Knowledge, perceptions, and practices of community health workers in zoonotic disease detection and reporting in Southwestern Uganda

Background Community health workers (CHWs) serve as the first point of contact between the healthcare system and communities, making them pivotal for early detection and effective response to zoonotic disease outbreaks. Southwestern Uganda is a known hotspot for recurrent zoonotic disease outbreaks, yet limited evidence exists on the capacity of CHWs in this region to detect and respond to these threats. We assessed the knowledge, perceptions, and practices of CHWs in zoonotic disease detection and reporting and factors associated with these outcomes in Mbarara, Kazo, Kiruhura, and Ibanda districts, Southwestern Uganda. Methods We conducted a cross-sectional study between November 2024 and March 2025. We included CHWs from both human and animal health, using systematic simple random sampling. We administered face-to-face interviews using standardized questionnaires. Responses were scored as 1 for positive and 0 for negative, with total scores categorized using Bloom’s cut-off points: <60% as poor, 60–80% as moderate, and > 80% as good. Modified Poisson regression was used to identify factors associated with knowledge, perceptions, and practices of CHWs. Results A total of 423 participants were included in the study. The majority (95%; n = 402) had low knowledge levels on zoonoses, with none reporting awareness of Crimean Congo Haemorrhagic Fever (CCHF). Community health workers who received training on their roles in detection and reporting were significantly more knowledgeable about anthrax (adjusted prevalence ratio [aPR] = 1.2, 95% CI: 1.1–5.3), viral haemorrhagic fevers (aPR = 2.2, 95% CI: 1.1–5.5), and rabies (aPR = 1.8, 95% CI: 1.6–2.1). CHWs in the human health sector had lower odds of recording zoonotic cases (aPR = 0.16, 95%CI: 0.07–0.38) and submitting reports (aPR = 0.42, 95% CI: 0.21–0.90) than animal extension workers. Trained CHWs reported better practices (aPR = 4.4, 95% CI:1.5–13) compared to those who were not trained. Conclusion We found that CHWs had low knowledge on zoonoses, with no participants aware of CCHF. Training on roles in detection and reporting was associated with improved knowledge and practices. CHWs in the animal sector were more likely to record and report zoonotic cases than their human health counterparts. Our findings highlight the need for targeted, cross-sectoral training programs to strengthen CHW capacity for early detection and reporting on zoonotic diseases in high-risk areas.