Search Results (368)

Background: HIV is one of the deadliest viruses in the world and the leading cause of mortality and morbidity in the Sub-Saharan African countries, including Ethiopia. Millions of new HIV infections are reported every year among the population in the 15–24 age group. Particularly, adolescents are vulnerable to HIV infection due to a lack of adequate information and engagement in risky sexual practices. Thus, the assessment of knowledge, attitudes, and practices (KAPs) is one of the cornerstones in the fight against HIV/AIDS for designing appropriate prevention strategies. This study aimed to assess the KAPs regarding HIV/AIDS among high school students in Burayu town, Ethiopia. Methods: A cross-sectional study design was conducted on students from three higher secondary schools in Burayu town from February to June 2022. A total of 394 students were selected using a stratified proportional sampling technique. Data were collected using pre-tested and self-administered questionnaires and analyzed by SPSS version 26. Descriptive statistics were conducted, and logistic regression was used to determine the associations between variables. A p-value ≤ 0.05 was considered significant in all cases. Results: Out of the 394 students, the majority of respondents (70%) had sufficient knowledge about HIV/AIDS transmission and prevention, while only 61% demonstrated a positive attitude towards people living with HIV/AIDS (PLWHA). In bivariate analysis, a higher level of knowledge was significantly associated with a positive attitude towards PLWHA at OR 23.4, 95% CI, 2.9–185.5, p = 0.003, and not having had sexual practice at OR 4.1, 95% CI, 1.2–13.9, p = 0.025. In multivariate analysis, sexual practice was significantly (p ≤ 0.05) associated with the level of knowledge, age, gender, and places of residence at AORs values of 5.5, 9.7, 3.4, and 5.5, respectively. Conclusions: This study suggests that students with high levels of knowledge had a positive attitude towards PLWHA and less sexual practice compared to students with low levels of knowledge. Furthermore, students’ sexual practice was significantly associated with knowledge level, age, gender, and place of residence. This underscores the urgent need for targeted education to empower vulnerable groups, foster positive attitudes and practive, and curb HIV/AIDS transmission for improved health outcomes. Full article

Inadequate hygiene knowledge and poor sanitation practices remain key challenges to safe learning environments in South Africa, with 462 million learners attending schools without basic handwashing facilities and many schools failing to meet sanitation standards. Although national policies and infrastructure investments have improved water, sanitation, and hygiene (WASH) services in some schools, access and behaviours remain uneven across socio-economic contexts. This study evaluated knowledge, attitudes, and practices (KAP) related to WASH among 1200 learners from 40 high schools in Durban using a cross-sectional design and interviewer-administered questionnaires. Data were analysed using descriptive statistics, Pearson correlations, ANOVA, and multiple regression. The study addressed the research question: To what extent do learners’ knowledge and attitudes predict hygiene practices across socio-economic contexts? It was hypothesised that higher knowledge and more positive attitudes would significantly predict improved hygiene practices. Results showed that while 74.6% reported handwashing after toilet use, only 39.3% consistently used soap. Knowledge of disease transmission through unsafe water was 35.4%, although overall attitudes were positive. Learners from higher-quintile schools had significantly better KAP scores than those from lower quintiles (p < 0.001). Both knowledge (β = 0.232, p < 0.001) and attitudes (β = 0.266, p < 0.001) were significant predictors of learners’ hygiene practices. Significant group differences were also observed by gender (t = 18.032, p = 0.001) and district (t = −3.895, p = 0.001). These findings highlight persistent WASH gaps and inequities across schools, underscoring the need for integrated interventions that strengthen both hygiene education and school infrastructure to achieve Sustainable Development Goal 6. Full article

Tick-borne diseases (TBDs) pose a significant threat to livestock productivity and rural livelihoods in South Africa, particularly among resource-poor communal farmers. This narrative review synthesises findings from case studies on communal farmers’ knowledge, attitudes, and practices (KAPs) toward TBDs and their control. The analysis reveals that while many farmers can identify TBDs and their symptoms, significant gaps exist in understanding acaricide resistance and effective tick management. Socioeconomic factors, including age, gender, education, and access to veterinary services, strongly influence knowledge and practices. Indigenous ethnoveterinary practices are commonly used alongside conventional methods, although their efficacy remains understudied. The review emphasises the importance of integrated pest management, participatory approaches, and targeted awareness campaigns. A One Health framework is recommended to enhance surveillance, collaboration, and sustainable TBD control. Empowering farmers through training and inclusive communication strategies is crucial for mitigating the impacts of TBDs on communal farming systems. Full article

Background/Objectives: The use of physical restraints in adult and pediatric intensive care units (ICUs) is common yet controversial. While restraints are intended to prevent treatment interference or self-harm, they pose significant physical, psychological, and ethical risks. Nurses in intensive care units play a key role in decisions about restraint application, but there is a global lack of validated tools to assess their knowledge, attitudes, and practices, particularly in non-English-speaking contexts. Aim of this study was to develop and validate a questionnaire for assessing knowledge, attitudes, and practices (KAP) of ICU nurses regarding restraint use in adult and pediatric settings. Materials and Methods: A multi-method psychometric validation study was conducted across both adult and pediatric ICU settings at two hospitals in northern Italy. Questionnaire development included literature review, expert consultation, and iterative content and face validity assessments. Reliability was tested using test–retest methods, and construct validity was explored through exploratory factor analysis. The study followed COSMIN guidelines. Results: The final CON-Ti-IT questionnaire comprised 29 items across three subscales: Practices, Attitudes, and Knowledge. It demonstrated strong content validity (CVI = 0.96) and good internal consistency for the Practices subscale (Cronbach’s α = 0.89). Internal consistency for the Attitudes (α = 0.51) and Knowledge (α = 0.47) subscales was lower, reflecting the broader conceptual variability of these domains. Exploratory factor analysis confirmed the structural validity of the tool and led to the removal of three items with low factor loadings. Conclusions: This study presents the first validated tool specifically designed to evaluate ICU nurses’ KAP on restraint in adult and pediatric settings. While developed and validated in Italy, it could undergo cross-cultural adaptation and translation for use in other languages and healthcare systems. Its strong psychometric properties support its application in future research, and the data collected through its use can serve both to improve patient care and to provide a foundation for targeted educational initiatives. Full article

African swine fever (ASF) is a transboundary viral disease that has heavily impacted Southeast Asia since its introduction in 2019. Smallholder pig production systems in Cambodia and the Lao People’s Democratic Republic (the Lao PDR), characterized by low biosecurity, free-ranging practices, and limited veterinary oversight, remain particularly vulnerable. To assess farmers’ awareness and practices regarding ASF, a knowledge, attitudes, and practices (KAP) survey was implemented between March and September 2023 by Agronomes et Vétérinaires Sans Frontières within the framework of the Biosecurity in Pig Farming (BIG) project. A total of 471 pig farmers, including 56% women, were interviewed across eight provinces using a standardized questionnaire (188 in Cambodia and 283 in the Lao PDR). Results showed that ASF awareness was generally high (92% in Cambodia, 66% in the Lao PDR), yet 15% of Cambodian and 30% of Lao respondents expressed doubts about the presence of ASF in their country. While recognition of ASF symptoms was moderate and positively correlated with farmers’ perceived capacity to identify the disease, knowledge of transmission pathways was low and often misaligned with perceptions. Airborne transmission was frequently cited as a risk, and the risks related to visitors and fomites were underestimated by more than 50% of the farmers. Implementation of biosecurity measures (BSM) was limited, with mean scores of 43% in Cambodia and 27% in the Lao PDR. Risky practices such as swill feeding, free-ranging, sharing of boars, traders, and inadequate carcass disposal remained widespread. Statistical analysis identified education level, herd size, knowledge, perceived risks, and perceived benefits of BSM as the main determinants of biosecurity implementation. Farmers with larger herds or stronger commercial orientation demonstrated higher biosecurity adoption, while misconceptions and knowledge gaps remained frequent among smallholder farmers. Strengthening awareness, promoting low-cost and feasible biosecurity practices, and integrating farmer-centred approaches are essential for reducing ASF transmission risks and improving the resilience of smallholder pig production systems in the region. Full article

Vaccine hesitancy represents a threat to immunization programs and herd immunity. Our objective was to validate a Spanish-language questionnaire to assess knowledge, attitudes, and practices (KAP) of students in the healthcare field regarding vaccination and the immunization schedule. Methods: An online questionnaire was developed and distributed via RedCap v.13.7.1 to healthcare students undertaking clinical placements at the University Hospital of Santiago de Compostela during the 2024–2025 academic year. The questionnaire assessed nine dimensions through thirty-four items. Validation was carried out in two phases: (1) translation and expert content validation, and (2) reliability testing using Cronbach’s alpha and validity assessment through principal component analysis (PCA). Results: A total of 398 students completed the questionnaire. The mean age was 23.78 ± 3.77 years. Of these, 19.60% were men (n = 80) and 77.50% were women (n = 316). Validation of the questionnaire was carried out with a random sample of 294 students. The final 30-item questionnaire demonstrated high internal consistency (Cronbach’s alpha = 0.83) and construct validity, confirmed by PCA, supporting the presence of nine dimensions that explained 60.93% of the total variance. Overall, 74.70% of students reported that scientific evidence was the main influence on their opinion about vaccines. Regarding practices, 76.10% believed that certain vaccines should be mandatory for healthcare personnel. Conclusions: The questionnaire demonstrated reliability and validity for evaluating KAP on vaccination among future healthcare professionals. Having this instrument available will help guide future educational interventions and strengthen their role as trusted agents in immunization. Full article

Background: Hypertension is a leading modifiable risk factor for cardiovascular diseases globally, disproportionately affecting low- and middle-income countries (LMICs), including South Africa. Primordial prevention targeting normotensive individuals plays a key role in reducing lifetime risk. Aim: To assess knowledge, attitudes and practices (KAP) and social determinants of health related to primordial hypertension prevention among normotensive adults in OR Tambo District, Eastern Cape province. Methods: A community-based cross-sectional study was conducted among 245 randomly selected normotensive adults. A validated questionnaire captured socio-demographic characteristics and KAP levels. Data analysis included descriptive statistics, Cronbach’s alpha, and chi-square tests (p < 0.05). Results: Participants demonstrated moderate knowledge (53.9%), highly positive attitudes (86.1%), and fair preventive practices (59.6%), highlighting a clear knowledge–practice gap. Higher knowledge was significantly associated with female gender (p < 0.001), older age (p < 0.001), and family history of hypertension (p = 0.001). Positive attitudes correlated with older age (p = 0.018) and higher education (p = 0.008). Knowledge level significantly predicted both positive attitudes (p < 0.001) and preventive practices (p = 0.009). Conclusions: Despite moderate knowledge and positive attitudes, a clear knowledge–practice gap was evident, possibly influenced by social and structural constraints. Strengthening primordial hypertension prevention in rural South Africa requires integrated strategies combining context-specific health education with interventions addressing structural barriers to enable sustainable behaviour change. Full article

Background/Objectives: Antimicrobial resistance (AMR) is a major global health issue. Since community pharmacists are frontline health officials regarding the provision and management of antibiotics, it is of great importance to study the knowledge, attitudes, and practices (KAPs) of pharmacists with respect to antimicrobial stewardship (AMS) to formulate specific interventions. In Jordan, where dispensing antibiotics without a prescription is a common situation, this study was designed to assess the KAPs of community pharmacists in southern Jordan on AMR and AMS, the gap in the knowledge base and the practice, and the effect of other variables on antimicrobial education and responsible dispensing. Results: Participant pharmacists (n = 383) confirmed a moderate or lack of knowledge in antibiotic choice, resistance mechanisms, and the basis of stewardship. Despite positive attitudes for AMS, important practice gaps occurred: 38.6% infrequently dispensed antibiotics without prescriptions, 67.4% mistakenly believed that antibiotics may cure viral infections (flu/common cold), and only 33.4% firmly rejected non-prescription antibiotic requests. Knowledge scores were significantly higher among bachelor’s degree pharmacists, public university pharmacists, and urban-working pharmacists. Practice scores were better among master’s degree holders and urban practitioners. Conclusions: This work indicates that the AMS knowledge and practices of pharmacists in the southern Jordanian community are lacking in a severe way, with almost 4 out of 10 having poor behaviors including dispensing non-prescription antibiotics. Full article

Antibiotics play a crucial role in the treatment of many complicated problems in clinical medicine, but antimicrobial resistance (AMR) has emerged as a serious concern threatening to undermine its effectiveness. Precision medicine (PM) which tailors treatment to individual and genetic and lifestyle factors, may offer a novel approach to combat AMR. Yet, little is known about how healthcare providers in Pakistan understand and integrate the concept of precision medicine within their knowledge, attitudes, and practices (KAP) towards AMR. This study aims to investigate the knowledge, attitude, and practices of healthcare professionals towards AMR and to explore their perception about precision medicine as a strategy to reduce AMR. A mixed method approach was employed for the study. The knowledge, attitude, and practices (KAP) of healthcare professionals (N = 326) were assessed through a validated questionnaire. SPSS version 26 (Statistical Package for the Social Sciences) was employed for descriptive and bivariate analyses to determine KAP score and its association with demographics. Qualitative data were gathered through a focus group discussion and thematic analysis was performed to explore the perception about PM. Results showed that healthcare professionals demonstrate poor knowledge (55.5%), relatively positive attitudes (54.6%), and that nearly half had unfavorable practices (48.3%). Significant associations (p < 0.05) were found between KAP scores and factors such as location, healthcare setting, educational level, professional designation, and prior infectious disease training. During focus group discussion (FGD), HCPs emphasized the cautious use of PM, particularly in the management of resistant infections. However, limitations in resources, poor governance, poverty, and access to data and testing facilities were highlighted as barriers in the implementation of PM into practice. This study highlights critical gaps in knowledge and practices towards AMR among HCPs. While PM is viewed as a potential tool against AMR, systemic support, resource allocation, and targeted awareness programs are essential to integrate PM into clinical practice. Full article

Background/Objectives: Paediatricians’ recommendations influence parental decisions to vaccinate their children. On 19 January 2022, the World Health Organization authorized the Pfizer-BioNTech COVID-19 vaccine (BNT162b2) under Emergency Use Listing for children under 12 years as a measure to mitigate disease spread and direct protection for children with underlying conditions. We assessed knowledge, attitudes, and practices (KAP) of Palestinian paediatricians regarding COVID-19 vaccination for children under 12 years and identified factors affecting support for vaccination. Methods: From 1 October to 8 November 2023, we surveyed paediatricians across the West Bank using structured telephone interviews. We collected data on sociodemographic characteristics and KAP regarding COVID-19 vaccination and calculated KAP scores from eight, nine, and nine items, respectively, with total scores categorized as poor/moderate/good. We performed bivariable and multivariable analyses to identify factors associated with paediatricians supporting COVID-19 vaccination for children under 12 years. Results: Of the 367 eligible paediatricians, 323 (88%) responded; the median age was 51 years (range: 28–70); 27% supported COVID-19 vaccination for children. Mean scores for knowledge (range 0–8), attitude (0–9), and practice (0–9) were 3.0 ± 2.1, 3.9 ± 2.4, and 4.0 ± 1.7, respectively. The mean overall KAP score (0–26) was 11 ± 4.8. Safety and efficacy concerns and lack of long-term data were the main reasons for hesitancy. Higher knowledge scores (PR = 1.8, 95% CI: 1.3–2.5, p = 0.001) and positive attitudes (PR = 1.6, 95% CI: 1.1–2.3, p = 0.01) were significantly associated with paediatricians’ support for vaccination. After adjustment for other factors, participants with regular continuing medical education attendance (aPR = 1.4, 95% CI: 1.0–2.6, p = 0.045), trusting WHO recommendations (aPR = 3.1, 95% CI: 1.4–7.8, p = 0.047), having a positive attitude score (aPR = 1.3, 95% CI: 0.4–4.4, p = 0.041), and a good total KAP score (aPR = 1.1, 95% CI: 1.0–1.2, p = 0.044) supported COVID-19 vaccination for children. Conclusions: Support for COVID-19 vaccination among Palestinian paediatricians was low, associated with their knowledge, attitudes, and trust in health authorities. The revised WHO recommendations from 10 November 2023, decreasing the priority of vaccinating healthy children, could influence the opinion of paediatricians. However, the low support for COVID-19 vaccinations could affect the performance of other vaccination programmes and should be carefully addressed through targeted education. Full article

Abortive zoonoses represent a major public-health threat and a significant constraint on small-ruminant production in West Africa, particularly in Benin. Yet they remain largely undocumented from the perspective of frontline actors. This cross-sectional study assessed the levels of knowledge, attitude, and perception (KAP) of Beninese farmers, butchers, meat inspectors, and para-veterinary staff. A structured questionnaire containing 28 items (11 knowledge, 9 attitudes, 8 perception) was administered to four professional groups (small ruminant keeper, para-veterinarian, butcher and meat inspectors) from four communes in the South, Central, and North of Benin. The number of correct and desirable responses was evaluated on a 0–100% scale. Overall, respondents demonstrated limited knowledge (50.4 ± 25.2%), highly undesirable attitudes (71.0 ± 23.2%) (higher attitude score means risky practices), and likely desirable (65.0 ± 24.4%) toward abortive zoonoses. Mixed-effect linear regression revealed that knowledge was generally higher among trained professionals such as meat inspectors and para-veterinarians. On the other hand, farmers and butchers showed larger informational gaps and more frequent risky practices. Respondents with previous experience of livestock abortion tended to be more aware of zoonotic risks but did not consistently translate this awareness into safer behavior. Correlations between knowledge and perception were weak and non-significant (r = 0.14; p = 0.135). Psychometric analysis revealed that the Knowledge scale was robust and effectively discriminated between respondents, while the Attitude scale showed poor validity, likely due to social desirability bias. Most participants perceived abortive diseases as a serious threat, yet this awareness did not translate into safer practices. The findings highlight substantial cognitive gaps, persistent risky practices and an incomplete perception of danger among value-chain actors. They underscore the need for targeted, behavior-change interventions in Benin, prioritizing practical training for farmers and butchers and the scaling-up of flock vaccination within a strengthened One Health framework. Full article

Background: Vaccination remains one of the most effective public health interventions, yet hesitancy persists even among healthcare students who aid in promoting immunization. Understanding students’ perspective plays a crucial role in designing targeted educational interventions. The purpose of this study was to evaluate knowledge, attitude, and practices of healthcare students (HSCs) in Kuwait about vaccines. Methods: A quantitative, cross-sectional study was conducted between August and October 2024. A validated 21-item questionnaire was used to assess vaccine-related knowledge, attitude, and practices, along with demographic data. Descriptive statistics and binary logistic regression were used to identify predictors of higher knowledge and positive attitude. Results: A total of 351 students participated (mean age 23.0 ± 2.4 years; 90.6% female). The mean knowledge score was 3.9/7 (55.7%), indicating moderate knowledge, with misconceptions noted regarding benefits of post-infection vaccination and extra vaccine doses. The mean attitude score was 3.6/6 (60%), indicating moderately positive attitude, yet safety concerns, particularly about long-term effect, were common (59.3%). Nearly half (45.9%) delayed vaccination until mandatory. Vaccine uptake was highest for COVID-19 (92.3%), followed by hepatitis B (73.8%). Older age, male gender, and being a medical student predicted higher knowledge (p = 0.011), while older age and being in later study years predicted more positive attitude (p = 0.032). Conclusions: HSCs demonstrated moderate knowledge and attitude toward vaccines, with significant hesitancy driven by safety concerns despite high eventual uptake. Early targeted curricular interventions addressing vaccine safety evidence, benefits of timely immunization, and professional responsibility are warranted to improve confidence and proactive vaccine acceptance among future healthcare professionals (HCPs). Full article

Background/Objective: This cross-sectional study assessed the knowledge, attitudes, and practices (KAP) of radiology professionals in Saudi Arabia regarding environmental sustainability. Methods: An online survey with 298 participants revealed moderate knowledge and positive attitudes towards sustainability. Results: However, a significant gap between awareness and practice was observed. The most common sustainable practice was digital documentation (53.4%), while energy saving and water saving measures were rare, with more than half rarely or never practicing energy saving. The primary barrier to implementation was a lack of awareness and training (50%). The sustainability association was significantly higher among older, female, and hospital-based professionals. Conclusions: The findings underscore the urgent need for improved educational initiatives, strong institutional support, and clear policy frameworks to effectively integrate sustainable practices into radiology departments in Saudi Arabia. Full article

Background: Hearing loss remains significantly underrecognised as a diabetes complication, despite diabetic individuals experiencing double the risk of sensorineural hearing impairment. This review synthesised healthcare provider and patient knowledge, attitudes, and practices (KAP) concerning diabetes-related hearing loss. Methods: Using Arksey and O’Malley’s framework and PRISMA-ScR guidelines, systematic searches were conducted across five databases (PubMed/MEDLINE, Embase, Scopus, Web of Science, Cochrane Library) through August 2025. Grey literature and reference screening supplemented database searches. Eligible studies examined KAP among healthcare professionals and diabetic patients. Results: Five studies from four countries reported KAP findings were identified from 2029 records, encompassing 2813 healthcare providers. Only one study included KAP data from patients. Knowledge deficits were pronounced: American provider awareness ranged 25.6–44.5%, contrasting sharply with >94% awareness of other complications. Only 24.3% of Chinese providers demonstrated complete understanding, while 59.7% of South African practitioners remained unaware of auditory complications. Patient knowledge was similarly limited (21% recognition). Attitudes showed moderate engagement, with 68–75% of Chinese practitioners accepting management responsibilities. Barriers included unfamiliar guidelines, competing priorities, and restricted audiological access. Practices were suboptimal: 16.9% conducted routine screening, referrals remained reactive, and 64.9% never discussed hearing risks. Training opportunities were minimal. Conclusions: Substantial KAP deficits exist regarding diabetes-related hearing loss. Recognition disparities compared to established complications represent lost opportunities for early intervention. Urgent needs include standardised assessment instruments, large-scale intervention studies, and comprehensive educational programs to integrate hearing health into standard diabetes management protocols. Full article

Background: Antimicrobial resistance (AMR) is a major public health threat in India, driven by the misuse of antibiotics. However, there is a lack of community-level data on AMR awareness and antibiotic use practices, especially in low-income urban settings. This study aimed to assess the knowledge, attitudes, and practices (KAPs) regarding antibiotic use and AMR among residents of a low-income area in Delhi. Methods: A community-based, cross-sectional study was conducted from April to June 2025 among 1601 adults in a low-income urban area of Delhi, using a validated questionnaire. Data on sociodemographic and KAP regarding antibiotics and AMR were collected. Ordinal and binary logistic regression analyses were performed to identify sociodemographic determinants of KAP. Results: While 68.0% of participants had heard of antibiotics, specific knowledge was poor. Only 19.4% were aware of AMR, and significant misconceptions were prevalent, with 47.5% believing that antibiotics were effective for colds and flu. Self-medication with antibiotics was reported by 24.6% of respondents. Lower educational attainment, female gender, and lower income were significantly associated with poorer antibiotic knowledge and practices. Higher knowledge scores were strongly associated with better practices (AOR: 1.30, 95% CI: 1.23, 1.37, p < 0.001). Conclusions: Critical knowledge gaps and high-risk antibiotic use practices are prevalent in this low-income urban community, strongly linked to social determinants like education, gender, and income. There is an urgent need for evidence-informed and tailored educational and behavior change interventions to curb irrational antibiotic demand and preserve these vital medicines. Full article