Knowledge, attitude and practices of high risk populations on louse- borne relapsing fever in Bahir Dar city, north-west Ethiopia

Background: Louseborne relapsing fever (LBRF) is an acute febrile illness caused by Borrelia recurrentis (B. recurrentis). It is transmitted by body lice, Pediculus humanus corporis (P. humanus corporis). LBRF is more prevalent in high risk populations such as prisoners, street children and yekolotemaries (traditional students of the Ethiopian Orthodox Church with low levels of socio economic status and poor personal hygiene). Thus, this study was conducted to assess the knowledge, attitude and practices (KAPs) among high risk populations towards LBRF prevention in Bahir Dar city. Methods: A crosssectional survey was conducted on KAPs of high risk populations regarding LBRF from November to December, 2012. Data was collected using a standardized pretested closed ended questionnaire by face to face interviews to address socio demographic characteristics, KAPs and sources of information regarding LBRF prevention. The overall KAPs of the study participants were analyzed using the sum score of each outcome based on Bloom’s cut-off point (60-80%). Having a score above the cut-off point was equated with having high levels of knowledge, positive attitude and good practice. Results: Of the 407 study participants, 383 (94.1%) were males with the mean age of 31 years. Among the study participants, 243 (59.7%) had no formal education. The response rate of the participants was 98.2%. Overall, 222 (54.5%) of the study participants had low knowledge, 247(60.7%) had neutral attitude (30-39 scores out of 50 itemquestions on LBRF) and 320 (78.6%) had fair practice (20-25 scores out of 32 item-questions). Prisoners had the highest knowledge, attitude and practices followed by street children and yekolotemaries towards LBRF prevention (p < 0.001). Conclusion: The overall KAPs of the high risk populations towards prevention of LBRF were poor. However, prisoners had highest level followed by street children and yekolotemaries. Moreover, the sources of information on LBRF received by the high risk populations have determined their KAP levels towards LBRF prevention. This showed that information on LBRF using television, radio and through their friends is essential to bring knowledge and attitudinal change towards LBRF prevention.