
not eat contaminated (42.9%) or raw or undercooked (42.9%) pork.
Out of the people interviewed, 85.7% of them considered taeniasis/
cysticercosis to be of high health risk.
Out of the three people surveyed with knowledge of brucellosis,
only one of them associated its transmission with the consumption
of infected beef. In relation to the signs and symptoms of the disease
in humans, two of the interviewed residents mentioned the following:
fever, low blood pressure, loss of appetite and stomach pain. One
person surveyed mentioned that in animals the disease is contagious
for pregnant cows, causing spontaneous abortions. Only one person
mentioned knowing methods of prevention in animals, these being
vaccines, quarantine after purchasing cows and notifying the livestock
authorities. Two people said they perceived this disease as low risk
for their health, while the third person considered it a medium risk.
Only one person recognized toxoplasmosis and mentioned the
disease is transmitted through cat feces; however, the signs or
symptoms caused by the disease were not mentioned. This person
also mentioned a method of prevention is by avoiding contact with
stray or feral cats, and that this disease as a high risk for their health.
Trichinosis was mentioned by one interviewed resident, who identied
the consumption of contaminated pork as a source of transmission.
The interviewed resident mentioned lack of appetite and fever as
signs and symptoms of the disease; however, that good hygiene
and avoiding contaminated pork alone was enough as preventative
methods. This disease was perceived as a high risk to human health.
Diseases such as taeniasis/cysticercosis, brucellosis, trichinosis
and toxoplasmosis were rarely known by those interviewed (< 8%),
whereas leptospirosis, rickettsiosis and leishmaniasis had no
recognition. Although some cases of these diseases have decreased
in the past decades (e.g., taeniasis/cysticercosis, trichinosis) [35,
36], others have been dealing with an increase in cases in the state
of Yucatán, like localized cutaneous leishmaniasis and rickettsiosis.
Recent autochthonous cases and infected vectors indicate that
leishmaniasis is emerging in the state of Yucatán [37]. Similarly, an
increase in human cases of rickettsiosis has been reported in Mexico,
including the state of Yucatán [38]. The emergence of these diseases,
and other zoonoses, shows the need for strength and an update to the
intervention and control strategies through a One Health perspective.
The results found in the studied communities highlighted the
necessity to implement educational programs and campaigns to
increase the inhabitant’s knowledge on important zoonotic diseases in
the region. Beyond the dissemination of knowledge, these campaigns
and programs must consider the community’s necessities, like the
preference on receiving information through television, talks and
newspapers. The language level utilized is another important factor
to consider due to the general population’s lack of mastery of either
Spanish or Mayan. They may not be able to fully understand the
information disseminated due to illiteracy or the use of non–common
words. Methods that include participatory learning activities in
informal environments, such as plays, poster creations and seminars,
involving different sectors of the population such as teachers, health
module staff, parents, children and local authorities, are necessary
to establish long–term community surveillance strategies.
_____________________________________________________________________________Revista Cientifica, FCV-LUZ / Vol. XXXIV, rcfcv-e34475
9 of 10
CONCLUSION
The present study provides information on the knowledge and
perception of zoonoses among inhabitants of Mayan communities.
Although a high percentage of the interviewed people did not
recognize the term zoonosis, most of them were knowledgeable of
animals being able to transmit diseases to humans.
The results indicate that the interviewed inhabitants have moderate
knowledge mainly about rabies and Chagas disease, while other zoonotic
diseases were little known (e.g., taeniasis) or unknown (e.g., leptospirosis).
It is expected that the knowledge and perception of the inhabitants
will be considered in education and health promotion programs. This
will allow for greater participation and interest of the inhabitants in
the strategies for the control and prevention of zoonotic diseases.
Availability of data
The data that support the ndings of this study are available from
the corresponding author upon reasonable request.
ACKNOWLEDGEMENTS
The authors thank the interviewees from the communities
of Dzoyaxché, San Ignacio Tesip, Hunxectamán and Yaxnic for
their participation.
Financial support
The authors declared that no funds or other support were received
in this study.
Conict of interest
The authors declare no conict of interests.
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