Knowledge, Attitude, and Practice Regarding Zoonotic Risk in Wildlife Trade, Southern China

Development and Validation of a Questionnaire to Measure ICU Nurses' Knowledge, Attitudes, and Practices Related to Central Line Bloodstream Infection Practices

BACKGROUND

Currently, there is no instrument available to assess intensive care unit (ICU) nurses' knowledge, attitudes, and practices (KAP) of central line-associated bloodstream infection (CLABSI) prevention practices.

PURPOSE

To develop and validate a CLABSI questionnaire to measure ICU nurses' KAP (CLABSI-KAP-Q).

METHODS

Data were collected from 255 nurses at 4 hospitals in Gansu Province, China. Questions on the CLABSI-KAP-Q were generated through a review of the literature, interviews with nurses, and multiple rounds of content validity evaluation by experts. The validity and reliability of the CLABSI-KAP-Q were assessed with exploratory factor analysis, confirmatory factor analysis, internal consistency, and correlation coefficients.

RESULTS

The final version of the CLABSI-KAP-Q consisted of 32 items. The reliability was represented by a Cronbach α of 0.946, while the test-retest reliability was 0.945. The overall content validity was 0.95.

CONCLUSIONS

The CLABSI-KAP-Q is shown to be valid and reliable and recommended for use in clinical practice.

Wildlife Consumption, Health, and Zoonotic Disease in China After the Emergence of COVID-19

There has been much discussion in the conservation and policy realms of COVID-19 as a zoonotic disease, or a disease transmitted from wildlife to humans. However, wildlife consumption in China is not only a potential source of disease but also a practice embedded in complex beliefs about health. This paper used survey data (N = 974) collected in China in June 2021 to examine attitudes and behaviors related to (a) wildlife consumption, (b) Traditional Chinese Medicine (TCM) and (c) zoonotic risk after the emergence of the COVID-19 pandemic. 40.1% of respondents self-reported that they are less likely to consume wild animals since the outbreak of COVID-19. Respondents who used wildlife supplements for TCM, who believed in the benefits of wild animal consumption and fresh slaughter of wildlife, and who had higher levels of agreement with the zoonotic origin of COVID-19 were more likely to report that they had decreased their wildlife consumption after the outbreak of COVID-19. Use of wildlife in TCM significantly increased the odds that a respondent believed that COVID-19 was very likely zoonotic. We discuss how situating wildlife consumption within complex beliefs about health and disease can assist with protecting wildlife and public health in the wake of COVID-19.

Perceptions of COVID-19 origins and China's wildlife policy reforms

Given the link between perceptions of zoonotic risk and support for regulations such as wildlife consumption bans, debates regarding the origins of COVID-19 are likely to have conservation implications. Specifically, alternative hypotheses that cast doubt on COVID-19's zoonotic origins could potentially lessen momentum for China's wildlife policy reforms and their associated conservation impacts. To better understand the impact of COVID-19 origin debates on China's wildlife policies, we conducted a 974-respondent survey across mainland China, supplemented by policy and media reviews. We examined perceptions of three facets of COVID-19 origins: geographic location, source (e.g., wildlife farm, wet market, etc.), and specific wildlife species as transmitters. Our findings reveal that 64.6 % of respondents believed COVID-19 originated in the United States or Europe, not in China. Further, compared to the baseline group of respondents who selected China as the origin country, respondents who selected the United States or Europe as the origin had a greater likelihood of selecting laboratories/research and imported frozen foods as likely sources, while these respondents had a lower likelihood of selecting wild animals in a wet market or natural causes as likely sources. Despite such varied beliefs regarding COVID-19 origins, support for wildlife policy reforms was strong: 89.5 % of respondents who previously consumed wildlife self-indicated reduced consumption after the pandemic and 70.5 % of respondents supported banning the trade of all wildlife species. Moreover, those respondents who selected wild animals in a wet market as a likely source of COVID-19 had a greater likelihood of supporting a trade ban on all wild-caught wildlife and all farmed wildlife. Our results indicate that, although investigation of COVID-19's origins is on-going and politicized, there is clear support for wildlife reforms in China that can promote conservation outcomes.

COVID-19 impacts, opportunities and challenges for wildlife farms in Binh Duong and Ba Ria Vung Tau, Vietnam

The wildlife trade is a major cause of species loss and can trigger disease transmission. While the COVID-19 pandemic sparked public interest in eliminating the wildlife trade, a better understanding is needed of the economic repercussions of COVID-19 on those who rely on wildlife farming for their livelihoods. Using the case studies of Ba Ria Vung Tau and Binh Duong provinces in Vietnam - a country seen as Asia's wildlife trade hotspot - this paper explores COVID-19's impacts on wildlife farms and their owners. Understanding these impacts is important, both in order to design appropriate interventions to support local people in mitigating COVID-19's impacts as well as to inform effective policymaking around wildlife conservation in Vietnam. In this study, we adopted mixed research methods (including a literature and policy review, stakeholder consultation with government agencies and NGOs engaged in designing and monitoring wildlife conservation policies, a wildlife farming household survey, and research validation workshop) to understand the status of Vietnamese wildlife farms, as well as the impacts of COVID-19, and any opportunities and challenges for wildlife conservation and management in Vietnam. Our paper shows that, across the two studied provinces, numbers of wildlife farms and farmed wildlife animals have both declined since the pandemic, with declining market demand and wildlife farm owners experiencing difficulties accessing markets due to travel restrictions. Although this affected wildlife-related income, this represented less than 30 % of families' overall income on average, and thus households were able to maintain their livelihoods through other sources. Most wildlife is raised as an additional food source for farming families and plays an important role in the diets of surveyed households. Findings also highlighted that most surveyed households' post-pandemic recovery strategies involved expanding their wildlife farms in scope and scale; these households perceived a stable domestic market and high prices for wildlife products in future. Our study found several opportunities for sustainable wildlife farming practices, including greater political commitment, an increasing number of wildlife conservation policies, and stronger law enforcement mechanisms. Challenges remain, however; including an unclear and inconsistent policy framework, the presence of an illegal market, and wildlife farm owners' limited knowledge and understanding of wildlife policies. Our paper also shows a lack of comprehensive data and understanding around actual wildlife transactions during the pandemic, leading to challenges in confirming whether COVID-19 had any real impact on wildlife trade. Further research is required to address this knowledge gap.

A strategy to assess spillover risk of bat SARS-related coronaviruses in Southeast Asia

Emerging diseases caused by coronaviruses of likely bat origin (e.g., SARS, MERS, SADS, COVID-19) have disrupted global health and economies for two decades. Evidence suggests that some bat SARS-related coronaviruses (SARSr-CoVs) could infect people directly, and that their spillover is more frequent than previously recognized. Each zoonotic spillover of a novel virus represents an opportunity for evolutionary adaptation and further spread; therefore, quantifying the extent of this spillover may help target prevention programs. We derive current range distributions for known bat SARSr-CoV hosts and quantify their overlap with human populations. We then use probabilistic risk assessment and data on human-bat contact, human viral seroprevalence, and antibody duration to estimate that a median of 66,280 people (95% CI: 65,351–67,131) are infected with SARSr-CoVs annually in Southeast Asia. These data on the geography and scale of spillover can be used to target surveillance and prevention programs for potential future bat-CoV emergence.

Coronaviruses may spill over from bats to humans. This study uses epidemiological data, species distribution models, and probabilistic risk assessment to map overlap among people and SARSr-CoV bat hosts and estimate how many people are infected with bat-origin SARSr-CoVs in Southeast Asia annually.