Awareness and attitudes towards anthrax and meat consumption practices among affected communities in Zambia: A mixed methods approach

<div><p>Background</p><p>In Zambia, human anthrax cases often occur following cases of animal anthrax. Human behaviour has been implicated in this transmission. The objective of the study was to explore human behavioural patterns that may contribute to outbreaks of anthrax among affected communities.</p><p>Methods</p><p>A mixed methods study was conducted in four districts of Zambia from November 2015 to February 2016. A cross sectional survey involving 1,127 respondents, six focus group discussions and seven key informant interviews with professional staff were conducted. Descriptive statistics on socio-demographic characteristics, awareness of anthrax, attitudes towards cattle vaccination and risk factors for anthrax and vaccination practices were run using STATA 12 for analysis.</p><p>Results</p><p>Overall, 88% of respondents heard about anthrax, 85.1% were aware that anthrax is transmitted by eating infected meat and 64.2% knew that animals and humans can be infected with anthrax. However, qualitative data suggested that awareness of anthrax varied across communities. Qualitative findings also indicated that, in Western and Muchinga provinces, human anthrax was transmitted by eating infected beef and hippo <i>(Hippopotamus amphibious)</i> meat, respectively.</p><p>Although survey data indicated that 62.2% of respondents vaccinated their animals, qualitative interviews and annual vaccination reports indicated low vaccination rates, which were attributed to inadequate veterinary service provision and logistical challenges. While 82% of respondents indicated that they reported animal deaths to veterinary officers, only 13.5% of respondents buried infected carcasses. Majority (78.1%) of respondents either ate, sold or shared meat from dead animals with other community members. Poverty, lack of access to meat protein and economic reasons were cited as drivers for consuming infected meat.</p><p>Conclusions</p><p>Health education campaigns must be intensified to reduce the risk of human exposure. Veterinary extension services should be strengthened and cold chain facilities decentralized in order to improve accessibility to anthrax vaccine. It is also important to involve the affected communities and collaborate with other disciplines in order to effectively tackle poverty, improve veterinary services and address inherent meat consumption practices within the communities.</p></div

Comparison of awareness of anthrax among respondents in 2 provinces, given as numbers (%).

<p>Comparison of awareness of anthrax among respondents in 2 provinces, given as numbers (%).</p

Comparison of socio-demographic characteristics of respondents between Western and Muchinga provinces.

<p>Comparison of socio-demographic characteristics of respondents between Western and Muchinga provinces.</p

Map of Zambia showing study sites.

<p>Green color is Western province with Nalolo, Limulunga and Mongu districts. Purple color is Muchinga province with Chama district.</p

Knowledge and attitude towards Ebola and Marburg virus diseases in Uganda using quantitative and participatory epidemiology techniques

<div><p>Background</p><p>Uganda has reported five (5) Ebola virus disease outbreaks and three (3) Marburg virus disease outbreaks from 2000 to 2016. Peoples’ knowledge and attitude towards Ebola and Marburg virus disease impact on control and prevention measures especially during outbreaks. We describe knowledge and attitude towards Ebola and Marburg virus outbreaks in two affected communities in Uganda to inform future outbreak responses and help in the design of health education and communication messages.</p><p>Methods</p><p>The study was a community survey done in Luweero, Ibanda and Kamwenge districts that have experienced outbreaks of Ebola and Marburg virus diseases. Quantitative data were collected using a structured questionnaire and triangulated with qualitative participatory epidemiology techniques to gain a communities’ knowledge and attitude towards Ebola and Marburg virus disease.</p><p>Results</p><p>Out of 740 respondents, 48.5% (359/740) were categorized as being knowledgeable about Ebola and Marburg virus diseases, whereas 60.5% (448/740) were having a positive attitude towards control and prevention of Ebola and Marburg virus diseases. The mean knowledge and attitude percentage scores were 54.3 (SD = 23.5, 95%CI = 52.6–56.0) and 69.9 (SD = 16.9, 95%CI = 68.9–71.1) respectively. People educated beyond primary school were more likely to be knowledgeable about Ebola and Marburg virus disease than those who did not attain any formal education (OR = 3.6, 95%CI = 2.1–6.1). Qualitative data revealed that communities describe Ebola and Marburg virus diseases as very severe diseases with no cure and they believe the diseases spread so fast. Respondents reported fear and stigma suffered by survivors, their families and the broader community due to these diseases.</p><p>Conclusion</p><p>Communities in Uganda affected by filovirus outbreaks have moderate knowledge about these diseases and have a positive attitude towards practices to prevent and control Ebola and Marburg viral diseases. The public health sector should enhance this community knowledge gap to empower them more by supplying educational materials for epidemic preparedness in future using appropriate communication channels as proposed by the communities.</p></div

Attitudes towards Ebola and Marburg viral disease.

<p>Attitudes towards Ebola and Marburg viral disease.</p

Map of Uganda showing Ebola and Marburg disease outbreaks and study districts (map developed in QGIS desktop software, the base layers from Uganda bureau of statistics-http://www.ubos.org/statistical-activities/gis/).

<p>Map of Uganda showing Ebola and Marburg disease outbreaks and study districts (map developed in QGIS desktop software, the base layers from Uganda bureau of statistics-<a href="http://www.ubos.org/statistical-activities/gis/" target="_blank">http://www.ubos.org/statistical-activities/gis/</a>).</p

Results of simple ranking and proportional piling as listed and ranked by five FGD participants.

<p>Results of simple ranking and proportional piling as listed and ranked by five FGD participants.</p

Knowledge on Ebola and Marburg viral diseases and their modes of transmission.

<p>Knowledge on Ebola and Marburg viral diseases and their modes of transmission.</p

Knowledge on control and prevention of Ebola and Marburg virus disease.

<p>Knowledge on control and prevention of Ebola and Marburg virus disease.</p