Knowledge, attitude, and practice (KAP) of yellow fever among community members in four districts after an outbreak in the Savannah Region, Ghana

Abstract

Background objectives: In 2021, a Yellow Fever (YF) outbreak occurred in rural and mostly nomadic communities within the Savannah region of Ghana, leading to over 40 deaths. Following this outbreak, we determined the knowledge, attitude, and practice (KAP) of YF in these hotspot communities.

Methods: A cross-sectional study was conducted using a random sampling technique and a standard questionnaire involving face-to-face interviews from June 2022 to July 2022. Four districts were selected among the hotspot areas of the 2021 YF outbreak. The participants targeted were residents aged 15 years and above.

Results: The majority (80.8%) had heard about YF through healthcare personnel in all four districts. Most of them associated the cause with poor sanitation, but 14% specifically associated it with mosquito bites (N=869). The level of education was associated with awareness of YF (P = 0.008), however, a pairwise analysis did not show any association between those with no formal education and the highest education (P = 0.903). Vaccination rates were high (average 78%), and the distance to health facility influenced the vaccination status (P < 0.0001). Preventive measures employed included vaccination, sleeping under insecticide-treated bed nets, clearing bushes and getting rid of stagnant water.

Interpretation conclusion: There was high awareness of YF and vaccination rates among the participants. The emergency mass YF vaccination conducted in 2021 in response to the outbreak increased community awareness. Preventive practices employed may be associated with participants' knowledge of mosquito-borne diseases such as malaria. YF education should be integrated with routine health service delivery.

Keywords: Ghana; KAP; Savannah Region; Yellow Fever; attitude; knowledge; outbreak; practice.