KNOWLEDGE, ATTITUDE, PERCEPTION AND THE BEHAVIOUR OF THE COMMUNITY TOWARDS VISCERAL LEISHMANIASIS (KALA - AZAR) IN LOIMA SUB - COUNTY OF TURKANA COUNTY, KENYA

Background : Visceral Leishmaniasis (Kala - azar) is a serious disease caused by species of the parasitic protists Leishmani and transmitted by Phlebotomus sandflies . It is classified as a neglected disease yet it is a public health problem, a debilitating disease causing an estimated 500,000 new cases each year, and a tenth of these patients will die in the endemic areas. Objective: To assess the knowledge, attitude, perception and the behaviour of the community towards kala - azar in Loima Sub - County of Turkana County, Kenya . Methods: Descriptive cross - sectional research design was employed and the study was conducted between October, 2015 and June, 2016. Cluster rand om sampling technique was used to identify study subjects in the purposively selected Loima area. A sample size of 341 respondents who were household heads or adult members were randomly sampled. Data collection was done using pretested structured question aires, interviews, focus group discussions and observations; entered into Statistical Package for Social Sciences (SPSS) version 17.0 for analysis and presentation done using both quantitative and qualitative approaches . The chi – square test with 95 CI w as used to compare the association between variables. P - value of less than 0.005 was considered as a level of significance. Results: The key factors influencing knowledge, attitude, perception and behaviour towards the disease in the community and with sig nificant association include:Age ((OR=0.6; 95%CI= (0.1 - 1.0), p=0.113) ,gender(OR=0.6; 95%CI= (0.2 - 0.8), p=0.011), educational level (OR=1.1; 95%CI= (0.4 - 1.6), p=0.0341, socio - economic status, housing (OR=1.6; 95%CI= (1.0 - 3.0), p=0.024 ), behaviour of res ting or sitting near termite mounds 70%(n=191) (OR=0.6; 95%CI= (0.1 - 2.1), p=0.0043)) and lack of proper knowledge on transmission of disease. Also, human practices such as deforestation and hunting 52%(n=32), and dancing at night (Edong'a - 64.8%(n=167), wh en the sand flies are active. Conclusion: The study concludes that kala - azar is endemic in the area and though the community is aware of its existence, the residents have different of beliefs about the transmission. The study recommends the need for enha nced general health education and awareness on the transmission cycle of kala - azar. Community empowerment and participation should be emphasized as well as structural development plans that include sand fly management strategies and control methods that wo uld ensure the removal of breeding and resting sites of the vectors within human habitation.