Knowledge, attitude, and practices regarding Crimean Congo hemorrhagic fever among students at Jami university, Herat, Afghanistan
DOI:
https://doi.org/10.58342/ghalibMj.V.2.I.1.2Keywords:
CCHF, KAP, University Students, AfghanistanAbstract
Background: CCHF is a severe tick-borne viral disease with a high fatality rate, endemic in 50 countries. In Afghanistan, particularly in Herat, CCHF poses a significant public health challenge, with 1,537 suspected cases and limited awareness among high-risk populations.
Methods: A cross-sectional study was conducted at Jami University in Herat, Afghanistan, from August to October 2024. Using stratified random sampling, 350 students were surveyed through a self-administered questionnaire. The study assessed students' KAP regarding CCHF, with questions covering transmission, symptoms, prevention, and personal risk perception.
Results: Only 23.1% recognized it as transmissible, and 39.4% knew it was viral, while 63.4% identified tick bites as a transmission route, but only 29.7% were aware of transmission through animal meat or secretions. Attitudes showed that 94.6% considered CCHF dangerous, and 73.4% felt personally at risk. In terms of practices, 79.7% consistently sought healthcare advice, yet only 41.4% always avoided contact with infected animal blood or meat. Medical students displayed significantly better knowledge (36.1%), and more positive attitudes (46.2%) compared to non-medical students.
Conclusion: The study highlighted substantial gaps in CCHF awareness among university students, with variations between medical and non-medical students. The findings underscore the need for targeted educational interventions, practical preventive training, and addressing psychosocial barriers to improve disease prevention strategies.
References
Flick R, Whitehouse CA. Crimean-Congo hemorrhagic fever virus. Curr Mol Med 2005;5:753–60.
Atif M, Saqib A, Ikram R, Sarwar MR, Scahill S. The reasons why Pakistan might be at high risk of Crimean Congo haemorrhagic fever epidemic; a scoping review of the literature. Virol J 2017;14:1–7.
WHO. Crimean-Congo haemorrhagic fever n.d. https://www.who.int/news-room/fact-sheets/detail/crimean-congo-haemorrhagic-fever (accessed November 26, 2024).
Leblebicioglu H, Sunbul M, Memish ZA, Al-Tawfiq JA, Bodur H, Ozkul A, et al. Preventive measures for Crimean-Congo Hemorrhagic Fever during Eid-al-Adha festival. Int J Infect Dis 2015;38:9–15. https://doi.org/10.1016/j.ijid.2015.06.029.
Gargili A, Estrada-Peña A, Spengler JR, Lukashev A, Nuttall PA, Bente DA. The role of ticks in the maintenance and transmission of Crimean-Congo hemorrhagic fever virus: A review of published field and laboratory studies. Antiviral Res 2017;144:93–119.
Nasirian H. New aspects about Crimean-Congo hemorrhagic fever (CCHF) cases and associated fatality trends: A global systematic review and meta-analysis. Comp Immunol Microbiol Infect Dis 2020;69:101429. https://doi.org/10.1016/j.cimid.2020.101429.
Masood I, Tahir MJ, Naeem A, Shrateh ON, Ahmed A. The new wave of Congo virus in Pakistan: emerging threat. Trop Med Health 2023;51:62. https://doi.org/10.1186/s41182-023-00559-z.
Jamil H, Din MFU, Tahir MJ, Saqlain M, Hassan Z, Khan MA, et al. Knowledge, attitudes, and practices regarding Crimean-Congo hemorrhagic fever among general people: A cross-sectional study in Pakistan. PLoS Negl Trop Dis 2022;16:e0010988. https://doi.org/10.1371/journal.pntd.0010988.
Rahmani K, Behrad R, Rahimi A, Shayan S, Uğurlu G, Shayan NA. Epidemiology and Outcomes of Crimean-Congo Hemorrhagic Fever in Afghanistan: A Review of 2010–2019. Afghan J Infect Dis 2024;2:63–74. https://doi.org/10.60141/AJID/V.2.I.1.8.
Niazi A-R, Jawad MJ, Amirnajad A, Durr PA, Williams DT. Crimean-Congo Hemorrhagic Fever, Herat Province, Afghanistan, 2017. Emerg Infect Dis 2019;25:1596–8. https://doi.org/10.3201/eid2508.181491.
Sahak MN, Arifi F, Saeedzai SA. Descriptive epidemiology of Crimean-Congo Hemorrhagic Fever (CCHF) in Afghanistan: Reported cases to National Surveillance System, 2016–2018. Int J Infect Dis 2019;88:135–40. https://doi.org/10.1016/j.ijid.2019.08.016.
Al-Abri SS, Abaidani IA, Fazlalipour M, Mostafavi E, Leblebicioglu H, Pshenichnaya N, et al. Current status of Crimean-Congo haemorrhagic fever in the World Health Organization Eastern Mediterranean Region: issues, challenges, and future directions. Int J Infect Dis 2017;58:82–9. https://doi.org/10.1016/j.ijid.2017.02.018.
Ahmed A, Saqlain M, Tanveer M, Tahir AH, Ud-Din F, Shinwari MI, et al. Knowledge, attitude and perceptions about Crimean Congo Haemorrhagic Fever (CCHF) among occupationally high-risk healthcare professionals of Pakistan. BMC Infect Dis 2021;21:35. https://doi.org/10.1186/s12879-020-05714-z.
Rahnavardi M, Rajaeinejad M, Pourmalek F, Mardani M, Holakouie-Naieni K, Dowlatshahi S. Knowledge and attitude toward Crimean–Congo haemorrhagic fever in occupationally at-risk Iranian healthcare workers. J Hosp Infect 2008;69:77–85. https://doi.org/10.1016/j.jhin.2008.02.007.
Khan AS, Maupin GO, Rollin PE, Noor AM, Shurie HHM, Shalabi AGA, et al. An Outbreak of Crimean-Congo Hemorrhagic Fever in the United Arab Emirates, 1994–1995. Am J Trop Med Hyg 1997;57:519–25. https://doi.org/10.4269/ajtmh.1997.57.519.
Mourya DT, Yadav PD, Gurav YK, Pardeshi PG, Shete AM, Jain R, et al. Crimean Congo hemorrhagic fever serosurvey in humans for identifying high-risk populations and high-risk areas in the endemic state of Gujarat, India. BMC Infect Dis 2019;19:104. https://doi.org/10.1186/s12879-019-3740-x.
[Mostafavi E, Pourhossein B, Esmaeili S, Bagheri Amiri F, Khakifirouz S, Shah-Hosseini N, et al. Seroepidemiology and risk factors of Crimean-Congo Hemorrhagic Fever among butchers and slaughterhouse workers in southeastern Iran. Int J Infect Dis 2017;64:85–9. https://doi.org/10.1016/j.ijid.2017.09.008.
Sheikh N, Sheikh A, Sheikh AA. Knowledge, attitude and practices regarding Crimean-Congo haemorrhagic fever among healthcare workers in Balochistan. J Ayub Med Coll Abbottabad JAMC 2004;16 3:39–42.
Salimi M, Aghaei Afshar A, Limoee M, Babakhani S, Chatrabgoun O, Hanafi-Bojd AA, et al. Knowledge, attitude and practice of healthcare workers concerning Crimean-Congo hemorrhagic fever in Western Iran. Asian Pac J Trop Biomed 2016;6:546–50. https://doi.org/10.1016/j.apjtb.2016.04.007.
Hatami H, Qaderi S, Omid A. Investigation of Crimean-Congo hemorrhagic fever in patients admitted in Antani Hospital, Kabul, Afghanistan, 2017–2018. Int J Prev Med 2019;10:117. https://doi.org/10.4103/ijpvm.IJPVM_391_18.
Gorgich EAC, Arbabisarjou A, Abedi A, Barfrushan S. Knowledge of Medical Sciences Collegians about Protection against Crimean-Congo Hemorrhagic Fever (CCHF). Int J Humanit Soc Sci 2016;3:1642–53.
Ozer A, Miraloglu M, Ekerbiçer H, Cevik F, Aloğlu N. Knowledge levels about Crimean-Congo hemorrhagic fever among midwifery and nursing students in Kahramanmaras, Turkey. Southeast Asian J Trop Med Public Health 2010;41 1:77–84.
[Almorish MA, Al-Sayaghi KM, Alshoabi SA, Elneblawi NH, Machaly ER, Sobeh DES, et al. Knowledge and Attitudes Regarding Crimean-Congo Hemorrhagic Fever Among Slaughterhouse Workers in Sana’a and Dhamar Cities-Yemen: A Cross-Sectional Study. J Multidiscip Healthc 2024:3875–86.
Ahmed A, Tanveer M, Saqlain M, Khan GM. Knowledge, perception and attitude about Crimean Congo Hemorrhagic Fever (CCHF) among medical and pharmacy students of Pakistan. BMC Public Health 2018;18:1333. https://doi.org/10.1186/s12889-018-6248-1.
Bañuls P, Galán-Relaño Á, Romero-Salmoral A, Gómez-Gascón L, Tarradas C, Márquez RJA, et al. Knowledge, perception and attitude about Crimean-Congo Haemorrhagic Fever (CCHF) among veterinary students and professionals of Spain. Comp Immunol Microbiol Infect Dis 2024;115:102260.
Jalilian M, Chenary R, Mansori S, Sayyadi H, Aivazi A-A. Impacts of an educational program on rural women’s knowledge, attitudes and practices regarding Crimean Congo haemorrhagic fever (CCHF). J Hum Behav Soc Environ 2024;34:290–9.
Taqi F, Noori T, Shaker E. Knowledge level about Crimean-Congo hemorrhagic fever among a sample of medical students in Mosul City, Iraq. Rawal Med J 2023;48:614. https://doi.org/10.5455/rmj.20230427113738.
Fletcher TE, Gulzhan A, Ahmeti S, Al-Abri SS, Asik Z, Atilla A, et al. Infection prevention and control practice for Crimean-Congo hemorrhagic fever—A multi-center cross-sectional survey in Eurasia. PLOS ONE 2017;12:e0182315. https://doi.org/10.1371/journal.pone.0182315.
Safieyan P, Mansourian M, Pirouzeh R, Rahimi Khalifeh Kandi Z, Alipour H. Survey of Knowledge, Attitude, and Practice of Farmers About Crimean-Congo Hemorrhagic Fever. Thrita 2020;9. https://doi.org/10.5812/thrita.100006.
Ayub M, Hasnain S, Parveen F, Khan U, Alvi I, Nasir A, et al. Evaluation of Knowledge, Attitude and Perception towardsCrimean Congo Hemorrhagic Fever among Students: A CrossSectional Study. Electron J Biol 2016;12.
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 علی رحیمی, محمد مسعودی, سید عارف صالحی, محمد هادی بینش, سید فاروق حسینی, نثاراحمد شایان

This work is licensed under a Creative Commons Attribution 4.0 International License.