Hostname: page-component-76fb5796d-9pm4c Total loading time: 0 Render date: 2024-04-26T09:57:53.323Z Has data issue: false hasContentIssue false

A Tale of Two Cities: Community Psychobehavioral Surveillance and Related Impact on Outbreak Control in Hong Kong and Singapore During the Severe Acute Respiratory Syndrome Epidemic

Published online by Cambridge University Press:  02 January 2015

Gabriel M. Leung*
Affiliation:
Department of Community Medicine, The University of Hong Kong, Hong Kong, China
Stella Quah
Affiliation:
Department of Sociology, National University of Singapore, Singapore
Lai-Ming Ho
Affiliation:
Department of Community Medicine, The University of Hong Kong, Hong Kong, China
Sai-Yin Ho
Affiliation:
Department of Community Medicine, The University of Hong Kong, Hong Kong, China
Anthony J. Hedley
Affiliation:
Department of Community Medicine, The University of Hong Kong, Hong Kong, China
Hin-Peng Lee
Affiliation:
Department of Community, Occupational and Family Medicine, National University of Singapore, Singapore
Tai-Hing Lam
Affiliation:
Department of Community Medicine, The University of Hong Kong, Hong Kong, China
*
Department of Community Medicine, Faculty of Medicine Building, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong, China

Abstract

Objectives:

To compare the public's knowledge and perception of SARS and the extent to which various precautionary measures were adopted in Hong Kong and Singapore.

Design:

Cross-sectional telephone survey of 705 Hong Kong and 1,201 Singapore adults selected by random-digit dialing.

Results:

Hong Kong respondents had significantly higher anxiety than Singapore respondents (State Trait Anxiety Inventory [STAI] score, 2.06 vs 1.77; P < .001). The former group also reported more frequent headaches, difficulty breathing, dizziness, rhinorrhea, and sore throat. More than 90% in both cities were willing to be quarantined if they had close contact with a SARS case, and 70% or more would be compliant for social contacts. Most respondents (86.7% in Hong Kong vs 71.4% in Singapore; P < .001) knew that SARS could be transmitted via respiratory droplets, although fewer (75.8% in Hong Kong vs 62.1% in Singapore; P < .001) knew that fomites were also a possible transmission source. Twenty-three percent of Hong Kong and 11.9% of Singapore respondents believed that they were “very likely” or “somewhat likely” to contract SARS during the current outbreak (P < .001). There were large differences between Hong Kong and Singapore in the adoption of personal precautionary measures. Respondents with higher levels of anxiety, better knowledge about SARS, and greater risk perceptions were more likely to take comprehensive precautionary measures against the infection, as were older, female, and more educated individuals.

Conclusion:

Comparative psychobehavioral surveillance and analysis could yield important insights into generic versus population-specific issues that could be used to inform, design, and evaluate public health infection control policy measures.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Fouchier, RAM, Kuiken, T, Schutten, M, et al.Aetiology: Koch's postulates fulfilled for SARS virus. Nature 2003;423:240.Google Scholar
2.Nicholls, JM, Poon, LL, Lee, KC, et al.Lung pathology of fatal severe acute respiratory syndrome. Lancet 2003;361:17731778.Google Scholar
3.Tsang, KW, Ho, PL, Ooi, GC, et al.A cluster of cases of severe acute respiratory syndrome in Hong Kong. N Engl J Med 2003;348:19771985.Google Scholar
4.So, LK, Lau, AC, Yam, LY, et al.Development of a standard treatment protocol for severe acute respiratory syndrome. Lancet 2003;361:16151617.Google Scholar
5.Donnelly, CA, Ghani, AC, Leung, GM, et al.Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong. Lancet 2003;361:17611766.Google Scholar
6.Seto, WH, Tsang, D, Yung, RW, et al.Effectiveness of precautions against droplets and contact in prevention of nosocomial transmission of severe acute respiratory syndrome (SARS). Lancet 2003;361:15191520.Google Scholar
7.Spielberger, C, Gorusch, R, Luschene, R. State Trait Anxiety Inventory: A Test Manual/Test Form. Palo Alto, CA: Consulting Psychologists Press; 1970.Google Scholar
8.Yung, PMB, Szeto, CK, French, P, Chan, TMF. A controlled trial of music and pre-operative anxiety in Chinese men undergoing transurethral resection of the prostate. J Adv Nurs 2002;39:352359.Google Scholar
9.Cheung, YL, Molassiotis, A, Chang, AM. The effect of progressive muscle relaxation training on anxiety and quality of life after stoma surgery in colorectal cancer patients. Psychooncology 2003;12:254266.Google Scholar
10.Cohen, J. Statistical Power Analysis for the Behavioral Sciences, ed. 2. Hillsdale, NJ: Erlbaum; 1988.Google Scholar
11.World Health Organization. Consensus Document on the Epidemiology of Severe Acute Respiratory Syndrome (SARS). Geneva: Department of Communicable Disease Surveillance and Response, World Health Organization; 2003.Google Scholar
12.Rainer, TH, Cameron, PA, Smit, D, et al.Evaluation of WHO criteria for identifying patients with severe acute respiratory syndrome out of hospital: prospective observational study. BMJ 2003;326:13541358.Google Scholar
13.Riley, S, Fraser, C, Donnelly, CA, et al.Transmission dynamics of the etiological agent of severe acute respiratory syndrome (SARS) in Hong Kong: the impact of public health interventions. Science 2003;300:19611966.Google Scholar
14.Quah, S.R.Health and culture. In: Cockerham, WC, ed. The Blackwell Companion to Medical Sociology. Oxford: Blackwell; 2001:2342.Google Scholar