Knowledge, Attitude and Practice towards Leptospirosis among Municipal Sanitation Workers of Palakkad, Kerala, India

Introduction: Leptospirosis is a zoonotic bacterial infection caused by pathogenic Leptospira species. Humans acquire infection primarily through direct or indirect exposure to the urine of infected animals or to environments contaminated with infected urine, particularly water and soil. Since Kerala is prone to this disease due to rainfall and flooding, municipal sanitation workers are at a higher risk of contracting leptospirosis due to their occupation, which includes waste collection, cleaning drains and sewers and post-flood clean-up that bring them into repeated contact with contaminated water and rodent-infested environments. This places them at a higher risk of leptospirosis infection than the general population. Despite these risks, there is limited evidence on their knowledge, attitude and preventive practices, making it important to assess these factors. Aim: To assess the knowledge, attitude, and practices among municipal sanitation workers in municipality of Palakkad, Kerala, India. Materials and Methods: This cross-sectional study was conducted under the Department of Community Medicine, Government Medical College, Palakkad, Kerala, India, from March 2024 to March 2025, among municipal sanitation workers employed in the Palakkad municipality using a semi-structured questionnaire. There were 190 municipal workers employed in Palakkad municipality, and 173 of them were taken into consideration. After explaining the study, a semi-structured questionnaire was used to collect information on sociodemographic variables such as age, gender, education, socioeconomic status, and work experience, as well as knowledge, attitude and practices regarding leptospirosis. Data were entered in Microsoft Excel and analysed using Statistical Package for Social Sciences (SPSS) version 25.0. A p-value <0.05 was considered statistically significant. Results: Among the participants, 93 (54%) were aware that leptospirosis was transmitted by an animal (rodent). However, only 85 (49.1%) knew municipal workers were at risk. A total of 135 (78%) had a positive attitude towards safe work practices, and only 77 (44.5%) received doxycycline prophylaxis yearly. A statistically significant association was observed between work experience and entering sewage without protection. Conclusion: Despite a moderate level of knowledge and attitude towards leptospirosis, the study showed inadequate preventive practices that need to be addressed.