Beliefs and socio-cultural perspectives on hantavirus in a rural community in Panama: An ethnonursing study

Hantavirus pulmonary syndrome is a zoonotic disease that has been present in the Americas since 1993 and in Panama since the early 2000s. The disease is transmitted to humans through the inhalation of aerosols containing viruses from feces, urine, and saliva from asymptomatic, infected rodents. While various climatic, ecological, social and cultural factors have been associated with hantavirus transmission, research on beliefs and socio-cultural perspectives regarding its care and prevention remains limited. This study addresses this gap by exploring the beliefs, socio-cultural context and care practices related to hantavirus disease in an endemic community. Guided by the One Health approach and Leininger's Theory of Culture Care Diversity and Universality, an ethnonursing approach was used in a hantavirus-endemic community in Panama from September 3, 2021, to August 25, 2022. The study involved 30 participants, including 11 key participants (community members with personal or familial experience of hantavirus) and 19 general participants (community authorities and health professionals). Data were collected through in-depth interviews, participant observation and field notes. Leininger's four phases of ethnonursing analysis were followed using ATLAS.ti. Five themes were identified: (1) hantavirus develops within the context of the community, with its own expressions, meanings and lifestyles; (2) living in and of the land: what we are and what defines us; (3) hantavirus prevention and its challenges: what we do and what we propose; (4) God, the higher power that helps, protects, and gives strength and resilience in daily life and in the face of hantavirus disease; and (5) sharing within the family: joys, longings, celebrations and concerns about hantavirus. Based on the study findings, we propose a model of culture care decision and action modes for hantavirus prevention, emphasizing the importance of implementing relevant, sustainable, and culturally aligned prevention practices in the affected communities.