Knowledge, Attitude and Practice towards Anthrax in Northern Ethiopia: a mixed approach study

Abstract Background: Anthrax is the second most highly prioritized zoonotic disease in Ethiopia due to its negative impact at the household level, causing disease and production losses in livestock and severe disease in humans. This study seeks to assess the knowledge of, attitudes towards, and practices addressing (KAPs) anthrax in the communities of Eastern Tigray, Northern Ethiopia. Methods : A cross-sectional survey was conducted concurrently with focus group discussions (FGD) and key informant interviews (KII) between May 2019 and April 2020. A total of 862 respondents participated in the questionnaire survey. Of these, 800 were local community members, while 62 were professionals working at health service institutions. In addition, qualitative data were collected using six FGDs and 11 KIIs. Results : Sixty-two percent (496/800) of the community respondents said that they were aware of anthrax while 38% (304/800) of them did not. Only 9.3% (74/800) of the respondents reported that the causative agent of anthrax is germs/microbial. About 56.5% (35/62) of professional respondents said that it is bacterial. More than sixty percent (64.1%, 513/800) of the respondents did not know that whether the disease was zoonotic or not. Regarding clinical signs, 26.3 (210/800) and 36.8% (294/800) of the respondents could identify at least one in animals and humans, respectively, while 21.3 (170/800) and 20.1% (161/800) knew one or more transmission routes in animals and humans, respectively. Moreover, 43.4% (347/800) and 45.6% (365/800) of the respondents mentioned one or more control/prevention method(s) in animals and humans, respectively. Regarding qualitative results, some of the participants knew the disease (in animals) by their local names: Lalish and Tafia (splenomegaly), and Gulbus (abdominal cramps and shivering). Some reported that anthrax was exclusively a human disease while others recognized its zoonotic potential after the clinical signs in both animals and humans were listed. Conclusion : The KAP of the participants regarding anthrax was low. There was no consistent understanding of the disease among the participants. The study also revealed that the participants did not receive consistent, adequate, and continuous education regarding the disease.