Knowledge, attitude, and practices regarding Crimean Congo hemorrhagic fever among students at Jami university, Herat, Afghanistan

Authors

DOI:

https://doi.org/10.58342/ghalibMj.V.2.I.1.2

Keywords:

CCHF, KAP, University Students, Afghanistan

Abstract

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.

Author Biographies

Ali Rahimi, Faculty of Medicine, Jami University, Herat, Afghanistan

Faculty of Medicine, Jami University, Herat, Afghanistan & Faculty of Medicine, Herat University, Herat, Afghanistan

Mohammad Masudi, Faculty of Medicine, Jami University, Herat, Afghanistan

Faculty of Medicine, Jami University, Herat, Afghanistan & Faculty of Medicine, Herat University, Herat, Afghanistan

Sayed Aref Salehi, Faculty of Medicine, Herat University, Herat, Afghanistan

Faculty of Medicine, Herat University, Herat, Afghanistan

Mohammad Haid Binesh, Faculty of Medicine, Jami University, Herat, Afghanistan

Faculty of Medicine, Jami University, Herat, Afghanistan

Said Farooq Hosaini, Faculty of Medicine, Herat University, Herat, Afghanistan

Faculty of Medicine, Herat University, Herat, Afghanistan

Nesar Ahmad Shayan, Department of Epidemiology and Biostatistics, Western University, London-On, Canada

Department of Epidemiology and Biostatistics, Western University, London-On, Canada

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.

Downloads

Published

2025-04-19

How to Cite

1.
Rahimi A, Masudi M, salehi sayde aref, Binesh MH, حسینی SF, Shayan NA. Knowledge, attitude, and practices regarding Crimean Congo hemorrhagic fever among students at Jami university, Herat, Afghanistan . مجلۀ علوم طبی غالب [Internet]. 2025 Apr. 19 [cited 2025 Apr. 27];2(1):22-9. Available from: https://www.mj.ghalib.edu.af/index.php/mj/article/view/32