Factors Influencing Knowledge, Attitudes, and Practices Regarding Sickle Cell Disease Among the Tharu Community in Bardiya District, Nepal.

Abstract

Sickle cell disease (SCD) poses a major health burden among the Tharu community in Bardiya, Nepal, where gaps in knowledge, attitudes, and practices hinder effective disease prevention and management. This study aimed to assess the factors influencing knowledge, attitudes, and practice regarding SCD among the Tharu community in Bardiya District in Nepal. A community-based cross-sectional study was conducted among 423 individuals from the Tharu community across 3 municipalities in Bardiya District, Nepal, from April to September 2024, using a multi-stage random sampling technique. Data were collected through face-to-face interviews using a semi-structured questionnaire. Pearson's chi-square test and multivariable logistic regression analysis were performed at a 5% significance level to determine the associated factors. Of the total, 74.5% of the respondents demonstrated good knowledge, 70% exhibited positive attitudes toward SCD, while 81.8% displayed poor practices. Illiteracy and occupations such as laborer, farmer, housewife, and others were significantly associated with poor knowledge, negative attitudes, and poor practices. Male gender was linked to both poor knowledge and poor practice. Belonging to lower wealth quintiles was associated with negative attitudes and poor practices. Being aged ≥30 years was associated with poor practice only. Despite good knowledge and positive attitudes, SCD-related practices were poor among the Tharu community, influenced by age, gender, education, occupation, and income. Targeted, culturally appropriate interventions including awareness campaigns, school-based education, accessible screening, and genetic counseling are essential to improve practices and reduce SCD burden in Nepal.