Raw Sap Consumption Habits and Its Association with Knowledge of Nipah Virus in Two Endemic Districts in Bangladesh

• Published in: PloS one 2015-11, Vol.10 (11), p.e0142292-e0142292
• Main Authors: Nahar, Nazmun, Paul, Repon C, Sultana, Rebeca, Gurley, Emily S, Garcia, Fernando, Abedin, Jaynal, Sumon, Shariful Amin, Banik, Kajal Chandra, Asaduzzaman, Mohammad, Rimi, Nadia Ali, Rahman, Mahmudur, Luby, Stephen P
• Format: Article
• Language: English
• Subjects: Adult; Bangladesh - epidemiology; Bats; Behavior; Clustering; Cold season; Consumption; Diarrhea; Diet; Disease control; Disease Outbreaks; Disease transmission; Epidemiology; Evaluation; Female; Forecasts and trends; Gender; Habits; Health aspects; Health education; Health Knowledge, Attitudes, Practice; Health promotion; Henipavirus Infections - epidemiology; Henipavirus Infections - virology; Households; Humans; Infections; Infectious diseases; Intervention; Interviews; Knowledge; Laboratory animals; Male; Mathematical analysis; Mens health; Middle Aged; Nipah virus; Nipah Virus - physiology; Nutrition; Phoeniceae; Public health; Public health administration; Public health education; Raw Foods - virology; Risk factors; Risk reduction; RNA virus infections; Rural populations; Sap (Botany); Studies; Towns; Trees; Viruses; Vomiting; Womens health
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0142292

Human Nipah virus (NiV) infection in Bangladesh is a fatal disease that can be transmitted from bats to humans who drink contaminated raw date palm sap collected overnight during the cold season. Our study aimed to understand date palm sap consumption habits of rural residents and factors associated with consumption. In November-December 2012 the field team interviewed adult respondents from randomly selected villages from Rajbari and Kushtia Districts in Bangladesh. We calculated the proportion of people who consumed raw sap and had heard about a disease from raw sap consumption. We assessed the factors associated with raw sap consumption by calculating prevalence ratios (PR) adjusted for village level clustering effects. Among the 1,777 respondents interviewed, half (50%) reported drinking raw sap during the previous sap collection season and 37% consumed raw sap at least once per month. Few respondents (5%) heard about NiV. Thirty-seven percent of respondents reported hearing about a disease transmitted through raw sap consumption, inclusive of a 10% who related it with milder illness like diarrhea, vomiting or indigestion rather than NiV. Respondents who harvested date palm trees in their household were more likely to drink sap than those who did not own date palm trees (79% vs. 65% PR 1.2, 95% CI 1.1-1.3, p