Community knowledge, attitudes and practices related to cystic echinococcosis in Ethiopia: implication for control

Background: Cystic echinococcosis (CE), caused by Echinococcus granulosus, is a parasitic zoonosis of major public health and economic importance. Ethiopia is among the most endemic countries, yet baseline data on community knowledge, attitudes and practices are scarce. Addressing these issues are essential to reduce transmission, mitigate economic and public health impacts, and align national strategies with the WHO 2030 roadmap in combating neglected tropical disease and the Sustainable Development Goals.

Methods: We conducted a cross-sectional survey of 310 randomly selected participants across different regions of Ethiopia using a Research Electronic Data Capture administered questionnaire. The survey primarily included farmers; however, veterinarians, educators, abattoir workers, and others were also represented. Knowledge was assessed using ten binary questions while attitudes and practices were evaluated using 11 and 13 items, respectively. Data were analysed using descriptive statistics and chi-square tests in R software, and multiple correspondence analysis (MCA) was applied to identify latent KAP profiles in relation to education level.

Results: Farmers constituted the largest proportion (54.2%, n = 168), followed by veterinarians (20.3%), abattoir workers and butchers (11.6%). Dog ownership was common, and most livestock were grazed on open pasture. Only 11.0% (n = 35) of respondents demonstrated good knowledge of CE, the majority of whom were veterinarians, while 56.0% (n = 174) had limited knowledge. Furthermore, only 22.6% of respondents exhibited a positive attitude toward CE, whereas 54.2% displayed a negative attitude. Safe practices were observed in only 2.6% of respondents, while 71.3% reported risky practices. Education was strongly associated with greater awareness and safer practices. MCA revealed heterogeneous behavioural profiles across the study population.

Conclusion: These findings highlight entrenched knowledge gaps and behaviours that perpetuate CE endemicity in Ethiopia, reflecting both cultural practices and structural constraints. Addressing this burden will require coordinated One Health interventions that combine culturally tailored health education with regular dog deworming, improved abattoir services and surveillance, safe slaughter practices and better household hygiene.