Zoonotic disease knowledge, attitudes, and livestock biosecurity practices among community members in Ada East District, Ghana: a concurrent mixed-methods study

Zoonotic diseases disproportionately burden settings where humans and livestock coexist, yet community-level knowledge, attitudes, and practices (KAP) remain poorly characterized in West Africa. This study aimed to assess KAP regarding zoonotic diseases and document household biosecurity gaps among livestock-keeping community members in Ghana. A concurrent mixed-methods design was employed, integrating a quantitative cross-sectional survey with a qualitative focus group discussion. Livestock-keeping adults were recruited from five health facilities in Ada East District. A structured survey measured knowledge, attitudes, and livestock-handling practices. Composite KAP scores were dichotomized using a modified Bloom’s cutoff (≥ 60%). Multivariable logistic regression analyses were conducted to identify factors associated with good knowledge, positive attitudes, and good practices. A focus group discussion (FGD) explored perceptions of transmission, livestock management, and outbreak preparedness. Among 252 survey participants, 66.3% demonstrated good overall knowledge of zoonotic diseases; however, only 10.6% had good knowledge of Ebola virus disease symptoms. Positive attitudes were observed in 44.0% of respondents, while 86.9% reported good livestock-handling practices. Education beyond primary school was independently associated with higher odds of good knowledge (adjusted odds ratio (aOR) 1.97, 95% confidence intervals (CI) 1.05–3.69). Animal-related occupations were associated with lower odds of positive attitudes (aOR 0.46, 95% CI 0.25–0.85) but higher odds of good practices (aOR 3.58, 95% CI 1.26–11.8). FGD (n = 8) identified bats and sick animals as transmission sources, described economic barriers, and expressed variable beliefs regarding prevention and stigma. These findings highlight the need for locally tailored, One Health–oriented risk communication and biosecurity interventions targeting groups with lower educational attainment and limited access to animal health services.