Infectious disease risk perception among Tunisian students: a case study of Leishmaniasis

Abstract

# Background In North Africa, especially in Tunisia, leishmaniasis is a real public health problem with 2000 to 8000 cases per year and average incidence rate \>1/100 in some hyper-endemic villages. The geographical extension of the three forms of this zoonosis, the high incidence, the exorbitant cost (management, control) and especially the harms: functional, aesthetic, social, psychological are issues that question the promotional role of health education in Tunisian schools. In Tunisia, the introduction of health education in biological programs and textbooks aims at acquiring the knowledge and skills needed to prevent health risks. The present study aims to detect possible failures and to present a path of intervention to innovate preventive measures against infectious diseases. # Methods This is a study conducted in two stages: First, a cross-sectional survey, which included 261 Tunisian school students from different educational levels and residents in different regions of the country. Second, a didactic analysis of Tunisian curricula related to infectious diseases prevention. # Results All of the results showed that students in general, do not really know this disease, especially with regard to risks, treatments and prevention. The question on the knowledge of the three most common diseases in Tunisia that can be transmitted by contact with animals or insects seems to have been difficult to understand. The fact that a large proportion of school students did not answer the question, and, that another group, mentioned infectious diseases that are absent in Tunisia or not zoonotic, could reveal a lack of knowledge about infectious disease, related to animals. A curriculum analysis of recent Life Sciences textbooks reveals a dominance of the biomedical model. The promotional model is almost absent. # Conclusion Deficits noted in terms of knowledge, perceptions and management capabilities of cutaneous leishmaniasis can be explained by the absence of this disease in Tunisian Life Sciences curricula. Currently, empowerment and psychosocial skills development, which are essential to perceive and manage the risks of zoonotic infection, are not among the health educational aims.