EFFECT OF COMMUNITY-BASED HEALTH EDUCATION INTERVENTION ON KNOWLEDGE, ATTITUDES, AND PRACTICES TO WARDS BURULI ULCER IN ENDEMIC COMMUNITIES IN BENUE STATE, NIGERIA: A QUASI-EXPERIMENTAL STUDY

Buruli ulcer (BU), caused by Mycobacterium ulcerans, is a neglected tropical disease (NTD) that disproportionately affects rural communities in West and Central Africa. In Nigeria's Benue State, low community awareness, persistent cultural misconceptions, and delayed health-seeking behaviour remain critical barriers to early diagnosis and treatment. Community-based health education interventions represent a potentially effective strategy for improving knowledge, attitudes, and practices (KAP) in endemic populations, yet evidence from Nigeria remains sparse. This study evaluated the effect of a structured community-based health education programme on KAP towards Buruli ulcer among residents of endemic communities in Benue State, Nigeria. A quasi-experimental, non-equivalent control group pretest/post-test design was employed. Three communities in Benue State — Wadata, Andaka, and Abwa — were purposively selected. Participants aged ≥15 years were allocated to an intervention group (n = 180) or control group (n = 180). The intervention comprised structured health education sessions including group discussions, visual demonstrations, and distribution of culturally adapted materials. KAP was assessed at baseline, then at one, three-, and six-weeks post-intervention using a validated structured questionnaire. Paired t-tests and repeated measures analysis of variance (ANOVA) were used to assess within-group changes; independent t-tests compared between-group differences. Chi-square tests evaluated sociodemographic associations. Statistical significance was set at p < 0.05. At baseline, only 38.6% of participants had ever heard of Buruli ulcer. Following the intervention, mean knowledge scores improved significantly in the intervention group (pre: 41.25 ± 14.88 vs. post: 74.60 ± 13.42; t = -19.842; p < 0.001), representing an 80.8% improvement. Attitude scores improved markedly (pre: 50.18 ± 12.44 vs. post: 71.36 ± 11.90; t = -14.220; p < 0.001), and practice scores increased significantly (pre: 45.12 ± 13.67 vs. post: 69.80 ± 12.55; t = -16.903; p < 0.001). Gains were sustained across a six-week follow-up (F = 215.66, p < 0.001). No significant changes were observed in the control group. Education level was the only sociodemographic variable significantly associated with post-intervention KAP outcomes (p < 0.05). A structured community-based health education programme signific0antly and sustainably improved Buruli ulcer-related knowledge, attitudes, and preventive practices among residents of endemic communities in Benue State, Nigeria. These findings support integration of community health education into primary healthcare and NTD control programmes in endemic settings across Nigeria and sub-Saharan Africa.