Multinational municipal waste collectors and leptospirosis prevention: Assessment of knowledge, attitudes, practices and the associated factors

Background: Leptospirosis is a neglected zoonotic disease and often under-reported. Municipal waste collectors, engaging mainly migrant labour are at risk to leptospirosis due to their nature of work. The present study aimed to determine the knowledge, attitudes, and practices (KAP) of the multinational municipal waste collectors towards prevention of leptospirosis, and further identify factors associated with the KAP. Methods: A cross-sectional study was conducted using face-to-face interview among 184 municipal waste collectors. They completed a questionnaire on sociodemographics and KAP towards leptospirosis. Multiple linear regression was performed to determine factors associated with KAP towards the leptospira infection. Results: The majority of participants were Bangladeshi (75.0%) and Indonesian nationals (20.7%), with poor knowledge of leptospirosis (92.93%). The attitudes towards leptospirosis were moderate (59.78%) while preventive practices were good (74.46%). Indonesians had significantly better knowledge as compared to other nationals (p < 0.001) but had poor practices (p = 0.021). Workers with upper secondary school education had better attitudes (p = 0.026) and preventive practices scores (p = 0.045). Individual monthly income had inverse association with attitudes scores (p = 0.036). Conclusions: Overall, the preventice practices among municipal waste workers was good due to relatively ethical work behaviours. However, they had poor knowledge on the cause, modes of transmission, symptoms and treatment of leptospirosis. The study suggests that targeted education to increase knowledge and systematic preventive measures to reduce contact with the infection are necessary for this occupation group.