Knowledge, attitudes and practices (KAP) regarding leptospirosis among residents of riverside settlements of Santa Fe, Argentina

Background: Leptospirosis is a global and re-emerging zoonotic disease caused by Leptospira spirochetes that are shed into the environment by infected animals. Humans can get infected via contact with animal hosts or contaminated environment. In Argentina, the highest annual incidences were reported in the province of Santa Fe, where epidemic outbreaks occurred during flooding events. This study examined the knowledge, attitudes and practices (KAP) regarding leptospirosis among residents of riverside slum settlements from Santa Fe after a major flood. Methods and findings: A cross-sectional questionnaire was administered to 113 residents of 3 riverside settlements from Santa Fe. The influence of knowledge and attitudes regarding leptospirosis on the likelihood that an individual will use preventive practices were evaluated using linear mixed-effects models. The majority of respondents (83.2%) had previously heard about leptospirosis; however specific knowledge about leptospirosis was limited. The results of the modeling efforts, show that the likelihood of using preventive practices was associated with having greater knowledge score, but not with more positive attitudes. We also found that females were more likely to use safer practices than males. Conclusions: Even though the majority of respondents had heard about leptospirosis, a high percentage of them had limited knowledge regarding the severity of the disease and its prevalence in the region. Our results suggest that public health interventions in these riverside communities should focus on educating the public on the multiple dimensions of leptospirosis in order to attain greater adherence to preventive practices instead of intending to change the perceptions or attitudes towards the disease, which did not have a significant influence. The key challenge lies in identifying effective strategies to reach the high risk group for leptospirosis here that is male fishermen, who spend most of the time in precarious campsites on the river islands. Author summary: Leptospirosis is a zoonotic bacterial disease that has been recognized as a growing public health problem affecting mainly residents from slum settlements located in floodable areas. As such, it is considered a neglected disease that needs greater attention to reduce its global burden. A key step towards this purpose is to identify factors that influence the adherence to preventive practices regarding leptospirosis in endemic areas. We conducted a survey on residents of riverside settlements of the province of Santa Fe, an endemic area in Argentina, in order evaluate the knowledge, attitudes and practices regarding leptospirosis. Our results suggest that risky practices were performed mainly by men and that, contrary to our expectations, having a positive attitude towards leptospirosis does not appear to influence the likelihood of performing preventive practices, while greater knowledge about the disease does lead to safer practices. Public health officials should develop a comprehensive plan with diverse information, education and communication activities to promote a better understanding of the symptoms, treatment and prevention of leptospirosis by the various actors involved.