A qualitative exploration of the misconceptions, knowledge gaps and constructs of leptospirosis among rural and urban communities in Malaysia

Awareness and Practices Regarding Leptospirosis in Andaman and Nicobar Islands, Union Territory of India

Background Leptospirosis is a worldwide prevalent zoonotic infection and re-emerging disease caused by the bacterium of genus Leptospira transmitted by infected animals in the environment. Andaman and Nicobar Islands has one of the highest incidence rates of leptospirosis in India with a seroprevalence of 52.7%. This study examined the knowledge, attitudes, and practices (KAP) regarding leptospirosis among the urban and rural populations of the Union Territory (UT) of India. Aim and objective This study aims to assess the knowledge, attitude, and practices regarding leptospirosis in a rural and an urban community of Andaman and Nicobar Islands. Materials and methods This community-based cross-sectional study was conducted at rural and urban field practice areas under the aegis of the Department of Community Medicine, Andaman and Nicobar Islands Institute of Medical Sciences (ANIIMS), Port Blair, for a period of three months. A semi-structured interview schedule was administered to 450 participants in community settings selected from a list of households obtained from the municipal council using a systematic random sampling method. All interviews were conducted face-to-face by the investigators to collect data on the sociodemographic variables of the study participants and their knowledge, attitudes, and practices regarding the disease. The data was analyzed using Statistical Package for the Social Sciences (SPSS) version 27.0 (IBM SPSS Statistics, Armonk, NY, USA). Results The knowledge and attitude regarding leptospirosis and henceforth the likelihood of individuals using preventive practices were evaluated. The majority of respondents (97%) had previously heard about leptospirosis; however, specific knowledge regarding its risk factors, causative agent, and complications was limited among the participants. Although more than 90% of them had a favorable attitude toward seeking treatment for the disease and adopting specific preventive measures and general hygiene, they did not practice these hygiene habits nor used self-protective equipment in their day-to-day lives. Less than 50% of participants wore protective clothing, boots, and gloves while cleaning cattle sheds, and only 40% of them used rodenticides despite the presence of rodents in their houses. Most of the owners (60%) had not vaccinated their pets. We also found a significant association between the male gender and urban residence with a good knowledge score (p=0.05). Conclusion Despite having knowledge of and a positive attitude toward the disease, the participants did not practice preventive measures. We recommend that health interventions in endemic communities should focus on the implementation of protective measures by raising awareness in the susceptible population on multiple dimensions of leptospirosis in order to attain and ensure better compliance.

Knowledge, Attitude, and Practices regarding Leptospirosis among Visitors to a Recreational Forest in Malaysia

Leptospirosis is a zoonotic disease and a worldwide public health problem that affects mainly high-risk groups. Characterizing knowledge, attitude, and practice (KAP) among high-risk groups is important to develop appropriate prevention programs. Here, we performed a cross-sectional study among 300 visitors of a recreational forest in Malaysia to examine leptospirosis KAP and demographics. These variables were integrated to create knowledge and practice scores for each respondent. All respondents had heard about leptospirosis, and 87% of them correctly identified it as a disease. The majority of respondents had high knowledge (63%), positive attitude, and good practice (68%) toward prevention of the disease. However, there were gaps in knowledge, with 78% of the respondents indicating eating without washing hands as the major cause of leptospirosis transmission. Our final model identified that higher knowledge score was associated with higher practice score. Our results indicate that it is important to increase knowledge, especially on transmission routes of leptospirosis, among visitors in recreational areas. Moreover, more attention needs to be paid to promote good practice habits among visitors, targeting those at higher risk of being infected by leptospirosis to prevent potential outbreaks in the recreational areas.

Perceived Severity and Susceptibility towards Leptospirosis Infection in Malaysia

Background: Perceived severity and susceptibility refers to one’s belief of the seriousness and the risk of contracting a specific disease. It is an essential study in public health as it assists in the understanding of the motivating factors towards disease prevention. This qualitative study aimed to explore perceived severity and susceptibility towards leptospirosis infection among respondents in two states of Malaysia. Methods: Focus group discussions using the phenomenology approach was conducted involving 72 respondents in Selangor and Kelantan. Data were examined using content analysis. Results: Respondents perceived leptospirosis infection as severe due to its poor disease prognosis and complications. However, some rated it less severe when compared with other chronic diseases such as cancer and AIDS. Their perceptions were influenced by their knowledge about the disease, media portrayal and frequency of health campaigns by the government. All respondents believed they were not susceptible to the disease. Conclusion: The low perceived susceptibility of leptospirosis infection is a matter of concern as it may contribute to respondents’ lack of motivation towards preventing the disease. The study findings may provide the basis for health promotional activities designed to heighten public perceived threat towards leptospirosis infection and thereby improving preventive health behaviors for avoiding leptospirosis.

Public knowledge, attitudes and practices towards COVID-19: A cross-sectional study in Malaysia

In an effort to mitigate the outbreak of COVID-19, many countries have imposed drastic lockdown, movement control or shelter in place orders on their residents. The effectiveness of these mitigation measures is highly dependent on cooperation and compliance of all members of society. The knowledge, attitudes and practices people hold toward the disease play an integral role in determining a society's readiness to accept behavioural change measures from health authorities. The aim of this study was to determine the knowledge levels, attitudes and practices toward COVID-19 among the Malaysian public. A cross-sectional online survey of 4,850 Malaysian residents was conducted between 27th March and 3rd April 2020. The survey instrument consisted of demographic characteristics, 13 items on knowledge, 3 items on attitudes and 3 items on practices, modified from a previously published questionnaire on COVID-19. Descriptive statistics, chi-square tests, t-tests and one-way analysis of variance (ANOVA) were conducted. The overall correct rate of the knowledge questionnaire was 80.5%. Most participants held positive attitudes toward the successful control of COVID-19 (83.1%), the ability of Malaysia to conquer the disease (95.9%) and the way the Malaysian government was handling the crisis (89.9%). Most participants were also taking precautions such as avoiding crowds (83.4%) and practising proper hand hygiene (87.8%) in the week before the movement control order started. However, the wearing of face masks was less common (51.2%). This survey is among the first to assess knowledge, attitudes and practice in response to the COVID-19 pandemic in Malaysia. The results highlight the importance of consistent messaging from health authorities and the government as well as the need for tailored health education programs to improve levels of knowledge, attitudes and practices.

Public knowledge, attitudes and practices towards COVID-19: A cross-sectional study in Malaysia

In an effort to mitigate the outbreak of COVID-19, many countries have imposed drastic lockdown, movement control or shelter in place orders on their residents. The effectiveness of these mitigation measures is highly dependent on cooperation and compliance of all members of society. The knowledge, attitudes and practices people hold toward the disease play an integral role in determining a society’s readiness to accept behavioural change measures from health authorities. The aim of this study was to determine the knowledge levels, attitudes and practices toward COVID-19 among the Malaysian public. A cross-sectional online survey of 4,850 Malaysian residents was conducted between 27^th March and 3^rd April 2020. The survey instrument consisted of demographic characteristics, 13 items on knowledge, 3 items on attitudes and 3 items on practices, modified from a previously published questionnaire on COVID-19. Descriptive statistics, chi-square tests, t-tests and one-way analysis of variance (ANOVA) were conducted. The overall correct rate of the knowledge questionnaire was 80.5%. Most participants held positive attitudes toward the successful control of COVID-19 (83.1%), the ability of Malaysia to conquer the disease (95.9%) and the way the Malaysian government was handling the crisis (89.9%). Most participants were also taking precautions such as avoiding crowds (83.4%) and practising proper hand hygiene (87.8%) in the week before the movement control order started. However, the wearing of face masks was less common (51.2%). This survey is among the first to assess knowledge, attitudes and practice in response to the COVID-19 pandemic in Malaysia. The results highlight the importance of consistent messaging from health authorities and the government as well as the need for tailored health education programs to improve levels of knowledge, attitudes and practices.

A Cross-Sectional Assessment of Knowledge, Attitude, and Practice Toward Leptospirosis among Rural and Urban Population of a South Indian District

Back ground: Leptospirosis is one of the common zoonotic diseases, endemic among farmers. Globally, awareness of risk factors is reported to be very low. This study aims to quantitatively analyze the knowledge and attitude related to leptospirosis in Madurai district and to identify misconceptions that result in poor practice.Material & methods: A cross-sectional survey on rural and urban population using a structured, validated questionnaire to assess Knowledge, Attitude and Practice on Leptospirosis.Results: 902 participants from rural and 1074 participants from urban population were enrolled. More than 98% knew seasonal fever to be common during rainy season, of them only 2.8% and 3.6% from rural and urban population mentioned microbes as a cause.Conclusion: Vulnerable populations were found to be less knowledgeable on risk factors and they had poor practice. Education had significant impact on knowledge and attitude of urban population; however, their practice did not improve with education.