Knowledge, attitude, and practices to zoonotic disease risks from livestock birth products among smallholder communities in Ethiopia

Many causes of abortion in livestock are due to zoonotic pathogens that pose serious infection risks for humans. Carefully designed, empirical One Health research allows to untangle the complexity around these risks and guides the development of practical health education guidelines and best prevention practices for veterinary public health interventions. To support this, the study presented here aimed at understanding knowledge, attitudes, and practices (KAP) on zoonotic risks from livestock birth products among rural communities in Ethiopia. From July 2018 to February 2019, a cross-sectional study design was conducted with 327 randomly selected farmers and pastoralists in five districts in three regions in Ethiopia. The structured questionnaire consisted of 48 items to evaluate knowledge (24), attitude (9), and prevention practices (15) related to zoonotic diseases risks from livestock birth products. A unidimensional two-parameter logistic (2-PL) Item Response Theory (IRT) model was used for zoonotic disease risk KAP scale construction and evaluation. The 2-PL IRT model was fitted to determine the probability of a person to appropriately respond to an item with a provided zoonotic disease KAP level. We then examined differential item functioning (DIF) concerning to five important covariates. The attitude subscale had the highest total mean score (37.3, ± 28.92%) and the knowledge subscale had the lowest mean score (22.4, ± 33.6%) among the three subscales. The mixed model regression analysis indicated that region was the only apparent factor explaining differences in zoonotic diseases knowledge, attitude, and practice total mean scores. The knowledge and attitude subscales had good internal consistency with a Cronbach's α at 0.83 and 0.81, respectively, whereas the practice subscale had lower internal consistency with 0.51. There was a positive association between responding to knowledge questions correctly and a positive attitude (r2 = 0.44, p < 0.0001) and self-reported good practice (r(2) = 0.307, p < 0.0001). The differential item functioning test showed that 19 of 37 (51.35%) and 12 of 37 (32.43%) items of the retained KAPs survey items had non-uniform and uniform DIF linked to at least one covariate respectively and all the covariates were related with DIF in at least one item. This study found substantial knowledge gaps, a low level of the desired attitude, and high-risk behavioural practices regarding zoonotic disease from livestock birth products. Consequently, livestock keepers are likely exposed to pathogens and thus these practices are an important contributing factor for zoonotic disease infection in people.