TEPHINET Field Teams Conduct First Study Exploring Knowledge, Attitudes and Practices on Zika and Other Arboviruses in El Salvador, Guatemala and Honduras

Through Breakthrough RESEARCH, USAID’s flagship program for social and behavioral change research and evaluation, TEPHINET partnered with Tulane University to conduct KAP (Knowledge, Attitudes, and Practices) surveys in El Salvador, Guatemala, and Honduras from May through October of 2018. The resulting study, “Knowledge, Attitudes and Practices on Zika in High-risk Sites in Guatemala, El Salvador, and Honduras,” was funded by USAID; Tulane led its methodological design and TEPHINET its implementation.

TEPHINET was in charge of hiring and training field staff and monitoring data collection. In each country, a team of TEPHINET consultants and their field staff was established to implement the study. Regional and country coordinators of the teams included local FETP graduates and staff. These teams conducted surveys in urban and semi-urban areas where Zika and other arboviruses have been detected as potential health threats.

To identify households for sampling, the researchers incorporated a complex methodological design using Google Earth diagrams. Overall, the teams conducted face-to-face interviews of 1,946 men and women between the ages of 18 to 49, more than half of whom had completed secondary school studies. In general, men demonstrated less knowledge of the Zika virus and its complications and were less aware that the virus can be transmitted sexually. Men also perceived a lower risk of Zika.

Women demonstrated less knowledge that mosquitoes can transmit Zika at any time of the day in El Salvador and Honduras. The lowest-income individuals demonstrated less knowledge of the relationship between Zika and congenital malformations in the three countries; in Honduras, they perceived a greater risk of Zika. In both El Salvador and Guatemala, the main source of information on health in general was provided by public health services. Those who received home visits to educate the population reported greater preventive behaviors in El Salvador and Guatemala. Among the most frequently reported preventive behaviors were changing container water, eliminating stagnant water, cleaning containers, using mosquito netting and eliminating hatcheries.

The standardized questionnaire included questions about water storage within each household. Interviewers received training on entomology, including the stages of development of Aedes aegypti and how to observe water containers for larvae or pupae, with the aim to transfer knowledge to the surveyed population on the prevention of vector or mosquito reproduction.

One of the teams’ biggest challenges lay in adapting to local hazards posed by maras, or gangs. Significant efforts were made to select locations not considered to be dangerous. The teams carried out their work while accompanied by volunteers from local partner organizations, displayed logos that were well-known in the localities, and followed strict security protocols governing language, clothing, colors, working hours, and other factors.

This was the first study exploring knowledge, attitudes and practices regarding Zika and other arboviruses in these specific countries. The teams’ findings will be used by USAID to inform the development of innovative strategies to respond to Zika and other arboviruses in Central America and the Dominican Republic in the future.

For more information about this project, please contact Mariana Mansur at mmansur [at] tephinet [dot] org.