Search Results (641)

Rift Valley fever (RVF) is a viral zoonosis endemic in Madagascar, threatening human and animal health as well as the economy. Trade-related livestock movements are a major factor in the spread of RVF virus. While previous RVF research in Madagascar has focused on farmers or general ecology, this study is the first to specifically target livestock traders, the primary drivers for long-distance viral spread, in the Alaotra Mangoro endemic hotspot. This study aimed to assess the level of knowledge, prevailing attitudes and current practices regarding RVF among people engaged in livestock trade in the Alaotra Mangoro region, as well as the factors associated with these KAPs. A descriptive and analytical cross-sectional survey was conducted among 406 livestock traders in five districts of the Alaotra Mangoro region, using a structured questionnaire. A multi-stage sampling approach was employed, utilising purposive selection of markets followed by snowball sampling to reach informal traders often missed by traditional surveys. Generalised linear mixed models were used to analyse factors associated with KAPs regarding RVF. Awareness of RVF was very low (only 18.5% respondents had heard of it), with significant regional disparities (0% in Anosibe An’Ala versus 51.6% in Moramanga). Veterinarians (15.5%), family (12.8%), radio (9.6%) and neighbours (9.6%) were the main sources of information. Understanding of symptoms and modes of transmission (particularly mosquito bites) was limited. Higher levels of education (OR = 181.6; 95% CI: 29.9–1123.7; p < 0.001) and older age (50–60 years) were associated with better knowledge. Proactive attitudes were scarce (21.4%), although more than half (53.4%) believed that RVF is a real disease. Perception of personal risk and the contribution of livestock trade to the spread of the disease was low. However, confidence in animal vaccination was relatively high (60.3%). Preventive practices were highly inadequate. The majority did not wear protective equipment when handling sick animals (94.6%) and rarely avoided touching aborted foetuses (12.6%). Less than half (48.3%) expressed a willingness to report sick or dead animals, and nearly half admitted to having sold or purchased sick livestock (49.5%). Cooking meat (95.1%) and using mosquito nets (74.1%) were the only well-established practices. More than half of respondents (57.9%) lived more than 5 km from veterinary services, and cost was the most frequently cited barrier to consultation. Participation in awareness campaigns was virtually non-existent (5.4%). Results revealed critical gaps in KAP that may contribute to the persistence of RVF. A “One Health” approach is imperative, integrating human, animal and environmental health. Full article

Automobile spray painters in small informal workshops in developing countries face high occupational exposure to organic solvents. Although health effects are well known, the influence of workers’ knowledge, attitudes, and practices (KAP) on these effects is less well understood. This study examined spray painters’ KAP regarding organic solvents and health symptoms and assessed workplace safety compliance. A cross-sectional study in Region F, Johannesburg, collected data among 152 spray painters across 47 workshops using a questionnaire and checklist. KAP scores were analysed with multivariable logistic regression to identify associations with eye, skin, respiratory, and CNS symptoms, while controlling for confounders. Workplace controls were inadequate: 64% of workshops conducted spray painting outdoors, while only 17% had a functioning spray booth. Although knowledge scores were high (45.29/50 ± 6.025), practice scores remained low (9.01/20 ± 5.275). After adjustment, higher knowledge was significantly associated with reduced odds of eye (AOR = 0.846), skin (AOR = 0.915), and respiratory symptoms (AOR = 0.890). Better practice scores also correlated with fewer skin symptoms (AOR = 0.891). No KAP construct was linked to CNS symptoms. In the absence of engineering controls, workers’ knowledge is strongly linked to lower reporting of solvent-related symptoms affecting the eyes, skin, and respiratory system. However, knowledge does not appear to influence CNS symptoms, which are probably driven by ambient solvent concentrations that individual behavioural measures cannot effectively manage. Therefore, knowledge acts as a supplementary, rather than a substitute, safeguard where engineering controls are lacking. Interventions should include education and enforceable regulations to empower workers and ensure the use of engineering controls, especially in spray booths. Full article

Home food safety (HFS) is a major contributor to foodborne illness, often originating in domestic settings. Although population-based studies using surveys, questionnaires, and interviews are commonly used to assess consumers’ HFS-related knowledge, attitudes, and practices (KAP), methodological heterogeneity limits comparability across studies. This scoping review aimed to map studies assessing consumers’ HFS-related KAP in high-income countries, describe recurrent methodological and reporting features, and identify areas of variability. Following the Arksey and O’Malley framework and JBI guidance, the literature published between 2000 and 2023 was systematically searched across five scientific databases, as well as governmental and institutional sources for the grey literature. Data extraction and synthesis were guided by an expanded 15-feature framework refined from a previous rapid review. A total of 274 documents were included (247 scientific articles and 27 governmental and institutional reports). Across the included studies, several methodological features showed high consistency, including primary data collection (93%), predominantly cross-sectional designs (91%), the use of closed-ended instruments (71%), quantitative analytical approaches (78%), and voluntary, non-incentivised participation (68%), suggesting the presence of a common descriptive methodological core. At the same time, substantial variability was observed in sample size (62%), study aims (52%), analytical strategies (52%), modes of administration (51%), geographic coverage (47%), thematic scope (44%), and study period (54%). The coexistence of methodological convergence and context-dependent variability poses challenges in terms of evidence synthesis and comparability in HFS-related KAP research. The 15-feature framework developed in this review provides a structured, non-prescriptive tool to support transparent description and comparison of methodological and reporting practices. By pinpointing common approaches and areas of divergence, this review offers a foundation for guiding future HFS-related KAP research and supporting the development of more comparable and policy-relevant evidence. Full article

Dairy farms are complex environments where cattle, workers, and the farm environment interact, creating opportunities for infectious disease transmission across animal, human, and environmental interfaces. During the COVID-19 pandemic, little was known about dairy farmers’ knowledge, attitudes, and practices (KAP) regarding integrated livestock biosecurity and worker biosafety. This study aimed to develop and demonstrate the application of an integrated biosecurity–biosafety KAP questionnaire and pilot test for dairy farms. A novel English and Spanish version of the questionnaire was developed using published biosecurity literature, zoonosis-related studies, expert input, and existing dairy biosecurity tools. From June 2020 to August 2021, 18 Front Range Colorado dairy farms were contacted, and 6 farms enrolled. Data were collected from 50 participants, analyzed descriptively; selected associations were examined using Chi-square or Fisher’s exact tests, odds ratios, and 95% confidence intervals. The final questionnaire captured integrated KAP on livestock biosecurity, zoonoses, biosafety, and COVID-19. Important knowledge gaps were identified, particularly regarding human-to-animal disease transmission and zoonoses training. Supervisors generally demonstrated broader knowledge than workers and organic farms showed higher knowledge levels than conventional farms. Veterinarians were highly trusted information sources. Training was associated with improved zoonosis-related knowledge, and several animal-focused and human-focused preventive practices were significant. This study demonstrates the feasibility and value of an integrated dairy farm biosecurity–biosafety KAP tool and highlights the need for tailored, bilingual, One Health-oriented training. Full article

Background/Objectives: Oral health is integral to the overall well-being and quality of life of older adults. For institutionalized older residents who depend on staff for daily care, the knowledge, attitudes, and practices (KAP) of healthcare providers directly influence oral health outcomes. This study aimed to assess oral care KAP among healthcare providers in Macao’s residential care facilities and to examine the relationships between KAP and personal characteristics. Methods: A cross-sectional study was conducted from September to December 2023 using a structured KAP questionnaire. Data were collected from 225 healthcare providers across four nursing homes in Macao. Results: Significant positive correlations were found among KAP (Spearman’s γ = 0.293–0.419; p < 0.001). Mean scores were 15.60 (SD = 2.27)/19 for knowledge, 52.13 (SD = 5.75)/65 for attitudes, and 45.87 (SD = 5.93)/55 for practices. Denture care was the major knowledge deficit. Knowledge was associated with age 18–20 (p = 0.002), age 31–40 (p = 0.015), and university education (p = 0.003). Attitudes were associated with age 18–20 (p = 0.002), female gender (p = 0.005), and primary education (p = 0.044). Practice was associated with training programme attendance (p = 0.006) and female gender (p = 0.016). All associations involving the age 18–20 subgroup (n = 3) and male gender (n = 16) should be interpreted with caution due to very small sample sizes. Conclusions: Oral care KAP among HAs and PCWs in Macao’s residential care homes are positively but modestly correlated. Most providers acquired knowledge through induction training with verified competency outcomes and personal experience. These findings highlight the need for structured, repeatable training and suggest that Macao’s data can contribute to international efforts to improve oral care in institutionalized aging populations. Future research should employ longitudinal or observational designs and include all elderly care facilities in Macao. Full article

Introduction: Syphilis is a preventable sexually transmitted infection (STI) with severe health outcomes, yet it is not included in Saudi Arabia’s national premarital and antenatal STI screening programs. This study assessed knowledge, attitudes, and practices (KAP) toward syphilis in Saudi Arabia and identified predictors of acceptance for including syphilis testing in such programs. Methods: A cross-sectional online survey was conducted among 935 participants aged ≥20 years. Data included sociodemographic characteristics and measures of KAP and screening acceptance. Continuous variables were summarized as medians (IQR) and categorical variables as frequencies and percentages, with bivariate and multivariate logistic regression used to identify predictors of screening acceptance. Results: Knowledge and preventive practices were low, while attitudes were predominantly neutral (median attitude score: 34 IQR 32–38). Although intentions for personal testing were low (17%), support for syphilis testing in premarital (60.8%) and antenatal (48.9%) programs was considerable. Employment in the health sector, older age, and positive attitudes predicted acceptance of screening policies. Knowledge and practice showed a weak correlation (r = 0.14), whereas knowledge and attitude were moderately correlated (r = 0.55). Conclusion: KAP toward syphilis is influenced by specific sociodemographic factors. Although acceptance of screening is high at the policy level, individual-level preventive behaviors remain low. Full article

Streptococcus suis is a major zoonotic pathogen, with increasing human cases in Nakhon Ratchasima Province, northeastern Thailand. This study aimed to assess residents’ knowledge, attitudes, and practices (KAP) regarding infection risk and to characterize S. suis isolates from pigs. A structured questionnaire was administered to 500 residents to evaluate awareness and behaviors related to S. suis infection. Nasopharyngeal swabs were collected from slaughtered pigs at three slaughterhouses in Nakhon Ratchasima Province. Presumptive Streptococcus isolates were confirmed as S. suis by PCR and further characterized by molecular serotyping, virulence-associated gene profiling, and multilocus sequence typing (MLST). Among residents, mean scores suggested generally high levels of KAP; however, misunderstandings regarding transmission persisted. Residents expressed strong readiness to reduce infection risk. Of 285 pig samples, 122 (42.8%) were positive for S. suis, representing 16 serotypes. Serotype 9 (10.3%) predominated with several serotypes that have been reported in human infections. The predominant virulence-associated gene profile was mrp⁻/sly⁻/epf⁻ (77.4%). MLST identified eight STs with five novel STs (ST3147-3151), indicating substantial genetic diversity. Persistent misconceptions despite generally acceptable KAP levels highlight the need for targeted public health education. The high prevalence and genetic variability of S. suis in pigs support ongoing surveillance to monitor potentially pathogenic strains. Full article

Whole blood viscosity (WBV) is a key hemorheological property influenced by cellular and biochemical factors and is associated with cardiovascular, cerebrovascular, and microcirculatory disorders. Despite its clinical relevance, comprehensive reference intervals for WBV and oxygen delivery indices—the ODI (oxygen delivery index) and TODI (tissue oxygen delivery index)—in healthy male and female adults have not been established. The objectives of this study were to (1) determine sex-specific reference intervals of WBV in healthy adults, (2) establish reference intervals for the ODI and TODI, and (3) evaluate the influence of hematologic, biochemical, lipid, and non-lipid determinants—as well as the effects of age—on systolic and diastolic blood viscosity (SBV and DBV). WBV was measured across nine shear rates (1–1000 s⁻¹) in 150 healthy men and 150 healthy women using an automated scanning capillary tube viscometer (SCTV). Hematologic and biochemical profiles were obtained, and correlations with DBV and SBV were assessed. Reference intervals were calculated using CLSI-recommended nonparametric methods. WBV was consistently higher in men than women across all shear rates, with sex-based differences accentuated at low shear. Hemoglobin and hematocrit showed the strongest positive correlations with WBV (r ≈ 0.77–0.80), while RDW and HDL cholesterol showed negative associations. Triglycerides exhibited strong viscosity-enhancing effects in men, whereas total cholesterol, LDL, and triglycerides were all significantly increased viscosity in women. Protein-related determinants (total protein, albumin, and γ-gap) displayed striking sex divergence, with strong positive associations in men but attenuated or negative associations in women. Age showed no meaningful relationship with WBV in either sex. Reference intervals for the ODI and TODI revealed modest sex differences with tighter distributions in women. WBV, ODI, and TODI demonstrate clear sex-specific physiological patterns in healthy adults. Hematocrit remains the dominant determinant of blood viscosity, while lipid and protein-related factors contribute differently in men and women. These newly established reference intervals provide essential benchmarks for clinical interpretation and for understanding viscosity-related risk in cardiovascular and microcirculatory disease. Full article

Knowledge management platforms are increasingly important for strengthening governance, scientific collaboration, and evidence-based decision making in complex regional networks. This study analyses the prospective intention to adopt two strategic digital mechanisms of the Amazon Cooperation Treaty Organization (OCTA): the Amazon Regional Observatory (ORA) and the Network of Amazonian Research Centres (REDCIA). Adapting the Unified Theory of Acceptance and Use of Technology (UTAUT) to a pre-implementation context, the study focuses on performance expectancy, social influence, and facilitating conditions, while operationalizing these constructs through a Knowledge, Attitudes, and Practices (KAP) survey. Using a quantitative, non-experimental, cross-sectional design, penalized ordinal logistic regression models were estimated from 162 responses collected from institutional actors and experts across eight Amazonian jurisdictions. The results show that social influence is the only statistically significant predictor of intention to use in both mechanisms, whereas performance expectancy and facilitating conditions are not significant in the estimated models. These findings suggest that, in the Amazonian cooperation context, adoption is driven less by individual evaluations of utility or technical feasibility than by institutional legitimacy, peer expectations, and collaborative norms. The study contributes to the information systems literature by providing an ex ante analytical approach for assessing technology acceptance in the absence of an operational artefact. It also offers practical guidance for OCTA by highlighting the importance of change management, political endorsement, and network-based incentives to support future implementation. Full article

This study aimed to establish the first national diagnostic reference levels (DRLs) for coronary angiography (CAG) and interventional cardiology procedures in Korea, based on a nationwide patient-dose survey conducted in 2024. Radiation dose data were collected from 20 cardiovascular centers between April and December 2024 using a dedicated server system for radiation dose-structured reports, namely, Digital Imaging and Communications in Medicine. We classified 1980 procedures into the following seven procedural groups: CAG, CAG with percutaneous coronary intervention (CAG + PCI), CAG with percutaneous transluminal coronary angioplasty (CAG + PTCA), coronary spasm provocation, acute myocardial infarction (AMI), chronic total occlusion (CTO), and PCI alone. The DRLs were defined as the 75th percentile of the cumulative kerma–area product (KAP) and fluoroscopy time (FT). The established DRLs for KAP (Gy·cm²) were: CAG, 18.68; CAG + PCI, 63.40; AMI, 58.52; and CTO, 106.83. The corresponding DRLs for FT (s) were: CAG, 440.00; CAG + PCI, 1201.50; AMI, 947.64; and CTO, 2819.00. This study established the first official national DRLs for CAG and interventional cardiology procedures in Korea, using real-world clinical data. These reference levels provide a practical framework for institutions to benchmark radiation exposure, evaluate practice patterns, and optimize patient radiation safety. Full article

There is growing concern that antimicrobial use (AMU) in livestock may contribute to antimicrobial resistance (AMR) in humans and lead to the consumption of animal-derived foods contaminated with antimicrobial residues. As stakeholders in the livestock industry, farmers must participate in the joint effort to reduce AMU. This cross-sectional study, based on a survey questionnaire, was conducted to evaluate the biosafety measures implemented on small ruminant farms and to assess the knowledge, attitudes and practices (KAP) of small ruminant farmers regarding AMU, AMR and residues. The mean biosafety score obtained was 8.4 points on a 0–17 scale. Some biosafety measures appeared difficult to implement, namely vehicle disinfection, requiring visitors to change clothing and footwear at the farm entrance, cleaning and disinfecting farm facilities, using high-pressure washing equipment, and requiring employees to change clothing and footwear upon entering the farm. Although farmers self-reported moderate levels of knowledge (4.9 points on a 0–7 scale) and positive attitudes (5.8 points on a 0–7 scale), significant gaps in knowledge about antibiotics and antimicrobial stewardship persisted. Practices received lower scores (4.7 on a 0–7 scale), especially regarding medication recording, leftover antibiotic management, and waste disposal. Cluster analysis identified distinct farmer profiles with different patterns of knowledge and practices. These findings underscore the importance of considering farmer heterogeneity when designing interventions aimed at improving AMU. Full article

Background/Objectives: Blood donation is a critical component of healthcare systems worldwide, yet donor recruitment remains challenging. This study evaluates the knowledge, attitudes, motivations, and practices (KAP) of blood donation among the general population in Saudi Arabia to identify key barriers and propose targeted interventions. Methods: A cross-sectional study was conducted using a structured, validated questionnaire distributed over five months (December 2022 to April 2023) via social media and in-person recruitment at the Central Blood Bank in Riyadh. A total of 1150 participants aged 18–60 years residing in Saudi Arabia were included in the final analysis. Statistical analysis was performed using SPSS version 22, with p < 0.05 considered significant. Results: Participants demonstrated moderate knowledge (mean score 5.43 ± 1.81 out of 9), with significantly higher scores among males, individuals aged 21–30 years, and those holding a bachelor’s degree. Attitudes toward donation were highly positive (mean score 15.46 ± 2.74 out of 20) and correlated with age, gender, marital status, and occupation. Despite this positive outlook, only 34.96% of participants had donated blood previously, although 95.25% expressed willingness to do so. Primary motivators included mobile donation units (89.22%) and paid leave (89.22%), whereas 51.22% of respondents considered current media campaigns ineffective. Common barriers to donation included health concerns (25.30%), time constraints (12.87%), and fear of needles (7.74%). Conclusions: This study reveals a critical disparity between positive public attitudes and actual donation practices in Saudi Arabia. To enhance donor participation, we recommend implementing convenient donation strategies such as mobile blood drives, workplace incentives, and more effective, culturally tailored educational campaigns. Addressing these factors could help Saudi Arabia improve its voluntary donation rates and ensure a sustainable, safe blood supply. Full article

Background/Objectives: The presented study aimed to understand the relationship between knowledge, attitudes, and practices, as well as consumers’ preferences for the consumption of Spirulina-enriched fruit and vegetable juices. Methods: A survey about the consumers’ attitudes towards consumption of algae in general and especially Spirulina was conducted to better understand the target groups and marketing strategies for this novel non-alcoholic beverage product. Knowledge–Attitude–Practice (KAP) model in combination with structural equation modelling (SEM) was applied to test the hypothesised relationships between the variables. Additionally, consumers’ preference test was done using a seven-point hedonic scale and ranking of the six juice samples: plain sour cherry juice (SC1), sour cherry juice with 0.8% (SC2) and 1.6% (SC3) of blue Spirulina powder; plain tomato juice (T1), tomato juice with 0.8% (T2) and 1.6% (T3) of blue Spirulina powder. Results: The SEM results showed that there is a limited direct impact of knowledge on social motivation, while personal behaviour strongly predicts social motivation. Namely, perceived nutritional value and health benefits were shown to be the main factors for consumers’ willingness to drink Spirulina-enriched juice. Conclusions: The result of the consumer preference evaluation exposed that the juices containing sour cherry and Spirulina achieved better sensory acceptance and ranking than those containing tomato, pointing out the importance of the product matrix for achieving consumer acceptance. Full article

Background: Improper disposal of unused and expired medicines represents an environmental and public health concern. In Romania, Law No. 269/2023 assigned the responsibility for collecting household pharmaceutical waste to public and private hospitals, while operational procedures were further detailed in the Ministry of Health (MoH) Instruction No. 6226/2024. Objectives: This study aimed to assess knowledge, attitudes, and practices (KAP) related to the disposal of unused and expired medicines among the general public and community pharmacy staff during the early phase of implementation of the hospital-based medicine take-back system in Romania. Methods: A cross-sectional survey using convenience sampling was conducted between 1 and 31 August 2023. Two structured questionnaires were administered: one targeting the general public/patients and another addressing community pharmacy staff. Data were analyzed descriptively using frequencies and percentages. Several items allowed multiple responses. Results: Among public respondents (n = 108; predominantly male, 90.7%; urban, 75.0%), household waste disposal was the most frequently reported method (58.3%), followed by pharmacy return (43.5%). Willingness to use a dedicated collection system was very high (96.3%). Among pharmacy staff (n = 71; predominantly female, 78.9%; urban, 74.6%), 40.8% reported no collection activity; where collection occurred, it was typically on demand. Disposal routes included transfer to specialized waste companies (56.3%) and regulated destruction (43.7%). Only 1.4% of pharmacies offered incentives, while 45.4% of the public indicated discounts could motivate returns. Conclusions: Findings indicate an implementation and communication gap during the transition to a hospital-based pharmaceutical waste collection system. Strengthening public communication on official collection points and providing clearer operational guidance may support safer disposal practices. Full article

Food safety is a major global public health concern and a key contributor to the burden of foodborne diseases. This scoping review examined the knowledge, attitudes, and practices (KAP) related to food safety among urban consumers in low- and lower-middle-income countries (LLMICs). A systematic search was conducted across seven electronic databases: Medline (PubMed), Web of Science (Social Science Citation Index), Embase (Ovid), Global Health (Ovid), PsycINFO (Ovid), Econlit (EBSCOhost), and Scopus to identify studies published in English between 2000 and 2025. Data extraction and quality appraisal were conducted independently by two reviewers, and findings were synthesized in a narrative analysis. Twenty-six studies from 14 LLMICs met the inclusion criteria. Of the 25 studies assessing knowledge and awareness, the majority reported that consumers had some understanding of food safety, although 10 (40%) highlighted limited awareness. Fifteen studies examined practices, with several noting appropriate behaviours; however, nine (56.2%) reported poor practices. Seven studies assessed attitudes, with most reflecting positive perceptions, while one (16.7%) identified negative views. Only four studies examined the full KAP triad. Across studies, factors such as age, education, gender, marital status, training, employment status, income, field of study, and residential status were found to influence food safety KAP. Overall, the evidence suggests that while consumers in urban LLMIC settings generally demonstrate some knowledge and positive attitudes towards food safety, there remain significant gaps in practices that could compromise public health. Future research should prioritise underrepresented regions, employ more rigorous study designs, and incorporate longitudinal and qualitative approaches to gain deeper insights and inform targeted interventions. Full article