Knowledge, Attitudes, and Practices regarding Anthrax among affected Communities, Kazo District, South-Western Uganda, May 2022

Background Anthrax is a priority zoonotic disease in Uganda. Despite health education about risks of eating meat from animals found dead, some areas including Kazo District, experience repeated anthrax outbreaks associated with this practice. We assessed the knowledge, attitudes, and practices (KAP) around anthrax and consumption of meat of animals found dead in previously-affected communities in Kazo District. Methods We conducted a mixed-methods study in six villages in Kazo District from May 23-June 4, 2022. We administered structured questionnaires to 200 systematically-sampled community respondents aged ≥ 18 years about anthrax-related KAP and experiences with livestock loss. We conducted focus group discussions with community members identified as anthrax case-patients in previous outbreaks and those whose animals died suddenly in the previous year. We assessed overall knowledge through a set of eight questions on anthrax; species affected, signs and symptoms, transmission and prevention in humans and animals. We scored participants’ responses to KAP questions as 1 = correct or 0 = incorrect; adequate knowledge score was ≥ 4. Qualitative data were analyzed using content analysis. Results Among 200 survey respondents, 65% were female; mean age was 45 (SD ± 17.7) years. In total, 94% had heard of anthrax, 70% knew it was zoonotic; 63% did not know any signs of anthrax in animals, though 73% knew transmission could occur through eating animals found dead. Only 16% said they had lost their livestock suddenly in the last year; of these, 21% consumed the meat and 53% buried the carcasses. Overall, 77% had adequate knowledge about anthrax. Qualitative data indicated that farmers did not vaccinate their animals against anthrax due to cost, and inadequate access to vaccine and veterinary services. Poverty, limited access to meat protein, and economic challenges were cited as drivers for consuming meat from animals found dead despite the risk. Conclusion Good knowledge about anthrax among residents of a repeatedly-affected community did not translate to safe practices. It may be difficult for affected communities to forego opportunities to eat meat from animals they find dead, even when they suspect possible danger. Compensating farmers for anthrax-positive carcasses in exchange for permitting safe animal disposal might reduce risk of transmission.