Zoonotic diseases have serious impacts on human health and well-being, but they are often overlooked in rural Latin America. The design of effective preventive interventions is complex and requires an integrative approach from evidence-based information analyzed through robust theoretical frameworks. We conducted a systematized literature review and qualitative framework-guided thematic analysis to identify social ecological factors affecting the prevention and exposure to zoonotic diseases. Although resources for research are limited in Latin America, we found several studies with relevant results. We extracted and interpreted 8 themes as factors affecting the prevention, transmission, and exposure to zoonosis. These themes included knowledge and misconceptions, low risk perception, gaps in knowledge and communication, psychological effect of diseases, culture and traditions, inequality, disarticulated prevention programs, and organizational responsibility. Alongside this, we compiled and present the recommendations for actions to reduce the impact of zoonoses in these populations. The factors and recommendations here presented can be adapted to inform the design and improvement of preventive programs, focused on One Health and aiming to reduce the impact of zoonotic diseases in rural settings.

Introduction: Contact investigation is a proven intervention for tuberculosis (TB) case finding and prevention. Although widely endorsed by national public health authorities and the World Health Organization, many countries struggle to implement it effectively. The objective of the study is to describe and characterize the barriers and facilitators of TB contact investigation in Cali, Colombia from the perspective and experience of the key stakeholders involved.Methods: We collected data from group discussions during two workshop sessions with clinic and public health staff involved in TB contact investigation (June 2019 and March 2020 respectively) and semi-structured interviews with TB cases and their household contacts (July 2019 to April 2020). We undertook an inductive thematic analysis with the RADaR technique to characterize the barriers and facilitators of the TB contact investigation process.Results: The two workshops included 21 clinics and 12 public health staff. We also conducted 26 semi-structured interviews with TB cases and their household contacts. Using thematic analysis, we identified four common themes: Healthcare Operations, Essential Knowledge, Time Limitations and Competing Responsibilities, and Interpersonal Interactions. The main barriers to conducting household visits were low data quality, stigma and mistrust, safety concerns for health workers, and limited resources. The main barriers to TB uptake by contacts were competing responsibilities, low TB risk perceptions among contacts, and difficulty accessing diagnostic tests for contacts. In contrast, good communication and social skills among health workers and accurate TB knowledge facilitated successful household visits and TB test uptake, according to key stakeholders.Conclusion: This study provides a deeper understanding of TB contact investigation barriers and facilitators in a high-prevalence urban setting in a middle-income country from the perspective and experience of key stakeholders. The study shed light on the barriers that hinder household contacts engagement and TB test uptake such as issues of systemic capacity and TB knowledge. Also, highlighted facilitators such as the importance of interpersonal communication skills among health workers in the public and private sector. The insights from this study can serve as a valuable resource for public health organizations seeking to enhance their contact investigation efforts and improve TB control in similar settings.

Background: Rapid, accurate, nonsputum tests are needed to close gaps in tuberculosis (TB) detection. We evaluated the diagnostic performance of molecular testing on saliva and oral swabs. Methods: We conducted a nested case–control study with 1:1 incidence-density sampling within a prospective cohort of adults and children undergoing evaluation for pulmonary TB at primary care centers in Colombia (July 2023–August 2024). Participants provided a sputum sample for liquid mycobacterial culture and paired saliva and nylon-flocked oral swabs for storage at −80°C. A microbiologist blinded to clinical and culture data performed Xpert MTB/RIF Ultra on thawed saliva and on swab eluate, each mixed 1:1 with sample reagent. We calculated the sensitivity and specificity of saliva and swab against sputum culture and compared them using McNemar's test. Results: Among 648 enrolled participants, we tested saliva and swabs from all 95 individuals with culture-confirmed TB and 95 matched culture-negative controls (n = 190). Saliva sensitivity was 90.5% (95% confidence interval [CI], 82.8–95.6), and specificity was 95.8% (95% CI, 89.6–98.8). Swab sensitivity was 71.6% (95% CI, 61.4–80.4), and specificity was 99% (95% CI, 94.3–100). Saliva sensitivity exceeded that of swab by an absolute difference of 18.9% (95% CI, +10.0 to +27.9, P < .001), but there was no significant difference in specificity (−3.2%, 95% CI, −7.7 to +1.4, P = .25). Over 95% of participants found saliva and swab collection procedures acceptable. Conclusions: Both saliva and swabs were highly sensitive and specific for culture-confirmed pulmonary TB. Saliva sensitivity exceeded the World Health Organization's ≥80% target for a low-complexity, nonsputum TB diagnostic test.

This article presents the development and validation of a new instrument measuring social, cultural, and behavioral factors influencing exposure to occupational zoonoses in agricultural settings. The Social Ecological Model (SEM) and the Standards for Educational and Psychological Testing were used as guiding frameworks to ensure the instrument’s validity. The instrument’s content was compiled by combining the results of a scoping literature review and an expert qualitative study. The instrument items were drafted, organized, and underwent a meticulous process of revision and adjustment. It was translated into Spanish and tested in one-to-one cognitive interviews with five volunteer agricultural workers. Exploratory factor analysis was conducted for construct discrimination, and bivariate regression analyses were conducted to explore the association with exposure indicators. Evidence of validity was obtained from four out of five sources of validity evidence according to the AERA/APA’s Standards of Educational and Psychological Testing. The Social Ecology of Occupational Zoonoses (SEOZ) was successfully used to determine social and behavioral factors associated with a higher risk of exposure to occupational zoonoses. Further use of the SEOZ can provide valuable insights into developing effective interventions to improve the health and well-being of agricultural workers.