Knowledge without action: Exploring the gap between awareness and behaviour on Lassa fever prevention in Ondo State, Nigeria, July 2024

Introduction: Lassa fever (LF) poses a significant public health threat in Ondo State, Nigeria with persistent high-risk behaviours among community members contributing to continuous transmission. LF preventive measures include improved environmental and food hygiene, though cultural & social norms and psychological factors hinder adoption of preventive practices. This study examines the disconnect between awareness and behaviour in two high-burden Local Government Areas (LGAs) to understand the drivers of LF transmission. Methods: This qualitative study was conducted in Akure South and Owo in Ondo State. A structured questionnaire was administered to 47 participants during eight key informant interviews and six focus group discussions. Participants included politicians, community leaders, youths, traditional and religious leaders, healthcare workers, artisans, and LF survivors. A thematic analysis conducted to identify key themes related to LF knowledge, practices, and barriers to behavioural change. Ethical approval was obtained, and informed consent was secured from all participants. Results: All participants were knowledgeable about LF transmission and prevention, although behavioural gaps remained evident. Many reported continued consumptions of poorly-stored food, linked to economic hardship and lack of access to hygienic facilities. Cultural beliefs, including misconceptions about spiritual causes of LF and belief in its incurability, were commonly cited. Delayed care-seeking behaviour and stigma further limited timely treatment. Challenges such as ineffective government interventions, expired rodenticides and inadequate environmental sanitation were highlighted. These factors collectively undermined preventive behaviours despite widespread awareness. Conclusion: Bridging the gap between awareness and behavioural change in LF prevention requires context-specific, culturally sensitive interventions. Engaging local leaders and communities in ongoing education, strengthening environmental sanitation programs, and addressing misinformation through trusted sources is critical. Sustained government investment in preventive activities and timely healthcare access is essential to reducing LF transmission in Ondo State.