Knowledge and practices related to plague persistence in plague-endemic foci, Mbulu District, Tanzania.

Introduction: Plague continues to be a major public health concern in African countries. Several social practices and environmental conditions have been associated with the reoccurrence of bubonic plague, especially in places where the disease is prevalent. Therefore, it remains important to understand people knowledge, behavior and practices related to disease risks in order to identify factors that may hinder prevention and control strategies in the foci. Methods and results: A study survey of 100 households was conducted in Mbulu district to assess plague knowledge, factors that influence flea bite and measures used for rodent and flea control. Majority of participants (86%) were familiar with the plague disease and about (50%) mentioned swelling lymph nodes as a common symptom. Most of the participants (62%) claimed to observe human plague cases during the long rain season. The majority of participants (97%) reported to experience flea bite in their domestic settings, with most stating that they experienced more flea bites during the dry season. Houses with livestock had a greater likelihood of flea bite (OR = 2.7; 95% CI: 0.36–18.80, p = 0.267) compared to houses with no livestock. Furthermore, residents reported using both local and chemical methods to control rodents and flea inside houses. Most respondents preferred using local methods in flea control. Respondents stated that the efficacy of flea control methods being applied ranged from few days to several months. There was limited knowledge of the residual effects of the agricultural chemicals being used to control fleas among the surveyed community. Conclusion: Our study highlights the importance of raising awareness and adopting effective control methods for controlling fleas and lower the risk of plague transmission and other flea borne diseases in the local communities. Sensitization of the local community on the use of appropriate chemicals for flea control is urgent to avoid any potential long-term impacts of the residual effects on the health of the local communities. Author summary: Plague is a significant health challenge in Africa due to environmental conditions, lifestyle, and behaviors of the people living mostly in persistent areas. Understanding people's knowledge on the environmental conditions and lifestyle practices related to plague transmissions is essential to preventing the disease spread. We assessed community understanding on plague, factors influencing flea bites, and methods used to control rodents and fleas in the plague foci to inform the development of the potential mitigation strategies for the disease. Majority of respondents were familiar with the disease; however, few were aware of its symptoms. They reported that human cases occurred during the rainy season, with frequent flea bites experienced during the dry season. Also, households keeping livestock inside sleeping houses had a higher likelihood of flea bites compared to those without livestock. Furthermore, residents reported using both local and chemical methods to control rodents and fleas with the majority preferring local methods for flea control. Respondents stated the efficacy of the flea control methods used ranged from days to months, although there was limited understanding of the long-term health effects of the chemical residuals used among the surveyed community. The study findings emphasize the importance of understanding community awareness and preventive measures in controlling the spread of plague and call for greater community awareness raising on using appropriate flea control methods. Understanding local practices and preventive methods aids the development of interventions that are safer and more acceptable to the community, ultimately leading to more effective control strategies in these rural settings. [ABSTRACT FROM AUTHOR]