Understanding Community Knowledge, Attitudes, and Practices: A Narrative Review For Designing Context-Specific Interventions to Control Transmission and Reduce Disease Burden

Lassa fever, a viral hemorrhagic illness endemic in West Africa, poses a significant public health threat in Nigeria, particularly in the northeastern region where recurring outbreaks persist. Understanding community knowledge, attitudes, and practices (KAP) is critical for designing context-specific interventions to control transmission and reduce disease burden. This review aims to synthesize existing literature on KAP regarding Lassa fever among residents of northeastern Nigeria. It explores how socio-cultural beliefs, awareness levels, and behavioral practices influence disease transmission and healthcare-seeking behaviors, while also highlighting implications for public health strategies. A narrative review of peer-reviewed articles, national surveillance reports, and WHO/NCDC documents published between 2000 and 2024 was conducted. Studies assessing Lassa fever-related knowledge, attitudes, and practices in the general population and healthcare settings in northeastern Nigeria were included. Findings reveal significant gaps in public knowledge about Lassa fever's transmission, symptoms, and prevention. Misconceptions—such as supernatural causation—remain prevalent and are linked to delayed health-seeking behaviors and reliance on traditional healers. Attitudinal barriers, including fear, stigma, and fatalism, further impede outbreak reporting and adherence to preventive measures. Common risky practices include poor food storage, inadequate rodent control, and improper waste management. Despite awareness campaigns, economic and infrastructural limitations continue to hinder sustained behavioral change. Bridging the gap between knowledge and practice requires culturally sensitive education campaigns, community engagement, improved access to healthcare, and socio-economic support. Integrating local belief systems and empowering community stakeholders are essential for enhancing Lassa fever prevention and control efforts in the region.