Knowledge and practices of the adult population on diarrheal diseases, transmission, and prevention in Sierra Leone: A community-based cluster survey

Abstract

INTRODUCTION 
 There is limited information on the knowledge and prevention practices of diarrheal disease transmission among adults in Sierra Leone. We assessed the level of knowledge and practices of adults on diarrheal disease transmission and prevention in Sierra Leone. 
 METHODOLOGY 
 A community-based cross-sectional cluster survey was conducted in four districts of Sierra Leone. A pre-tested, structured questionnaire was used to collect demographic, knowledge and practices on water, sanitation and hygiene (WASH), diarrheal diseases transmission and prevention. On Knowledge questions, a score above 50% was categorized as adequate and below 50% was categorized as poor. We calculated frequencies, proportions and chi-square to compare knowledge and practice differences between urban and rural settings. 
 RESULTS 
 Of the total 926 study subjects, 676 (73%) were female, with a median age of 29 years (range:18 - 96 years). Almost, 75% (671/926) of study participants had adequate knowledge of the critical moments of hand washing, higher in urban (79%) compared to rural areas (66%), (p<0.001). Forty-one per cent (377/926) of the study participants had limited knowledge of diarrheal diseases transmission with 48% in urban and 33% in rural areas (p<0.001), 87% (801/926) had limited knowledge of the measures of diarrheal diseases prevention, higher in rural, 416 (92%) compared to urban, 385 (81%), (p<0.001). 
 CONCLUSION 
 Study participants had adequate knowledge on the importance of handwashing, and the critical times to wash hands. Study participants had limited knowledge about the transmission and prevention of diarrheal disease. The majority of the study subjects practice hand hygiene and safe water treatment method in urban as compared to rural settings. We recommend developing a WASH-related sensitization program to improve community awareness of diarrheal disease transmission and prevention.