Cholera in Syria, a crisis following crises: Assessment of knowledge, attitude, and practice in a cohort of syrian population

Cholera is an acute bacterial disease caused by intestinal infection with Vibrio cholerae. It is one of the major re-emerging communicable diseases in Syria following the Syrian crisis and the Covid-19 pandemic. The current study was undertaken to explore the level of awareness in a cohort of the Syrian population by testing their knowledge and investigating their attitudes and practices. An internet-based survey that queried knowledge of cholera transmission, prevention, risk factors, and treatment was designed. Of particular interest was revealing sources of information associated with higher knowledge. Furthermore, individual attitudes and practices towards the disease were collected and analyzed. Participants were 1521, mostly females (68.3%), 18–25 years old (56.4%), single (72.7%), and college degree holders (75.9%). The main sources of information on cholera were school/college (31.7%), social media (28.7%), family and friends (13.2%), and online search engines (11.3%). The average total knowledge of the cohort was 40.39%. The participants >40 years old, highly educated, living in urban areas, and females demonstrated higher knowledge of cholera. Schools/colleges and online search engines were associated with better knowledge. Most of the cohort showed serious attitudes and considered cholera a very dangerous disease. They were very concerned about cholera resurfacing in the country and were worried about getting infected. The majority of the cohort were leading their lives favorably by eating out/takeaway <5 times a month; however, their practices regarding handling raw produce were suboptimal. Succeeding cholera re-emergence, females, highly educated, and >40 years old participants were more committed to changing practices and taking stricter safety measures. As cholera imposes a health threat not only to Syrians but to the people of the whole Middle East, preventive strategies were suggested, mainly raising awareness with more focused media means and vaccination of people at high risk in the affected areas of the governorates.