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

Abstract

Cystic echinococcosis (CE), caused by Echinococcus granulosus sensu lato, is a parasitic zoonosis of major public health and economic significance. Ethiopia is among the most affected countries, yet baseline data on community knowledge, attitudes and practices (KAP) relating to CE remain limited. A cross-sectional questionnaire survey was administered to 310 individuals across four regions and four city administrations in central, western, southern and southwestern Ethiopia between May and August 2025. Data were analysed descriptively using chi-square tests, and multiple correspondence analysis (MCA) was applied to document latent KAP profiles in relation to education level. Respondents were predominantly male, rural and engaged in farming, although veterinarians and other occupational groups were represented. Dog ownership was common, livestock were largely grazed on open pasture, and high-risk behaviours were widespread, including free-roaming dogs, backyard slaughter, feeding infected offal to dogs, and consumption of raw vegetables and unboiled water. More than half of respondents demonstrated limited knowledge, negative attitudes and risky practices, whereas only small proportions exhibited sound knowledge, positive attitudes or safe practices. Veterinarians scored highest overall, while farmers and rural residents scored lowest, and education was strongly associated with improved knowledge and safer practices. MCA revealed heterogeneous behavioural profiles and an incomplete translation of knowledge into practice. These findings highlight persistent awareness-behaviour gaps and underscore the need for coordinated, context-specific interventions, including culturally tailored education, regular dog deworming, improved abattoir services, and guidance on safe slaughter and household hygiene, aligned with the WHO 2030 roadmap for neglected tropical diseases and the Sustainable Development Goals.