​Introduction
Anthrax is a zoonotic disease that affects humans, livestock, companion animals, and wild-life (Fasanella et al., 2010). It is a rare disease in developed countries (Dragon & Rennie, 1995), but still an endemic disease in developing countries (Shiva Chandra et al., 2016). B. anthracis, the anthrax causative agent, has a bimodal life cycle in which it develops spores in the environment and vegetates inside its host. According to Raymond et al. (2010), the spores can last in the environment for years under unfavorable circumstances and start an infection when the right circumstances are there. According to Dey et al. (2020), the livestock industry plays a significant role in improving the standard of living for the vast majority of rural residents in many developing nations. In addition to offering food, company, and sociocultural activities, they also generate cash in a number of ways since they play a significant economic role in the sale and services of these animals and their byproducts. People that rely on animals are more susceptible to zoonotic illnesses (Hossain et al., 2015).

Anthrax outbreaks in a given area are primarily determined by a number of variables, including the bacterium's distinct traits, environmental factors, animal density, and human activity. Anthrax outbreaks have been associated with ecological, demographic, and sociocultural factors. Anthrax epidemics are frequent in the dry season and are often associated with the onset of the first rains (Blackburn et al., 2010). The short grass during the dry season forces animals to graze closer to the ground, increasing the risk of ingesting anthrax spores. This is particularly true when slaughtering waste and corpses infected with anthrax have been dumped in areas where ruminants graze and reside.  Additionally, spores can spread across the environment by scavenging water, animals, and birds (Siamudaala et al., 2006). Repeated anthrax outbreaks in animals without vaccination have been reported; however, ongoing vaccination programs can break the cycle of transmission in domestic animals (Islam et al., 2013).

Human infection is frequently linked to consuming the meat of infected animals, as well as to exposure to contaminated animal materials or infected animals while engaging in agricultural activities, such as butchering livestock or industrial exposures through the processing of hair and bone (Mwakapeje et al., 2018).  From 2009 to 2013, there were 5,197 and 26,737 instances of human and animal anthrax, respectively, with 86 and 8,523 fatalities, according to government reports from Ethiopia (Bahiru et al., 2016). One study reported that the lack of awareness of zoonotic diseases was due to poor communication between veterinarians and human health-care professionals and the lack of involvement of educated family members in farming activities (Rajkumar et al., 2016).

1.1 Statement of problem

Adequate knowledge regarding this disease is essential for early recognition, detection, and notification. Inadequate monitoring, surveillance, and disease reporting, lack of public awareness, unrestricted movements, and poor management and vaccination strategies are the major factors to setting an appropriate control strategy against anthrax.

1.2 General Objective

• To assess the knowledge, attitude, and practices regarding anthrax among livestock owners in Meta Welkite district.

1.2.1 Specific Objectives

• To assess the current knowledge of animal owners regarding the cause, symptoms, prevention, and control activities of anthrax in the study area.
• To identify intervention gaps for anthrax prevention and control.
• To generate practical and implementable recommendations that will reduce the spread of the disease.

2. methods

2.1 Description of Study Area

The study was conducted in the Meta Welkite district in West Shoa Zone, Central Ethiopia. It was located at 103 km, from Addis Ababa and152 km from Ambo town, the zone capital city. The district was sub-divided into 21 (18 rural & 3 Urban) kebeles. Its annual rainfall ranges from 500 mm to 1000 mm.

Geographically, the district was located approximately between 9^o52”34.63” N latitudes and between 38^o23”34.49” E longitudes. The altitude ranges from 1500 up to 2780 masl, and agro-ecologically characterized as kola (Lowland-68%), Weyinadega (Mid-Land 27%) and dega (Highland-5%). The lowest and highest temperature of the area is 15℃ and 32℃ respectively. The district had a total population of 95,104 of whom 46,601 are men and 48,503 women. The livestock population of the district could be described as 150,347 cattle, 81,600 goats, 100,521 sheep, 32670 donkeys, 12,629 horses, 154 mules, and 62,527 poultry (MWWAO, 2024).

2.2 Study Design, Sample Size Determination and Sampling

A cross-sectional study was conducted from September up to November 2024 to assess the current KAP towards anthrax infection among livestock owners.

A total of 14 kebeles (PA’s) were selected randomly from the 21 kebeles (18 rural and 3 Urban Kebeles) in the district. The sample size was calculated using the single population proportion formula (Thrusfield and Brown, 2017)

n = (Z² * P * (1-P)) / E²

where n is the sample size, Z is the z-score corresponding to the desired level of confidence (e.g., 1.96 for a 95% confidence level), p is the estimated proportion of the population with the outcome of interest, and E is the desired margin of error.

n = (1.96² * 0.5 * (1-0.5)) / 0.5²

n = 384

This is by considering the following assumptions: there is no previous study on the knowledge, attitude and anthrax prevention practices in the study area. The sample size will be calculated by considering the assumptions of 50% prevalence, 95% confidence interval (Z=1.96), and 5% margin of error (d=0.05) revealed=384 and the owners were select randomly.

Figure 1: Study Area of the District (Adindan UTM zone, 37N)

2.4 Data Collection

The questionnaire was first translated from English to Afaan Oromoo (local language), and administered to the respondents. The questionnaires were then collected and translated in to English. The questionnaires focused on; the socio-demographic characteristics of the respondent; KAP assessing questions; and community practices towards animal anthrax infection in the study area.

2.5 Data analysis

Microsoft Excel was used to enter the survey responses, and Statistical Package for the Social Sciences (SPSS) statistical software was used for the descriptive analysis of data.

2.6 Exclusion criteria

Age groups less than 18 years of age and over 85 years were not included in this study.

3. Results

3.1 Socio-demographic characteristics

Of the 384 Livestock Owners, 76.82 (295/384) and 23.18% (89/384) were males and females, respectively. The age of the respondents: were 29.17% (112/384), 61.46% (236/384) and 9.38 (36/384) with a range of 18-35, 36-55 and 56-85 years respectively. About 24.22% (93/384) and 75.78% (291/384) were Urban (Kiltu Arara, Arbu Keransa & Roge Ela) and Rural Kebeles (Ilu Denisa, Dheleta Welkite, Agemsa Borea, Sire Babu, Goro Mako, Kunde Geresu, Aleltu Cebere, Mande Ela, Lillu, Luma Tatesa and Sendefa Bonaya) respectively. The marital status of the respondents showed that: 91.93% (353/384), 6.77% (26/384) and 1.3% (5/384) were married, single and divorced respectively. Based on their religion, more than 97.92% (376/384) were Christian while the remaining 2.08% (8/384) were Wakefata & Others. All of the respondents 100% (384/384) were livestock owners. The Occupation of the respondents showed that: 89.32% (343/384), 5.73 (22/384), 3.39% (13/384), and 1.56% (6/384) were farmers, self, government and students respectively (Table 1)

Table 1: Socio-demographic characteristics

  3.2 Knowledge of Respondents towards Anthrax

All of the respondents (100%) knew the disease anthrax, locally (in Oromigna) called Aba Sanga. The majority (69.27%, 266/384) of the respondents reported that they did not know the cause of the disease (Table 2). However, of the respondents (30.73%, 118/384) who believed to have known the cause of the disease: 19.01% (73/384) said that the disease was caused by bacteria, 7.81% (30/384) by viruses, and 3.91 % (15/384) mentioned other causes such as hereditary or locally Aba Sanga birds (in Oromigna)) as the causative agent of the disease. Among species of animal affected by Anthrax most of the respondents 93% (357/384) knew ruminants, while other respondents 3.1% (12/384), 2.1% (8/384), 0.5% (2/384), 0.3% (1/384) and 1% (4/384) were said equine, human, poultry, dog, and do not now, respectively. 61.7% (237/384) of the respondents said that their animal was affected by Anthrax and 38.3% (147/384) of the respondent’s animal was not affected previously by Anthrax disease. Regarding the zoonotic importance of the disease, 100% (384/384) of respondents said that anthrax was a zoonotic disease. However, the respondents 2.34% (9/384) did not know the way of transmission of the disease from animal to humans while 63.8% (245/384), 30.73% (118/384), and 3.12% (12/384) knew the mode of transmission: by ingestion, contact, and inhalation, respectively.

The livestock owner respondents who knew one or more symptoms and prevention methods of anthrax in animals were 82.03 (315/384) and 56.25% (216/384), respectively. Respondents who did not know the symptoms and prevention methods of anthrax were 17.97% (69/384) and 43.75% (168/384), respectively. The most well-known symptoms by the owners were sudden death in cattle (38.28%, 147/384), tarry blood fuses from natural opening (54.95%, 211/384) and difficulty in breathing (6.77%, 26/384).

The Livestock owner’s respondents control the anthrax disease 66.41% (255/384), 23.44% (90/384), and 10.16% (39/384) by traditional medicine, vaccination, and treatment with antibiotics, respectively. The livestock owner respondents who knew the relationship between Anthrax disease and sudden death of animals were 86.46% (332/384) while 13.54% (52/384) did not know the relationship between Anthrax disease and sudden death of animals (Table 2).

Table 2: Knowledge of respondents towards Anthrax Disease

3.3 Attitude and practices of respondents towards anthrax

The majority of the respondents 97.14% (373/384) considered anthrax was fatal disease while 2.86% (11/384) did not consider anthrax a fatal disease. In the study areas, most of the participants 66.41% (255/384) believed vaccination of animals against anthrax disease was important while 33.59% (129/384) were not. The respondents of the study area 15.1% (58/384), 53.65% (206/384), 18.75% (72/384), and 12.5% (48/384) were Very confident, Confident, somewhat and not confident, respectively on the ability of local veterinary services to handle Anthrax cases (Table 3).

Table 3: Attitude of Respondents toward Anthrax Disease

The respondents mainly managed carcass of animals that died from anthrax by buried method 83.59% (321/384). Very few participants disposed the carcass by throwing them in water 1.3% (5/384), throwing them at the roadside 5.21% (20/384), and throwing them in the field away from their house 9.9% (38/384). Most of the respondents checked their livestock for signs of illness daily (91.93, 353/384) while few respondents 5.47% (21/384), 0.52% (2/384), and 2.08% (8/384) check their animals weekly, monthly, and never, respectively. The study area respondents 45.83% (176/384), 26.3% (101/384), 24.74% (95/384), and 3.12% (12/384) took the action by call to veterinarians, treat the animal themselves, isolate the sick animals and do nothing respectively if their animals infected by anthrax disease (Table 4).

Table 4: Practices of Respondents toward Anthrax Disease

4. discussion

The current study applied a broad concept in terms of knowledge, attitude, and practices by livestock owners in Meta Welkite District of West Shoa Zone, central Ethiopia. It opens the door for future findings, research, surveillance, prevention, and control efforts of anthrax in the study area and throughout the country. Anthrax is a zoonotic disease that affects humans, livestock, companion animals, and wild-life (Fasanella et al., 2010). It is a rare disease in developed countries (Dragon & Rennie, 1995), but still an endemic disease in developing countries (Shiva Chandra et al., 2016). The bimodal lifecycle of B. anthracis, the causative agent of anthrax, involves vegetative form within the host and spore form developing in the environment.  If the right conditions are available, the spores can persist in the environment under unfavourable conditions for years and start an infection (Raymond et al., 2010).  The majority of rural residents in many developing nations rely on the cattle industry to enhance their standard of living (Dey et al., 2020).

In the current study, the social-demographic characteristics of participants revealed that 76.8% were males and 23.2% were females. Although Ethiopian Demographic data shows that the proportion of males and females is almost similar, there were a significantly higher number of male than female respondents in this study (Index Mundi, 2020). It can be attributed to the fact that females are less likely to be listed as household heads and that males dominate animal rearing. Most respondents fall in age between 36-55 years of age (61.5%); this result was in line with the actual country’s demographics data, which infers about (56%) of the total population categorized under the working age group (Bekele and Lakew, 2014). Regarding employment or occupation, most respondents were farmers (89.3%); this is similar to the fact that agriculture is the livelihood of most Ethiopians (FAO, 2019). The majority of respondents had some primary/elementary level education (47.7%) and were illiterate (43%); agree with the education survey shows above half (53.3%) of the total population had little or no education (SCA, 2016). It might be due to most participants involved in this survey were from rural areas where access to education was comparatively less than in Urban areas. All (100%) of farmers in this study area keeps livestock; this is consistent with more than 70% of the total population raising animals in the country (Relief Web, 2019).

In this study, a total of the respondents (100%) knew Anthrax. This finding is similar to the studies done by Chacha in Maragua, Kenya (Chacha. 2017) who reported 96.3%. However, the current study was higher than the findings in South Gonder (Mesfin et al., 2021) and in Northern Ethiopia (Romha and Girmay, 2020) which reported knowledge rates of 71% and 62%, respectively. These differences could be associated with the awareness level of the community, educational status, and information access. Even though 100% of the respondents stated that they knew the disease anthrax/Abbaa Sangaa, only 26.8% of them explained its causative agent, i.e. the microbe/ germ. About 3.9% believed that the disease was caused by other entities (heredity and Abbaa Sangaa birds), while 69.3% did not know the causative agent of the disease (Sitali et al., 2017).

In this study, almost all the study participants (97.7%) knew anthrax was transmitted from animal to human. The current study finding was higher than the study conducted in India 56% (Munisamy et al., 2017). Transmission through the consumption of infected meat was mentioned by 63% of the respondents, contact by 30.7%, and inhalation by 3.1%. This is line with a study done in Ethiopia (Tesfaye et al., 2013) 54.9% ingestion, 14.3% contact & the current study was disagree study done in India (Munisamy et al., 2017) 55% ingestion, 1% contact, aerosol 1% and insect 1%. These low levels of knowledge related to transmission routes of disease expose livestock owners to the disease.

The finding of this study shows that 47.3% of livestock owner respondents knew anthrax is preventable. This result was in agreement with the previous studies conducted by, who reported 43.4% in Northern Ethiopia and 39.2% in Bangladesh, respectively. However, the present finding was comparably lower than the study which reported 81.6% in Maragua Kenya, 67.2% in Sekota Zuria District northeast Ethiopia, and 65% in Sodo Zuriya District of Wolaita Zone, Southern Ethiopia, respectively. This variation may be due to demographic differences and the magnitude of the disease (Seid et al., 2019).

In the current study 82% of livestock owners knew the symptoms of anthrax in animals, 54.9%, 38.3% and 6.8% of respondents mentioned bleeding from natural orifices, sudden death, and difficulty in breathing as clinical symptoms of anthrax, respectively. The finding of this study shows that the overall practice of respondents towards anthrax disease prevention was found to be fifty-six point three (56.3%). This finding agrees with the study done in Turkey 51.9 % (Cakmur et al., 2015) and lower than the study done in Zimbabwe 86 % (Chikerema et al., 2013). This may be due to economic discrepancy between them. In the current study, 66.4%, 23.4%, and 10.2% of respondents mentioned traditional medicine, vaccination and using antibiotics as control methods of anthrax disease in animals, respectively. Sudden death was mentioned as a major clinical sign by the majority of the respondents which is in line with (Dutta et al., 2021).

In the current study, about 66.4% of respondents had appropriate information about animal vaccination in preventing anthrax disease. In contrast, the study in Southern Ethiopia (Oromia region) indicated only 31% of participants believed that vaccinating animals could help anthrax prevention efforts (Salli et al., 2024). In general, according to the current study, 83.6% of livestock owners were aware that the best approach to dispose of animal carcasses is to bury them. However, 9.9%, 5.2%, and 1.3% of respondents, respectively, suggested throwing in the field, on the road, and in the water.

5. conclusions and recommendations

This study is the first study to address the perspectives of livestock owners regarding anthrax in the Meta Welkite district. The study revealed that the majority of the livestock owners- had idea about anthrax or knew about Anthrax disease and its symptoms in animals and humans. However, more than half of the respondents did not know the Cause and Control method of anthrax disease. The KAP of the livestock owners toward the disease was influenced by traditional beliefs.Hence, livestock owners’ attitudes towards the treatment of animals were frequently adversely affected by traditional approaches towards treatment care both for animals and humans. The knowledge among the Livestock Owners has been enhanced over time by awareness created by veterinarians in the area.

Based on the above conclusions the following recommendations are forwarded:

Creating awareness for the community and livestock owners on the causes and control of anthrax disease.

With the availability of resources, additional studies should be extended to other districts of the zone to compare findings and wholesome intervention measures for the disease.

The government and the experts improve the traditional belief of livestock owner’s /community/ toward Anthrax disease through a Community-Centered program.