Search Results (343)

Objective: The purpose of this study was to investigate the knowledge, attitudes, and practices (KAPs), including ageism, of rehabilitation service providers regarding older adults with substance use disorders to examine the association between KAPs and ageism on the knowledge of rehabilitation providers and confidence in treating this population. Methods: An online survey was developed to assess providers’ familiarity with geriatric substance use disorders, attitudes towards aging, and perceived barriers to treatment. The survey included the Expectations Regarding Aging (ERA-12) tool to measure ageist attitudes. Data was collected from 25 rehabilitation healthcare providers across rehabilitation centers in North Carolina. Descriptive statistics and ERA-12 scoring were used to analyze the results. Results: Most (52.0%) respondents reported slight or moderate familiarity with specific risk factors for substance use disorders associated with older adults, and participants most commonly expressed ambivalence (48.0% indicated they were neither satisfied nor dissatisfied) with their training on this demographic. Barriers included a lack of specialized training, limited availability of age-appropriate treatment programs, and resistance to change. Negative attitudes towards aging and substance use disorders were prevalent among respondents. Providers indicated a need for enhanced education, clinical guidelines, and access to geriatric-trained professionals. Discussion: The findings highlight a critical need for specialized training for rehabilitation providers to improve care for older adults with substance use disorders. Addressing ageism, increasing awareness, and enhancing provider education are essential to improving treatment outcomes. Implementing targeted training programs and specialized resources could significantly enhance the quality of care for this underserved population. Full article

Unsafe disposal of unused and expired antimicrobial drugs increases their presence in the environment, thereby contributing to the emergence and spread of antimicrobial resistance. This study addressed the lack of sufficient data on unused and expired antimicrobial disposal practices among peri-urban residents in Ghana. This knowledge–attitude–practice (KAP)-based study offers context-specific insights to inform public health education and antimicrobial disposal policy interventions. A cross-sectional study was conducted among 310 residents in the Ho municipality using a well-structured questionnaire. Data was collected on the knowledge, attitudes, and practices of households on how they dispose of unused and leftover antimicrobials. Origin Pro 2022 software was used to analyze the data. Many respondents were males (n = 175, 56.5%) and aged between 18 and 30 years (n = 196, 63.2%). About 87.1% (n = 270) of the respondents agreed that improper disposal of unused antimicrobials could negatively affect the environment. Most of the respondents (71.9%, n = 223) had not received counseling on recommended antimicrobial disposal; 75.5% (n = 234) of respondents were not aware of institutions collecting unused or expired medicines; and 73.5% (n = 228) had never participated in a medicine-return program. Discarding antimicrobials into household trash bins was the most common way of disposal among respondents. The preferred sites to return unused/leftover antimicrobials were community pharmacies and hospitals. Although respondents showed some knowledge and positive attitudes toward safe antimicrobial disposal, further education is needed. Furthermore, most respondents disposed of antimicrobials in household trash, highlighting the need for take-back programs and community pharmacy-based collection. Incorporating disposal guidance into medication counseling and patient information leaflets can enhance awareness and promote appropriate practices. Full article

Background/Objectives: Childhood obesity rates in Jordan have reached alarming levels, with 28% of school-age children classified as overweight or obese. School-based gardening interventions show promise for promoting healthy eating behaviors, yet limited research exists in Middle Eastern contexts. This study evaluated the effectiveness of a five-month school-based vegetable gardening and nutrition education intervention on anthropometric measures, dietary intake, and knowledge, attitudes, and practices (KAP) regarding vegetable consumption among Jordanian primary school children. Methods: A quasi-experimental controlled trial was conducted with 216 students (ages 10–12 years) from two demographically matched schools in Amman, Jordan. The intervention group (n = 121) participated in weekly one-hour gardening sessions combined with nutrition education and vegetable tasting activities over five months, while the control group (n = 95) continued the standard curriculum. Outcomes measured at baseline and post-intervention included anthropometric assessments, dietary intake via 24 h recalls, and vegetable-related KAP using a validated questionnaire. Data were analyzed using paired t-tests and repeated measures ANCOVA. Results: The intervention group demonstrated significant improvements in body composition, including reductions in BMI (−1.57 kg/m²), weight (−1.88 kg), and BMI z-score (−0.37), while controls showed minimal increases. Vegetable intake showed significant time × group interaction (p-value = 0.003), with a non-significant increase in the intervention group (2.7 to 2.9 times/day) and a non-significant decrease in the controls (2.5 to 2.4 times/day). Dietary quality improved, including increased fiber intake (+2.36 g/day) and reduced saturated fat consumption (−9.24 g/day). Nutrition knowledge scores increased substantially in the intervention group (+22.31 points) compared to controls (+1.75 points; p-value ≤ 0.001). However, attitudes and practices toward vegetable consumption showed no significant changes. Conclusions: This intervention effectively improved body composition, dietary quality, and nutrition knowledge among Jordanian primary school children. These findings provide evidence for implementing culturally adapted school gardening programs as childhood obesity prevention interventions in Middle Eastern settings, though future programs should incorporate family engagement strategies to enhance behavioral sustainability. Full article

Mpox has re-emerged as a global public health threat, particularly in endemic regions such as Nigeria, where human, animal, and environmental health sectors intersect. To inform surveillance and control strategies, this study assessed the knowledge, attitudes, and practices (KAP) toward Mpox among One Health stakeholders in Nigeria. A cross-sectional survey was conducted among 492 participants from human, veterinary, and environmental health sectors using a structured questionnaire. Descriptive statistics, ordinal logistic regression, and margins analysis were used to evaluate levels and predictors of KAP. Results showed that 33.7% of respondents had low knowledge, 43.5% moderate, and 22.8% high. While 62.6% demonstrated high attitude scores, only 48.2% reported moderate preventive practices. Gender was significantly associated with attitudes, with females having lower odds of expressing higher attitudes than males (OR = 0.70, 95% CI: 0.49–1.00, p = 0.052), and margins analysis revealed a predicted probability of high attitude at 56% for females and 64% for males. Multivariable modeling for practice was not pursued because model fit did not improve compared to univariable results, and sparse data led to unstable estimates, thus offering no added explanatory power. These findings underscore persistent knowledge gaps and gender-related disparities that may hinder effective Mpox response. Targeted risk communication and capacity building are recommended to strengthen One Health preparedness in Nigeria. Full article

Lyme borreliosis (LB), a zoonotic disease caused by Borrelia burgdorferi sensu lato and transmitted by Ixodes ricinus, is increasingly relevant in France, yet data on public awareness and prevention are limited. This cross-sectional study assessed the knowledge, attitudes, and practices (KAP) of companion-animal owners (CAOs) and veterinarians regarding LB. Online questionnaires were distributed between January and April 2023, yielding 159 valid CAO responses and 48 responses from veterinarians. Among owners, 95% reported outdoor access for their pets, 73.9% had observed ticks, and 88.8% used ectoparasiticides. However, only 16.4% reported LB vaccination, and just 38% recognized key canine clinical signs. Veterinarians frequently suspected LB (70%) but confirmed diagnoses less often (39.6%), relying mainly on clinical signs and the results of rapid tests. While prevention through antiparasitic use was common, communication between veterinarians and owners regarding LB was inconsistent. Despite this, most owners reported compliance with veterinary guidance. These findings reveal good preventive habits but identify knowledge gaps and underdiagnosis. Enhancing veterinary–client communication and promoting a One Health approach could improve LB prevention and control in France. Full article

Background/Objectives: Continuous renal replacement therapy (CRRT) is a critical intervention for managing acute kidney injury (AKI) in critically ill patients. Critical care nurses (CCNs) play a pivotal role in its implementation, requiring adequate knowledge, a positive attitude, and practice proficiency. This study aimed to assess the levels and factors affecting CCNs’ knowledge, attitudes, and practices (KAPs) regarding the care of patients receiving CRRT in Hail Hospitals, Saudi Arabia. Methods: A cross-sectional study was conducted with 190 registered CCNs from the critical care units of Hail Hospitals, Saudi Arabia, from March to May 2025. Data were collected using a sociodemographic characteristics sheet and the knowledge, attitudes, and practices questionnaire on CRRT. Non-parametric statistical tests (Mann–Whitney U, Kruskal–Wallis, and Spearman’s correlation tests) were used to determine the relationships between variables. A multiple linear regression analysis was used to explore the factors affecting the study variables. Results: The majority of CCNs had a high level of knowledge regarding CRRT management (66.3%), followed by moderate (21.1%) and low (16.6%) levels. Additionally, the majority had a high level of attitude regarding CRRT management (74.7%), followed by moderate (18.4%) and low (6.9%) levels. The majority of CCNs had a high level of practice regarding CRRT management (66.8%), followed by low (23.7%) and moderate (9.5%) levels. There was a significant positive correlation between CCNs’ knowledge, attitudes (rs = 0.230, p < 0.001), and practices (rs = 0.192, p < 0.001). Additionally, there was a significant positive correlation between CCNs’ attitudes and practices (r = 0.419, p < 0.001). Multiple linear regression revealed a significant model (p  <  0.001) when sociodemographic and work-related factors were analyzed as predictors of CCNs’ levels of knowledge, attitudes, and practices regarding CRRT: Having more experience, working with a nurse-to-patient ratio of 1:2, and frequently using CVVHDF as a CRRT modality were significant factors for higher knowledge levels when compared to the reference categories. In addition, having a bachelor’s degree and frequently using CVVHD, CVVHDF, or SCUF as a CRRT modality were significant factors for higher attitude levels regarding CRRT when compared to the reference categories. Having a bachelor’s degree and frequently using CVVHD or CVVHDF as a CRRT modality were significant factors for higher practice levels regarding CRRT when compared to the reference categories. Conclusions: CCNs in Hail Hospitals self-reported high levels of knowledge, attitudes, and practices regarding CRRT management, followed by moderate levels. Targeted educational programs, standardized protocols, and organizational support are recommended to improve CCN care for CRRT and to optimize patient outcomes. Full article

Introduction/Objectives: Cervical cancer screening is a vital preventive strategy, yet the extent of healthcare workers’ knowledge, attitudes, and practices (KAP) can significantly influence its uptake, especially in rural settings. This study aimed to explore the knowledge, attitudes, and practices regarding cervical cancer screening among nurses in selected rural health facilities of the Eastern Cape province, South Africa. Methods: A cross-sectional, quantitative study was conducted among 108 nurses selected from 12 health facilities across two districts in the Eastern Cape. All participants had received some training on cervical cancer screening. Structured questionnaires were used to assess knowledge, attitudes, and practices. Comparisons between professional nurses (higher academic qualification) and enrolled nurses (lower academic qualification) were made using appropriate statistical tests. Results: Findings revealed significant disparities in knowledge and attitudes between professional and enrolled nurses. Professional nurses demonstrated significantly better knowledge and more positive attitudes towards cervical cancer screening than enrolled nurses, who showed inadequate knowledge (p = 0.021) and negative attitudes (p = 0.023). Despite universal training, the level of academic qualification remained a key factor influencing KAP. Conclusions: Academic qualification is closely linked to knowledge and attitudes regarding cervical cancer screening among nurses. Health workforce policies and programmatic initiatives should prioritize targeted training for enrolled nurses, focusing on addressing specific knowledge and skill gaps. Tailored interventions are recommended to enhance competencies and improve cervical cancer screening practices among all nursing cadres. Full article

Antimicrobial resistance (AMR) is a critical global health concern, with the food production sector, particularly poultry production, playing a significant role in the spread of resistant bacteria. This study aims to identify and analyze the key factors influencing antimicrobial use (AMU) and thereby/or the spread of AMR within the poultry production chain, spanning from farm to consumer. A scoping literature review was conducted to investigate factors influencing AMU and/or the emergence and dissemination of AMR in poultry production. Knowledge synthesis was conducted from 69 relevant publications covering data from 41 countries. A total of 327 factors were identified from the various studies. Most factors (221) were related to knowledge, attitudes, and practices (KAPs) concerning farms. The other significant group, with 57 factors, involved intentional misuse or poor practices related to antimicrobials. The findings highlight the complexity of factors influencing AMR in poultry production, including financial pressures on farmers and varied training effectiveness. Integrated and tailored interventions are essential. Drug/feed sellers’ practices require stronger regulations, while economic motivations and policy gaps must be addressed. Systematic management of these interactions and further research on environmental and genetic influences are crucial for effective strategies to combat this pressing public health challenge. Full article

Background: Calcitonin gene-related peptide (CGRP) inhibitors represent a novel class of medications for the prevention and treatment of migraines. Given their expanding role in migraine management, pharmacists are increasingly expected to be knowledgeable about their use. However, limited data exist regarding pharmacists’ awareness and engagement with CGRP inhibitors in Saudi Arabia. Objective: To assess the knowledge, attitudes, and practices (KAP) of pharmacists in Saudi Arabia toward CGRP inhibitors for migraine management and identify areas for improvement. Methods: A cross-sectional survey was conducted from October 2024 to January 2025 among licensed pharmacists in Saudi Arabia using an online questionnaire distributed via social media platforms, pharmacy networks, and in-person outreach. The survey consisted of 26 questions across four sections: demographics, knowledge, attitudes, and practices. Descriptive statistics and regression analyses were performed to evaluate the data using SPSS version 29. Results: A total of 419 pharmacists participated (response rate: 98.8%). Most practiced in community pharmacies (90.5%) and the Western region (48.2%). Overall, pharmacists demonstrated moderate knowledge (54.7%), attitudes (55.6%), and practices (49.9%) toward CGRP inhibitors in migraine management. While 54.7% were familiar with CGRP inhibitors, only 37.2% were aware of relevant clinical guidelines, and 32.5% recognized adverse effects such as hypertension. Regarding attitudes, 32.2% believed CGRP inhibitors were superior to conventional therapies, but over 50% expressed neutral views across key items. Practice patterns revealed limited engagement, with more than half reporting neutral responses toward patient education, interdisciplinary collaboration, and safety monitoring. Conclusions: The study highlights moderate awareness but suboptimal application of CGRP inhibitor knowledge among pharmacists. Notable gaps exist in guideline familiarity, patient education, and interdisciplinary collaboration. Targeted training and inclusion of CGRP inhibitors in pharmacy curricula and continuing education programs are warranted to support effective migraine management. Full article

Background: Trust in information sources is essential to enhance an individual’s understanding of the message and boost their willingness to change or act on specific health behavior, including vaccine uptake. This study explores the association between trust in information sources and parents’ knowledge, attitudes, and practices regarding their children’s 13-valent pneumococcal conjugate vaccine (PCV13) uptake across seven cities in the Yangtze River Delta (YRD) region in China. Methods: A cross-sectional web-based survey was conducted from May to June 2023. Adult parents (N = 1304) who had at least one child aged 24 months or less and lived in the YRD region were recruited. The Adjusted Ordinary Least Squares (OLSs) regression model was applied to estimate the association between participants’ level of trust in different information sources and their knowledge, attitudes, and practices of children’s PCV13 vaccination. Results: Information from the Disease Control and Prevention Center (CDC) source received the highest trust score. Age, gender, education, and annual household income were related to varied trust levels in specific sources. Trust in the health service provider source was significantly associated with a better command of PCV13 knowledge, acceptance of PCV13, and a higher likelihood of vaccination. Trust in online community sources was positively associated with vaccine uptake. Conclusions: The study participants highly trusted information from health service provider sources. These sources may be effective channels with potential to enhance parents’ vaccine knowledge and acceptance of PCV13. Public health workers could utilize trusted sources to disseminate the benefits of the PCV13 and encourage the uptake of the vaccine. Full article

Post-consumer plastic waste poses increasing challenges in urban areas, where recycling heavily relies on consumer cooperation. In Japan, two recycling routes for post-consumer plastic waste from households exist, the municipal recycling route and the retailer recycling route, with the latter requiring more voluntary effort. This study aims to explore the diversity of consumers’ cooperative behaviors in Japan’s post-consumer plastic waste recycling system, with a focus on the retailer route. We conducted an online survey with 758 respondents from Sendai, Kawasaki, and Kyoto in urban Japan, using a structured questionnaire based on the knowledge–attitude–practice (KAP) framework. K-means clustering was conducted to identify behaviorally distinct consumer groups. Three clusters were revealed: Fully Engaged Consumers, Knowledge-Driven Consumers, and Passively Engaged Consumers. These groups exhibited distinct differences in cooperative recycling behaviors and socio-demographic characteristics. Our findings demonstrate the heterogeneity of consumer cooperation and underscore the importance of targeted strategies. By focusing on the retailer recycling route and consumer segmentation, this study addresses key gaps in Japan’s research on urban plastic waste. The results provide a theoretical and empirical foundation for differentiated policy-making, ultimately supporting the transition to a more sustainable and circular economy in post-consumer plastic waste recycling in urban Japan. Full article

Vector-borne diseases (VBDs) continue to pose a persistent global health challenge, disproportionately impacting low- and middle-income countries where surveillance and healthcare infrastructure are constrained. Within these countries, residents of remote island communities are particularly vulnerable to emerging VBD threats; however, they remain critically understudied. We conducted a community-based cross-sectional survey of 300 residents from Shahpori Island, Bangladesh, and Gaya Island, Malaysia, to assess knowledge, attitudes, and practices (KAP) related to VBDs. Using a structured questionnaire and mixed-effects Poisson regression modeling, we identified socio-demographic predictors of VBD-related knowledge and compared KAP outcomes across the two islands. Significant disparities were observed between the two settings: the Gaya Island residents demonstrated a higher level of awareness regarding VBDs and preventive practices compared to the Shahpori residents. Education was a strong predictor of VBD knowledge, with individuals possessing secondary education or above exhibiting significantly better knowledge (β = 0.2024, p = 0.0003). Marital status was also a significant factor, with unmarried respondents showing lower levels of knowledge (β = –0.1657, p = 0.0372). Age was positively correlated with VBD knowledge (β = 0.0051, p = 0.0119), indicating a gradual increase with age, while income, gender, occupation, and household size were not significantly associated. Despite basic awareness of VBD symptoms and transmission, detailed understanding of mosquito ecology, disease symptoms, and breeding prevention strategies was remarkably poor, especially among the Shahpori residents. Our findings highlight critical gaps in VBD-related knowledge and prevention behaviors shaped by socio-economic and educational disparities. Community-focused public health strategies including educational campaigns, establishment of health infrastructure, access to trained healthcare providers, and integrated vector control interventions are urgently needed to enhance resilience against emerging VBD threats such as drug-resistant malaria in remote island populations. Full article

Malaria remains a significant public health challenge in Angola, particularly in Cuando Cubango province. This study aimed to characterize the local Anopheles mosquito population, evaluate the impact of indoor residual spraying (IRS) on key entomological indicators, and assess the community knowledge, attitudes, and practices (KAP) related to malaria and vector control. Mosquito collections were conducted indoors at three sites over five months using CDC light traps and Prokopack aspirators. Ten Anopheles species were identified, with An. funestus s.s. being the predominant vector, accounting for 91.7% of the Funestus group. The overall Plasmodium falciparum circumsporozoite protein (CSP) infection rate was 9.2%, with Makua exhibiting the highest rate (10.2%). Following IRS, the indoor resting density of the Funestus group decreased significantly in Makua and Agostinho Neto. In Makua, An. funestus s.s. CSP infection rates decreased by 55% following IRS implementation; however, this reduction was not statistically significant. Knockdown resistance mutations were detected in An. arabiensis and An. gambiae s.s. The 2020/2021 IRS campaign achieved 95% spray coverage and reached 421,856 individuals. Complementary KAP surveys with 647 households showed that 87% of respondents correctly identified mosquitoes as malaria vectors, 78% recognized key symptoms, and 89% supported continued IRS. Reported adherence to post-IRS precautions exceeded 70% and preference for IRS over ITN was expressed by most households. These findings highlight both biological and social dimensions of malaria control, demonstrating that vector control, community acceptance, and entomological surveillance are essential for effective and sustainable malaria interventions in Cuando Cubango. Full article

Background: Hansen’s disease or leprosy is one of the 21 neglected tropical diseases (NTDs). In Ecuador, leprosy is considered eliminated as a public health problem; however, new cases are reported annually. Additionally, Mycobacterium leprae infection was detected in nine-banded armadillos across the country, suggesting a potential zoonotic reservoir. This literature review aims to provide an updated overview of the epidemiological situation of leprosy in Ecuador, identify knowledge gaps, and outline research priorities to support the development of a comprehensive national strategy for achieving zero autochthonous cases. Methods: This article analyses the current situation of leprosy in Ecuador based on international and national publications. A retrospective literature search using five international, regional, and national publications on leprosy published between 1954 and 2024 (70 years) with no restriction on language or publication date, was performed. Findings: Our review identified 28 publications with the earliest article dating back to 1954. Of these, 14 were published in international journals, 15 (53.6%) were in Spanish. Four nationwide studies documented leprosy cases across Ecuador’s three continental regions (Coast, Andes, and Amazon) with a predominance in the tropical coast. No cases have been reported from the Galápagos Islands. From 1983, Ecuador started multi-drug therapy. Data from the Ministry of Public Health (MoH) system identified 1539 incident cases, showing a significant decline in new cases from 2000 to 2024, with no cases in children. New cases detection rate by 100,000 inhabitants was 0.51 in 2019 according to the World Health Organization (WHO). No study has genotyped the Mycobacterium spp. in human cases, other animal species, or environment. According to the MoH, multibacillary leprosy accounts for 78.95% of diagnosed cases, with confirmation based on Ziehl–Neelsen staining and histopathology. No survey has assessed disabilities, knowledge, attitudes, and practices (KAP) or stigma related to leprosy. Research is needed on transmission routes, Mycobacterium genotyping, genetic susceptibility, and antibiotic resistance. BCG vaccination coverage fell to 75.3% in 2021. Cases are currently diagnosed and treated on an outpatient basis in large hospitals. Conclusions: This comprehensive review highlights persistent gaps in leprosy research and critical information, despite seven decades of documented cases in Ecuador. The disease is still endemic across the country, particularly at subnational level in the subtropics and tropics of the Pacific coast and the Amazon. There is a need for nationwide epidemiological research on reservoirs and the environment applying the One Health concept. Increased laboratory facilities and readily available official data are required to improve our understanding of leprosy in Ecuador. Strengthening community-level efforts is essential for Ecuador to meet the targets of the “WHO’s Towards Zero Leprosy: Strategy 2021–2030.” Full article

Background/Objectives: Antimicrobial resistance (AMR) is a major threat to human, animal, and environmental health. To tackle AMR in the livestock sector, there is a need to understand the antimicrobial use (AMU) practices of different stakeholders in order to target the common knowledge gaps and inappropriate practices with tailored interventions. In the Western Balkans, published evidence shows the presence of AMR in both humans and animals. Since studies on AMU have mainly been conducted in humans, there is a significant knowledge gap about AMU in the livestock sector. The aim of this study was to assess the knowledge, attitudes, and practices of farmers, veterinarians, veterinary pharmacy personnel, and feed mill personnel related to AMU (focusing on antibiotics) and AMR in Albania, Bosnia and Herzegovina, Kosovo (References to Kosovo shall be understood to be in the context of Security Council resolution 1244 (1999)), Montenegro, North Macedonia, and Serbia. Methods: Field interviews were conducted in 2022 with 2815 participants in selected regions of the countries. Results: The findings showed that farmers engaged in imprudent practices, including purchasing antimicrobials without a prescription, administering antimicrobials for growth promotion, and disposing of expired antimicrobials in the garbage. Farmers’ main knowledge gaps were related to the duration of antimicrobial treatment and the differentiation between AMR and antimicrobial residues. This study also revealed poor record-keeping on animal treatments and a lack of some biosecurity measures. In terms of the attitudes and practices of veterinarians and veterinary pharmacy personnel, the belief that antimicrobial drugs are important for growth promotion, and the common use and sales of highest priority critically important antimicrobials should be targets for future interventions. Conclusions: Despite significant ongoing efforts to tackle AMR, there is still a need for training, awareness-raising, and policy interventions to address the knowledge gaps identified by this study and optimize AMU in the livestock sector in the Western Balkans. Full article