Field Epidemiology and Laboratory Training (FELTP) Kenya, Ministry of Health, Nairobi, Kenya.
County Government of Migori, Migori, Kenya.
PLoS One. 2020 Feb 26;15(2):e0229437. doi: 10.1371/journal.pone.0229437. eCollection 2020.
Cholera remains a public health problem in Kenya despite increased efforts to create awareness. Assessment of knowledge, attitude and practice (KAP) in the community is essential for the planning and implementation of preventive measures. We assessed cholera KAP in a community in Isiolo County, Kenya.
This cross-sectional study involved a mixed-methods approach utilizing a questionnaire survey and focus group discussions (FGDs). Using multistage sampling with household as the secondary sampling unit, interviewers administered structured questionnaires to one respondent aged ≥18 years old per household. We created knowledge score by allotting one point for each correct response, considered any total score ≥ median score as high knowledge score, calculated descriptive statistics and used multivariate logistic regression to examine factors associated with high knowledge score. In FGDs, we randomly selected the participants aged ≥18 years and had lived in Isiolo for >1 year, conducted the FGDs using an interview guide and used content analysis to identify salient emerging themes.
We interviewed 428 participants (median age = 30 years; Q1 = 25, Q3 = 38) comprising 372 (86.9%) females. Of the 425/428 (99.3%) who had heard about cholera, 311/425 (73.2%) knew that it is communicable. Although 273/428 (63.8%) respondents knew the importance of treating drinking water, only 216/421 (51.3%) treated drinking water. Those with good defecation practice were 209/428 (48.8%). Respondents with high knowledge score were 227/428 (53.0%). Positive attitude (aOR = 2.88, 95% C.I = 1.34-6.20), treating drinking water (aOR = 2.21, 95% C.I = 1.47-3.33), age <36 years (aOR = 1.75, 95% C.I = 1.11-2.74) and formal education (aOR = 1.71, 95% C.I = 1.08-2.68) were independently associated with high knowledge score. FGDs showed poor latrine coverage, inadequate water treatment and socio-cultural beliefs as barriers to cholera prevention and control.
There was a high knowledge score on cholera with gaps in preventive practices. We recommend targeted health education to the old and uneducated persons and general strengthening of health education in the community.
尽管肯尼亚加大了宣传力度，但霍乱仍然是一个公共卫生问题。评估社区的知识、态度和实践（KAP）对于规划和实施预防措施至关重要。我们评估了肯尼亚伊西奥洛县的社区的霍乱 KAP。
本横断面研究采用混合方法，利用问卷调查和焦点小组讨论（FGD）。采用多阶段抽样，以家庭为二级抽样单位，访谈员对每个家庭中年龄≥18 岁的一名受访者进行了结构化问卷调查。我们通过为每个正确回答分配 1 分来创建知识得分，将任何总分≥中位数的得分视为高知识得分，计算描述性统计数据，并使用多变量逻辑回归来检查与高知识得分相关的因素。在 FGD 中，我们随机选择年龄≥18 岁且在伊西奥洛居住超过 1 年的参与者，使用访谈指南进行 FGD，并使用内容分析来确定突出的新兴主题。
我们采访了 428 名参与者（中位数年龄=30 岁；Q1=25，Q3=38），其中 372 名（86.9%）为女性。在听说过霍乱的 425 名/428 名（99.3%）参与者中，311 名/425 名（73.2%）知道霍乱具有传染性。尽管 273 名/428 名（63.8%）受访者知道处理饮用水的重要性，但只有 216 名/421 名（51.3%）处理了饮用水。有良好排便习惯的有 209 名/428 名（48.8%）。有 227 名/428 名（53.0%）的受访者知识得分较高。积极的态度（aOR=2.88，95%CI=1.34-6.20）、处理饮用水（aOR=2.21，95%CI=1.47-3.33）、年龄<36 岁（aOR=1.75，95%CI=1.11-2.74）和正规教育（aOR=1.71，95%CI=1.08-2.68）与高知识得分独立相关。FGD 显示，较差的厕所覆盖率、处理水不足和社会文化信仰是霍乱预防和控制的障碍。
关于霍乱的知识得分较高，但预防措施存在差距。我们建议对老年人和未受教育者进行有针对性的健康教育，并加强社区的一般健康教育。
