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Published in: BMC Infectious Diseases 1/2021

Open Access 01-12-2021 | Research article

Knowledge, attitude and perceptions about Crimean Congo Haemorrhagic Fever (CCHF) among occupationally high-risk healthcare professionals of Pakistan

Authors: Ali Ahmed, Muhammad Saqlain, Maria Tanveer, Azhar Hussain Tahir, Fakhar Ud-Din, Maryum Ibrar Shinwari, Gul Majid Khan, Naveed Anwer

Published in: BMC Infectious Diseases | Issue 1/2021

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Abstract

Background

Crimean Congo Haemorrhagic Fever (CCHF), a tropically neglected infectious disease caused by Nairovirus, is endemic in low middle-income countries like Pakistan. Emergency health care professionals (HCPs) are at risk of contracting nosocomial transmission of CCHF. We, therefore, aim to analyze the knowledge, attitudes, and perceptions (KAP) of at-risk physicians, nurses, and pharmacists in Pakistan and the factors associated with good KAP.

Method

A validated questionnaire (Cronbach’s alpha 0.71) was used to collect data from HCPs in two CCHF endemic metropolitan cities of Pakistan by employing a cross-sectional study design. For data analysis percentages, chi-square test and Spearman correlation were applied by using SPSS version 22.

Results

Of the 478 participants, 56% (n = 268) were physicians, 37.4% (n = 179) were nurses, and 6.5% (n = 31) were pharmacists. The proportion of HCPs with good knowledge, attitude, and perception scores was 54.3%, 81, and 69%, respectively. Being a physician, having more work experience, having a higher age, working in tertiary care settings, were key factors for higher knowledge (p < 0.001). The correlation coefficient showed significant positive correlation between attitude- perception (r = 0.560, p < 0.001).

Conclusion

We have observed average knowledge of HCPs. Therefore, we recommend time to time education campaigns and workshops in highly endemic CCHF regions to be launched by health ministries and HCPs, in particular nurses, encouraged to follow authentic academic sources of information to prevent nosocomial transmission.
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Literature
1.
go back to reference Mourya DT, Yadav PD, Gurav YK, Pardeshi PG, Shete AM, Jain R, Raval DD, Upadhyay KJ, Patil DY. 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(1):104. https://doi.org/10.1186/s12879-019-3740-x. Mourya DT, Yadav PD, Gurav YK, Pardeshi PG, Shete AM, Jain R, Raval DD, Upadhyay KJ, Patil DY. 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(1):104. https://​doi.​org/​10.​1186/​s12879-019-3740-x.
2.
go back to reference Kamboj, Aman and H. Pathak. “Crimean-Congo Hemorrhagic Fever: a comprehensive review.” Vet World . 2013;6:812–7. Kamboj, Aman and H. Pathak. “Crimean-Congo Hemorrhagic Fever: a comprehensive review.” Vet World . 2013;6:812–7.
4.
go back to reference Appannanavar SB, Mishra B. An update on Crimean Congo Hemorrhagic Fever. J Global Infect Dis. 2011;3(3):285.CrossRef Appannanavar SB, Mishra B. An update on Crimean Congo Hemorrhagic Fever. J Global Infect Dis. 2011;3(3):285.CrossRef
5.
go back to reference Al-Abri SS, Al Abaidani I, 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.PubMedPubMedCentralCrossRef Al-Abri SS, Al Abaidani I, 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.PubMedPubMedCentralCrossRef
6.
go back to reference 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):63.PubMedPubMedCentralCrossRef 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):63.PubMedPubMedCentralCrossRef
8.
go back to reference Greiner AL, Mamuchishvili N, Kakutia N, Stauffer K, Geleishvili M, Chitadze N, et al. Crimean-Congo hemorrhagic fever knowledge, attitudes, practices, risk factors, and Seroprevalence in rural Georgian villages with known transmission in 2014. PLoS One. 2016;11(6). Greiner AL, Mamuchishvili N, Kakutia N, Stauffer K, Geleishvili M, Chitadze N, et al. Crimean-Congo hemorrhagic fever knowledge, attitudes, practices, risk factors, and Seroprevalence in rural Georgian villages with known transmission in 2014. PLoS One. 2016;11(6).
9.
go back to reference Rehman K, Bettani MAK, Veletzky L, Afridi S, Ramharter M. Outbreak of Crimean-Congo haemorrhagic fever with atypical clinical presentation in the Karak District of Khyber Pakhtunkhwa, Pakistan. Infect Dis Poverty. 2018;7(1):1–6.CrossRef Rehman K, Bettani MAK, Veletzky L, Afridi S, Ramharter M. Outbreak of Crimean-Congo haemorrhagic fever with atypical clinical presentation in the Karak District of Khyber Pakhtunkhwa, Pakistan. Infect Dis Poverty. 2018;7(1):1–6.CrossRef
10.
go back to reference Koculu S, Oncul A, Onal O, Yesilbag Z, Uzun N. Evaluation of knowledge of the healthcare personnel working in Giresun province regarding Crimean-Congo hemorrhagic fever before and after educational training. J Vector Borne Dis. 2015;52(2):166.PubMed Koculu S, Oncul A, Onal O, Yesilbag Z, Uzun N. Evaluation of knowledge of the healthcare personnel working in Giresun province regarding Crimean-Congo hemorrhagic fever before and after educational training. J Vector Borne Dis. 2015;52(2):166.PubMed
11.
go back to reference Leblebicioglu H, Sunbul M, Memish ZA, Al-Tawfiq JA, Bodur H, Ozkul A, et al. Consensus report: preventive measures for Crimean-Congo hemorrhagic fever during Eid-al-Adha festival. Int J Infect Dis. 2015;38:9–15.PubMedCrossRef Leblebicioglu H, Sunbul M, Memish ZA, Al-Tawfiq JA, Bodur H, Ozkul A, et al. Consensus report: preventive measures for Crimean-Congo hemorrhagic fever during Eid-al-Adha festival. Int J Infect Dis. 2015;38:9–15.PubMedCrossRef
12.
go back to reference Mallhi TH, Khan YH, Sarriff A, Khan AH. Crimean-Congo haemorrhagic fever virus and Eid-Ul-Adha festival in Pakistan. Lancet Infect Dis. 2016;16(12):1332–3.PubMedCrossRef Mallhi TH, Khan YH, Sarriff A, Khan AH. Crimean-Congo haemorrhagic fever virus and Eid-Ul-Adha festival in Pakistan. Lancet Infect Dis. 2016;16(12):1332–3.PubMedCrossRef
13.
go back to reference Ahmed A, Tahir MJ, Siddiqi AR, Dujaili J. Potential of Crimean-Congo Hemorrhagic fever outbreak during Eid-Ul-Adha Islamic festival and COVID-19 pandemic in Pakistan. J Med Virol. 2020. Ahmed A, Tahir MJ, Siddiqi AR, Dujaili J. Potential of Crimean-Congo Hemorrhagic fever outbreak during Eid-Ul-Adha Islamic festival and COVID-19 pandemic in Pakistan. J Med Virol. 2020.
15.
go back to reference Yousaf MZ, Ashfaq UA, Anjum KM, Fatima S. Crimean-Congo Hemorrhagic Fever (CCHF) in Pakistan: The “Bell” is Ringing Silently. Crit Rev Eukaryot Gene Expr. 2018;28(2). Yousaf MZ, Ashfaq UA, Anjum KM, Fatima S. Crimean-Congo Hemorrhagic Fever (CCHF) in Pakistan: The “Bell” is Ringing Silently. Crit Rev Eukaryot Gene Expr. 2018;28(2).
17.
go back to reference Zohaib A, Saqib M, Athar MA, Hussain MH, Sial A-u-R, Tayyab MH, et al. Crimean-Congo Hemorrhagic Fever Virus in Humans and Livestock, Pakistan, 2015–2017. Emerg Infect Dis. 2020;26(4):773.PubMedPubMedCentralCrossRef Zohaib A, Saqib M, Athar MA, Hussain MH, Sial A-u-R, Tayyab MH, et al. Crimean-Congo Hemorrhagic Fever Virus in Humans and Livestock, Pakistan, 2015–2017. Emerg Infect Dis. 2020;26(4):773.PubMedPubMedCentralCrossRef
18.
go back to reference Burney M, Ghafoor A, Saleen M, Webb P, Casals J. Nosocomial Outbrak of viral Hemorrhagic fever caused by Crimean Hemorrhagic fever-Congo virus in Pakistan, January 1976. Am J Trop Me Hyg. 1980;29(5):941–7.CrossRef Burney M, Ghafoor A, Saleen M, Webb P, Casals J. Nosocomial Outbrak of viral Hemorrhagic fever caused by Crimean Hemorrhagic fever-Congo virus in Pakistan, January 1976. Am J Trop Me Hyg. 1980;29(5):941–7.CrossRef
22.
go back to reference Yadav PD, Patil DY, Shete AM, Kokate P, Goyal P, Jadhav S, et al. Nosocomial infection of CCHF among health care workers in Rajasthan, India. BMC Infect Dis. 2016;16(1):624.PubMedPubMedCentralCrossRef Yadav PD, Patil DY, Shete AM, Kokate P, Goyal P, Jadhav S, et al. Nosocomial infection of CCHF among health care workers in Rajasthan, India. BMC Infect Dis. 2016;16(1):624.PubMedPubMedCentralCrossRef
23.
go back to reference 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(1):77–85.PubMedCrossRef 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(1):77–85.PubMedCrossRef
24.
go back to reference Yildirmak T, Tulek N, Bulut C. Crimean–Congo haemorrhagic fever: transmission to visitors and healthcare workers. Infect. 2016;44(5):687–9.CrossRef Yildirmak T, Tulek N, Bulut C. Crimean–Congo haemorrhagic fever: transmission to visitors and healthcare workers. Infect. 2016;44(5):687–9.CrossRef
26.
go back to reference Sheikh NS, Sheikh AS, Sheikh AA. Knowledge, attitude and practices regarding Crimean–Congo haemorrhagic fever among healthcare workers in Balochistan. J Ayub Med Coll Abbottabad. 2004;16(3). Sheikh NS, Sheikh AS, Sheikh AA. Knowledge, attitude and practices regarding Crimean–Congo haemorrhagic fever among healthcare workers in Balochistan. J Ayub Med Coll Abbottabad. 2004;16(3).
27.
go back to reference 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(1):1333.PubMedPubMedCentralCrossRef 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(1):1333.PubMedPubMedCentralCrossRef
28.
go back to reference Salimi M, Afshar AA, 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(6):546–50.CrossRef Salimi M, Afshar AA, 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(6):546–50.CrossRef
29.
go back to reference Athar MN, Baqai HZ, Ahmad M, Khalid MA, Bashir N, Ahmad AM, et al. Crimean-Congo hemorrhagic fever outbreak in Rawalpindi, Pakistan, February 2002. Am J Trop Med Hyg. 2003;69(3):284–7.PubMedCrossRef Athar MN, Baqai HZ, Ahmad M, Khalid MA, Bashir N, Ahmad AM, et al. Crimean-Congo hemorrhagic fever outbreak in Rawalpindi, Pakistan, February 2002. Am J Trop Med Hyg. 2003;69(3):284–7.PubMedCrossRef
30.
go back to reference Mofleh JA, Asghar RJ, Kakar R, Zaidi S, Kazi B. Nosocomial outbreak of Crimean-Congo hemorrhagic fever in holy family hospital, Rawalpindi, Pakistan, 2010. J Public Health Epidemiol. 2013;5(4):173–7. Mofleh JA, Asghar RJ, Kakar R, Zaidi S, Kazi B. Nosocomial outbreak of Crimean-Congo hemorrhagic fever in holy family hospital, Rawalpindi, Pakistan, 2010. J Public Health Epidemiol. 2013;5(4):173–7.
31.
go back to reference Raosoft I. Sample size calculator. Available from: ww raosoft com/samplesize 2004. Raosoft I. Sample size calculator. Available from: ww raosoft com/samplesize 2004.
34.
go back to reference Khan AM, Ansari J, Ishaq M, Muazam AR. Crimean Congo Hemorrhage Fever Cases in a Butcher Family at Hawailian, Abbottabad. J Saidu Med College. 2017;7(2):131–3. Khan AM, Ansari J, Ishaq M, Muazam AR. Crimean Congo Hemorrhage Fever Cases in a Butcher Family at Hawailian, Abbottabad. J Saidu Med College. 2017;7(2):131–3.
35.
go back to reference Cagdas SNA, SAGLAM ZA, Toprak D, Sargn F, Mutlu HH. Knowledge attitude and practice survey regarding Crimean Congo Hemorrhagic fever among a sample of physicians in Turkey; 2012. Cagdas SNA, SAGLAM ZA, Toprak D, Sargn F, Mutlu HH. Knowledge attitude and practice survey regarding Crimean Congo Hemorrhagic fever among a sample of physicians in Turkey; 2012.
36.
go back to reference Yolcu S, Kader C, Kayipmaz AE, Ozbay S, Erbay A. Knowledge levels regarding crimean-Congo hemorrhagic fever among emergency healthcare workers in an endemic region. J Clin Med Res. 2014;6(3):197.PubMedPubMedCentral Yolcu S, Kader C, Kayipmaz AE, Ozbay S, Erbay A. Knowledge levels regarding crimean-Congo hemorrhagic fever among emergency healthcare workers in an endemic region. J Clin Med Res. 2014;6(3):197.PubMedPubMedCentral
37.
go back to reference Suchitra J, Devi NL. Impact of education on knowledge, attitudes and practices among various categories of health care workers on nosocomial infections. Indian J Med Microbiol. 2007;25(3):181.PubMedCrossRef Suchitra J, Devi NL. Impact of education on knowledge, attitudes and practices among various categories of health care workers on nosocomial infections. Indian J Med Microbiol. 2007;25(3):181.PubMedCrossRef
38.
go back to reference Manzoor I, Daud S, Hashmi NR, Sardar H, Babar MS, Rahman A, et al. Needle stick injuries in nurses at a tertiary health care facility. J Ayub Med College Abbottabad. 2010;22(3):174–8. Manzoor I, Daud S, Hashmi NR, Sardar H, Babar MS, Rahman A, et al. Needle stick injuries in nurses at a tertiary health care facility. J Ayub Med College Abbottabad. 2010;22(3):174–8.
39.
go back to reference Ul-Haq Z, Shah BH, Ardakani M, Khan SA, Muhammad S, Farooq S, et al. Health system preparedness in Pakistan for crisis management: a cross-sectional evaluation study. East Mediterr Health J. 2019;25(8):553–61.PubMedCrossRef Ul-Haq Z, Shah BH, Ardakani M, Khan SA, Muhammad S, Farooq S, et al. Health system preparedness in Pakistan for crisis management: a cross-sectional evaluation study. East Mediterr Health J. 2019;25(8):553–61.PubMedCrossRef
40.
go back to reference Ozer A, Miraloglu M, Ekerbicer HC, Cevik F, Aloglu 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.PubMed Ozer A, Miraloglu M, Ekerbicer HC, Cevik F, Aloglu 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.PubMed
41.
42.
Metadata
Title
Knowledge, attitude and perceptions about Crimean Congo Haemorrhagic Fever (CCHF) among occupationally high-risk healthcare professionals of Pakistan
Authors
Ali Ahmed
Muhammad Saqlain
Maria Tanveer
Azhar Hussain Tahir
Fakhar Ud-Din
Maryum Ibrar Shinwari
Gul Majid Khan
Naveed Anwer
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2021
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-020-05714-z

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