Knowledge, Attitudes, and Practices regarding Diarrhea and Cholera following an Oral Cholera Vaccination Campaign in the Solomon Islands

Background: In response to a 2011 cholera outbreak in Papua New Guinea, the Government of the Solomon Islands initiated a cholera prevention program which included cholera disease prevention and treatment messaging, community meetings, and a pre-emptive cholera vaccination campaign targeting 11,000 children aged 1–15 years in selected communities in Choiseul and Western Provinces. Methodology and Principal Findings: We conducted a post-vaccination campaign, household-level survey about knowledge, attitudes, and practices regarding diarrhea and cholera in areas targeted and not targeted for cholera vaccination. Respondents in vaccinated areas were more likely to have received cholera education in the previous 6 months (33% v. 9%; p = 0.04), to know signs and symptoms (64% vs. 22%; p = 0.02) and treatment (96% vs. 50%; p = 0.02) of cholera, and to be aware of cholera vaccine (48% vs. 14%; p = 0.02). There were no differences in water, sanitation, and hygiene practices. Conclusions: This pre-emptive OCV campaign in a cholera-naïve community provided a unique opportunity to assess household-level knowledge, attitudes, and practices regarding diarrhea, cholera, and water, sanitation, and hygiene (WASH). Our findings suggest that education provided during the vaccination campaign may have reinforced earlier mass messaging about cholera and diarrheal disease in vaccinated communities. Author Summary: We assessed knowledge, attitudes and practices of diarrhea and cholera disease and prevention in two areas of the Solomon Islands near Papua New Guinea. Both areas were ‘at risk’ for cholera disease and received messages about cholera prevention. Later, one of the areas also received vaccination against cholera. This was the first time cholera vaccine was administered to a population that had never reported cholera. Our survey found that people living in the area were cholera vaccine was administered were more likely to know the signs and symptoms and treatment of cholera, as well as be aware of cholera vaccine. We think this could be related to the extra education provided with vaccination. This was the first knowledge, attitudes, and practices survey about diarrhea and cholera disease and prevention and prevention in a population that had not been exposed to cholera.