Including a service learning educational research project in a biology course-II: Assessing community awareness of legionnaires' disease?

Abstract

For a university service learning educational research project addressing Legionnaires’ disease (LD), a Yes/No questionnaire on community awareness of LD was developed and distributed in an urban community in North Carolina, USA. The 456 questionnaires completed by the participants were sorted into yes and no sets based on responses obtained to the first question on whether the participant has heard of LD, and 194 participants (~43%) answered in the affirmative. For the other nine questions the yes response percentages ranged from 16% - 68%. Using  analysis, the study showed that the age of the participant was a major factor in enhancing awareness of LD, whereas education was a minor factor at best. Differences in responses among the age groups were strongly significant (<0.005) for general LD awareness, knowledge of its causes and prevalence, as well as body systems affected, prevention and treatment. Significance at the lower level of  <0.05 was observed among the different age groups on knowledge of exposure to LD through inhalation of contaminated air (Q5). In fact Q5 was the only question for which the responses of pre-university and university groups varied significantly ( <0.05). Interest among the participants in learning more about LD (68%) was higher than in attending a university seminar on the topic (54%). This study provided many educational opportunities to the students to enhance and apply their data analysis skills and to intensify several aspects of their knowledge acquisition and communication skills. Fostering the active involvement of students in an educational activity that can set the stage for an innovative university-community partnership on enhancing awareness of the preventable environmental disease LD is of benefit to all stakeholders.

Keywords

• Legionnaires’ disease, community awareness, service learning

Kaynakça

1. Abu-Shakra, A. & Saliim, E. (2012) Including a service learning educational research project in a biology course: Assessing community awareness of childhood lead poisoning. European Journal of Educational Research, 1(3), 241-253.
2. Carr, R., Warren, R., Towers, L., Bartholomew, A., Duggal, H.V., Rehman, Y., Harrison, T.G., & Olowokure, B. for the Shropshire Outbreak Investigation Team (2010). Investigating a cluster of Legionnaires’ cases: Public health implications, Public Health, 124, 326-331.
3. Centers for Disease Control and Prevention (2007). Surveillance for Travel-Associated Legionnaires Disease, United States, 2005 -2006. MMWR, 56(48) 1261-1263.
4. Cordes, L.G., Fraser, D.W., Skaliy, P., Perlino, C.A., Elsea, W.R., Mallison, G.F., & Hayes, P.S. (1979). Legionnaires’ disease outbreak at an Atlanta, Georgia, country club: evidence for spread from an evaporative condenser, American Journal of Epidemiology 111, 425-431.
5. Cunha, B.A., Klein, N.C., Strollo, S., Syed, U., Mickail, N., & Laguerre, M. (2010a). Legionnaires’ disease mimicking swine influenza (H1N1) pneumonia during the ‘‘herald wave’’ of the pandemic. Heart and Lung, 39, 242-248.
6. Cunha, B.A., Mickail, N., Syed, U., Strollo, S., & Laguerre, M. (2010b). Rapid clinical diagnosis of Legionnaires’ disease during the ‘‘herald wave’’ of the swine influenza (H1N1) pandemic: The Legionnaires’ disease triad. Heart and Lung, 39, 249-259.
7. De Schrijver, K., Dirven, K., Van Bouwel, K., Mortelmans, L., Van Rossom, P., De Beukelaar, T., Vael, C., Fajo, M., Ronveaux, O., Peeters, M.F., Van der Zee, A., Bergmans, A., Ieven, M., & Goossens, H. (2003). An outbreak of Legionnaire’s disease among visitors to a fair in Belgium in 1999, Public Health, 117, 117–124
8. Den Boer, J.W., Nijhof, J., & Friesema, I. (2006). Risk factors for sporadic community-acquired Legionnaires’ disease. A 3-year national case - control study. Public Health, 120, 566–571

9. Den Boer, J.W., Verhoef, L., Bencini, M.A., Bruin, J.P., Jansen, R., & Yzerman, E.P.F. (2007). Outbreak detection and secondary prevention of Legionnaires’ disease: A national approach. Int. J. Hyg. Environ.-Health, 210, 1–7
10. Diederen, B.M.W. (2008). Legionella spp. and Legionnaires’ disease. Journal of Infection, 56, 1-12.
11. Dunn, C.E., Bhopal, R.S., Cockings, S., Walker, D., Rowlingson, B., & Diggle, P. (2007). Advancing insights into methods for studying environment-health relationships: A multidisciplinary approach to understanding Legionnaires’ disease, Health & Place, 13, 677–690.
12. Eisenberg, V. H., Eidelman, L. A., Arbe, R., & Ezra, Y. (1997). Legionnaire's disease during pregnancy: a case presentation and review of the literature. European Journal of Obstetrics & Gynecology and Reproductive Biology, 72, 15-18
13. Erdogan, H., Erdogan, A., Lakamdayali, H., Yilmaz, A., & Arslan, H. (2010). Travel-associated Legionnaires’ disease: clinical features of 17 cases and a review of the literature. Diagnostic Microbiology and Infectious Disease, 68, 297–303
14. Evenson, L.J. (1998). Legionnaires’disease. Prim Care Update Ob/Gyns, 5(6), 286-289.
15. Fraser, D.W. (2005). The challenges were legion. The Lancet, 5 (April), 237-241.
16. Fraser, D.W., Tsai, T.F., Orenstein, W., Parkin, W.E., Beecham, H.J., Sharrer, R.G., Harris, J., Mallison, G.F., Martun, S.M., McDade, J.E., Shepard, C.C., & Brachman, P.S., (1977). Legionnaires’ disease: description of an epidemic pneumonia. The New England Journal of Medicine, 29, 1189-1197.
17. Goetz, A.M., Stout, J., Jacobs, S.L., Fisher, M.A., Ponzer, R.E., Drenning, S., & Yu, V.L. (1998). Nosocomial legionnaires’ disease discovered in community hospitals following cultures of the water system: Seek and ye shall find. American Journal of Infection Control, 26, 8-11.
18. Greenberg, D., Chiou, C.C., Famigilleti, R., Lee, T.C., & Yu, V.L. (2006 ). Problem pathogens: paediatric legionellosis - implications for improved diagnosis. The Lancet, 6(August), 529-535.
19. Guyard, C. & Low, D.E. (2010) Legionella infections and travel associated legionellosis. Travel Medicine and Infectious Disease. In press, 1-11. doi: 10.1016/j.tmaid.2010.05.006
20. Ishimatsu, S., Miyamoto, H., Hori, H., Tanaka, I., & Yoshida, S.-I. (2001). Sampling and detection of Legionella pneumophila aerosols generated from an industrial cooling tower. Ann. Occup. Hyg, 45, 421–427.
21. Kirrage, D., Hunt, D., Ibbotson, S., McCloskey, B., Reynolds, G., Hawker, J., Smith, G.E., & Olowokure, B. for the Hereford Legionnaires’ Outbreak Control Team (2007a). Lessons learned from handling a large rural outbreak of Legionnaires’ disease: Hereford, UK 2003. Respiratory Medicine, 101, 1645–1651.
22. Kirrage, D., Reynolds, G., Smith, G.E., & Olowokure, B. for the Hereford Legionnaires Outbreak Control Team (2007b). Investigation of an outbreak of Legionnaires’ disease: Hereford, UK 2003, Respiratory Medicine, 101, 1639–1644
23. Kool, J.L., Carpenter, J.C., & Fields, B.S. (1999). Effect of monochloramine disinfection of municipal drinking water on risk of nosocomial Legionnaires’ disease. The Lancet, 353(January), 272-277.
24. Mc Carter, Y.S. (2009). Infectious disease outbreaks on cruise ships, Clinical Microbiology Newsletter, 31, 161-168
25. Mietzner, S. M., & Stout, J. E. (2002). Laboratory detection of Legionella in environmental samples. Clinical Microbiology Newsletter, 24, 81-85
26. Mouchtouri,V.A., Goutziana, G., Kremastinou, J., & Hadjichristodoulou, C. (2010). Legionella species colonization in cooling towers: Risk factors and assessment of control measures. American Journal of Infection Control, 38, 50-55.
27. Neil, K. & Berkelman, R. (2008). Increasing incidence of Legionellosis in the United States, 1990–2005: Changing epidemiologic trends, Clinical Infectious Diseases, 47, 591-599
28. Ozerol, H.I., Bayraktar, M., Cizmeci, Z., Durmaz, R., Akbas, K., Yildirim, Z., & Yologlu, S. (2006). Legionnaire’s disease: a nosocomial outbreak in Turkey. Journal of Hospital Infection, 62, 50–57
29. Phares, C.R., Russell, E., Thigpen, M.C., Service, W., Crist, M.B., Salyers, M., Engel, J., Benson, R.F., Fields, B., & Moore, M.R. (2007). Legionnaires’ disease among residents of a long-term care facility: The sentinel event in a community outbreak. American Journal of Infection Control, 35, 319-323
30. Ricci, M.L., Fontana, S., Bella, A., Gaggioli, A., Cascella, R., Cassone, A., & Scaturro, M. (2010). A preliminary assessment of the occupational risk of acquiring Legionnaires’ disease for people working in telephone manholes, a new workplace environment for Legionella Growth. American Journal of Infection Control, 38, 540-545
31. Simmons, G., Jury, S., Thornley, C., Harte, D., Mohiuddin, J., & Taylor, M. (2008). A Legionnaires’ disease outbreak: A water blaster and roof-collected rainwater systems, Water Research, 42, 1449-1458
32. Squier, C.L., Stout, J.E., Krsytofiak, S., McMahon, J., Wagener, M.M., Dixon, B., & Yu, V.L. (2005). A proactive approach to prevention of health care–acquired Legionnaires’ disease: The Allegheny County (Pittsburgh) experience. American Journal of Infection Control, 33, 360-367.
33. US Department of Labor’s Occupational Safety and Health Administration (OSHA) (2012). Legionnaire’s Disease, Section II: A. Cooling Towers, Evaporative Condensers, and Fluid Coolers. Retrieved from http://www.osha.gov/dts/osta/otm/legionnaires/cool_evap.html