Escolares como multiplicadores da informação sobre Leishmaniose visceral no contexto familiar: elaboração e análise de modelo

Abstract

In the metropolitan region of Belo Horizonte (MRBH), visceral leishmaniasis (VL) is a health problem which had a significant increase over the last ten years (almost 10%) in the number of its occurrences, in the geographic expansion of autochthonous cases and in fatal ones. In this study, we examined a model of information transmission concerning VL with 5th and 8th grade students from public middle schools and their relatives. Two schools from Caeté, in the State of Minas Gerais were invited to participate and were classified as experimental school (ES) andcontrol school (CS). Science teachers of both schools received prior training to minister one class about the disease. After the class, the students from ES were instructed by their teachers to act as multipliers of the classess content. In addition, all students received a pamphlet aboutVL, which was previously tested in terms of its information. In order to find out what the students knew about the disease, they were asked to answer a multiple choice questionnaire before the class was taught and 90 days after. In ES, students were instructed to spread the informationcontained in the pamphlet to their family members. This activity was considered a homework task, and lasted 15 days, being monitored throughout this period by the teacher during classes. Students from CS received no homework tasks, nor were encouraged to discuss the issue. For the analysis of the information multiplication, 100 families were randomly selected (25 of each grade in both schools). Before and after the intervention of the students (30, 90, and 120 days), families were visited by a health worker who applied the same questionnaire used with the students, and handed out the same pamphlet. In addition, the health worker filled out a form about cleanliness conditions outside the house, such as the maintenance of the yard and of other areas. The analysis of knowledge about the disease and of the information multiplicationprocess was made through focus groups (FC) with the students and by quantitative methods (Delineament of Subdivided Parcels and T-Tests). For this analysis, 188 students were selected, 92 from ES and 96 from CS. Among the 100 families members selected, 77 were present in the entire evaluation process. Of these, 31 were responsible for ES students and 46 for CS. Before the classes were taught, the percentage of correct answers amongst ES and CS students was low and almost the same (33.2% in ES and 28,9% in CS). Nevertheless, 90 days after the classes, the students performance showed significant improvement (53.3% of correct answers on ES and 39,2% in CS), representing an increase of 20.1% in correct answers for ES students and of 10.3% for CS students (p<0.05). In the comparative analysis of the same grade, students from the 8th grade from ES had more correct answers than the ones from CS (19.7% and 9.8% respectively). The percentage of correct answers to the questionnaire amongst family members of both schools before the intervention of the multiplier was 51% for ES and 44% for CS. The results of family members from ES showed an increase of 16,1%, 20,9%, and 20% at 30, 90, and 120 days after intervention, respectively, while for CS this percentage was of 9.0%, 12.3%, and 8.7% (p<0.05). The FG analysis demonstrated that when acting as multipliers, students reminded their relatives of the information they learnt in class and in the pamphlet.Students from both 5th and 8th grades were asked to transfer information to their family as a homework task. Most of the doubts the relatives had were answered by the students themselves; in some cases they asked the teachers to help them. The transference of information was appropriate to spread information about VL to the students relatives, and there was no difference in this transference when comparing 5th and 8th grade students. The model used for spreading the information on VL was promising, especially considering the better cleanliness conditions outside the houses (with the removal of accumulated vegetation) of theES families after the intervention of the multipliers as compared to the residences of CS family members (p<0.05). Integrated work between health and education professionals which involves students as messengers of VL information may be a sustainable alternative to strengthen preventive and control actions of VL in urban areas