Knowledge, Attitudes and Practices on Cholera and Water, Sanitation, and Hygiene among Internally Displaced Persons in Cabo Delgado Province, Mozambique

Francesco Di Gennaro Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy;
Operational Research Unit, Doctors with Africa CUAMM, Padua, Italy;

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Edoardo Occa Doctors with Africa CUAMM, Maputo, Mozambique;

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Ketan Chitnis Unicef Mozambique, Maputo, Mozambique;

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Giorgia Guelfi Doctors with Africa CUAMM, Maputo, Mozambique;

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Andrea Canini Doctors with Africa CUAMM, Maputo, Mozambique;

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Inusso Chuau Unicef Mozambique, Maputo, Mozambique;

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Simone Cadorin Doctors with Africa CUAMM, Maputo, Mozambique;

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Davide F. Bavaro Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy;

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Lucy Ramirez Doctors with Africa CUAMM, Maputo, Mozambique;

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Claudia Marotta Operational Research Unit, Doctors with Africa CUAMM, Padua, Italy;

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Sergio Cotugno Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy;

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Francesco V. Segala Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy;

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Angelo Ghelardi Unicef Mozambique, Maputo, Mozambique;

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Annalisa Saracino Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy;

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Isabel M. Periquito Unicef Mozambique, Maputo, Mozambique;

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Giovanni Putoto Operational Research Unit, Doctors with Africa CUAMM, Padua, Italy;

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Ally Mussa Nucleo de Investigacao Operacional de Pemba, Pemba, Mozambique

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ABSTRACT.

In disaster situations, cholera outbreaks represent a public health emergency due to their high fatality rates and high spreading risk through camps for refugees and internally displaced persons (IDPs). The aim of this study is to examine water, sanitation, and hygiene attitudes and cholera knowledge, attitude, and practice (KAP) among people living in resettlement sites in Cabo Delgado, the northernmost province of Mozambique. Between January 1 and March 31, 2022, a cross-sectional survey was conducted by administering a face-to-face interview to IDPs and residents in six relocation sites in Cabo Delgado Province. A total of 440 people were enrolled in the study. Overall, 77.8% (N = 342) were female, 61% (N = 268) were younger than 35 years old, and 60.5% (N = 266) reported primary school to be the highest education level. Seventy-five percent (N = 334) of participants lived with children under 5 years old. Thirty-one percent (N = 140) and 11.8% (N = 52) of the respondents reported, respectively, at least one cholera case and at least one diarrheal-related death among their family members in the previous 2 years. In multivariate analysis, being female, being younger than 35 years old, having attained a higher education level, owning a phone, or having soap at home were factors significantly associated with improved cholera KAP. In severely deconstructed social contexts, continuous education and community sensitization are crucial to achieve and maintain positive cholera prevention attitudes.

Author Notes

Address correspondence to F. Di Gennaro, Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari, p.zza G Cesare 13, Bari, Italy. E-mail: francesco.digennaro1@uniba.it

Authors’ addresses: Francesco Di Gennaro, Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy, and Operational Research Unit, Doctors with Africa CUAMM, Padua, Italy, E-mail: francesco.digennaro1@uniba.it. Edoardo Occa, Giorgia Guelfi, Andrea Canini, Simone Cadorin, and Lucy Ramirez, Doctors with Africa CUAMM, Mozambique, E-mails: e.occa@cuamm.org, g.guelfi@cuamm.org, andrea.canini1@gmail.com, s.cadorin@cuamm.org, and l.ramirez@cuamm.org. Ketan Chitnis, Inusso Chuau, Angelo Ghelardi, and Isabel M. Periquito, Unicef Mozambique, Mozambique, E-mails: kchitnis@unicef.org, ichuau@unicef.org, aghelardi@unicef.org, and iperiquito@unicef.org. Davide F. Bavaro, Sergio Cotugno, Francesco V. Segala, and Annalisa Saracino, Clinic of Infectious Diseases, Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy, E-mails: davidebavaro@gmail.com, sergio.cotugno@gmail.com, fvsegala@gmail.com and annalisa.saracino@uniba.it. Claudia Marotta and Giovanni Putoto, Operational Research Unit, Doctors with Africa CUAMM, Padua, Italy, E-mails: marotta.claudia@gmail.com and G.putoto@cuamm.org. Ally Mussa, Nucleo de Investigacao Operacional de PembaMozambique, E-mail: alymussamanuel@yahoo.com.br.

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