Assessment of communal farmers' knowledge of foot-and-mouth disease (FMD) within the FMD protection zone with vaccination of Limpopo and Mpumalanga Provinces, South Africa.

Foot-and-mouth disease (FMD) is a highly contagious disease affecting domestic livestock and its control in South Africa depends on methods including event-based surveillance and the reporting of disease by farmers. This study assessed FMD knowledge level among small-scale, communal livestock farmers in South Africa's FMD zone with vaccination. A cross-sectional study was conducted with 629 farmers from 44 dip-tanks (animal assembly points). A FMD knowledge score was derived from 25 yes/no questions with scores above the median classified as high FMD knowledge. Mixed-effects logistic regression was used to evaluate predictors of high FMD knowledge with associations reported as odds ratios (OR) and their corresponding 95 % confidence intervals (CI). Eighty percent of the participants were male and 65 % aged 60 or older. The most common livestock raised was cattle (98.1 %). Sixty-six percent (415/629) of the interviewed farmers reported that they were aware of the existence of FMD. Formal education (OR 2.0, 95 % CI, 1.4-2.9, P < 0.001), poultry ownership (OR 1.7, 95 % CI 1.1-2.5, P = 0.006), livestock farming as the main occupation (OR 1.6, 95 % CI 1.1-2.3, P = 0.026) and the total livestock units of their farm (OR 1.5, 95 % CI 1.1-1.9, P = 0.002) were significant predictors of FMD recognition. Most respondents (54 %) that claimed to be aware of the existence of FMD did not know that African buffalos were a source of FMD virus. Also, less than half of the respondents cited lameness (38 %) and excessive salivation (37 %) as the main FMD clinical signs. Only a small proportion (2.4 %) of these respondents were aware that movement of infected animals can cause FMD virus to spread to new areas. FMD knowledge scores were calculated for the 415 respondents claiming to be aware of the existence FMD with 174 (42 %) having a total knowledge score greater than the median (hereafter referred to as "high FMD knowledge" compared to the rest of the farmers). Farmers from Vhembe District in Limpopo had an odds of high FMD knowledge four times higher than those in Ehlanzeni District in Mpumalanga (OR 4.0, 95 % CI 1.7-9.4, P = 0.002). Farmers that owned more than 15 cattle (OR 1.7, 95 % CI 1.0-2.8, P = 0.035) and farmers that supervised their own cattle during grazing (OR 1.6, 95 % CI 1.0-2.5, P = 0.043) also had a significantly higher odds of high FMD knowledge. Communal farmers in South Africa have gaps in their FMD knowledge and specifically were not aware that movement of infected animals and their products pose a threat for the spread of FMD. Comprehensive information, education and training for communal livestock farmers are essential for improving event-based surveillance and FMD prevention and control in the region.