Public knowledge,practices and perceptions on typhus fevers in Southern Sri Lanka

Objective:To assess public knowledge,practices and perceptions on typhus fevers in Sri Lanka.Methods:A descriptive study was done in four selected typhus-prone areas in Southern Sri Lanka.A mixed-method was employed using face-to-face interviews and questionnaire-based surveys among confirmed cases of typhus and at-risk populations,respectively.Frequencies,percentages,and means were used to characterize socio-demography and evaluate disease awareness.Results:The lay terms for typhus fevers reported in the studied region were“peacock fever”,“tick fever”and“bird fever”.A total of 499 subjects participated[mean±SD,(45±16)years]in the questionnaire-based survey,and 13.6%(n=68)reported past experience of typhus fever,1.2%(n=6)identified the disease as“typhus”while 58.7%(n=293)and 11.8%(n=59)knew it as‘peacock fever’and‘tick fever’,respectively.The etiological agent was unknown to 95.2%(n=475),but 53.5%(n=267)were aware that it was vector-borne.Fever(57.3%,n=286),eschar(35.7%,n=178),headache(22.0%,n=267)and myalgia(19.2%,n=96)were identified as key symptoms.Past disease experience was significantly associated with higher awareness of the main disease symptoms(fever:χ^(2)=15.713,P<0.001;headache:χ^(2)=19.447,P<0.001;lymphadenopathy:Fisher’s exact test,P=0.023;eschar:χ^(2)=12.049,P<0.001).None knew of any disease prevention methods.Participants with a past history of typhus fever had sought treatment at state hospitals(55.9%,38/68)and private sector hospitals(5.9%,4/68).Conclusions:Public awareness on preventive practices for typhus fevers was rare among the participants though vector-borne aspect was known to many.Clinical disease awareness was deficient among those without past experience of typhus fever.Community sensitization on vector avoidance strategies is highly recommended.