Knowledge, attitudes, and practices regarding brucellosis in the West Bank, Palestine: high awareness and persistent risk behaviors

Abstract

Brucellosis is a significant disease that can spread from infected livestock to humans, mainly through consuming unpasteurized dairy products or direct contact with animals. The disease remains endemic in the Middle East, including Palestine. This study examines the knowledge, attitudes, and practices (KAP) regarding brucellosis among adults in the West Bank. It also explores whether certain demographic factors and livestock ownership are related to awareness levels and behaviours associated with risk. A cross-sectional online survey was conducted with 897 adults from 11 cities in the West Bank from April to June 2025. Researchers used a validated questionnaire to collect information on sociodemographic factors, knowledge about brucellosis, attitudes toward prevention, and practices involving animal handling and dairy consumption. Associations were assessed using chi-square tests. About 82% of participants were aware of (had heard of) brucellosis. Awareness was noticeably higher among women, younger adults (18–24 years), university graduates, and those who were single (P < 0.05). Among those aware, deeper knowledge (scored as high/low) was associated with similar demographics. Despite this relatively high awareness, many respondents, particularly animal owners, reported risky behaviours such as consuming unboiled milk or fresh cheese. Among animal owners, those with low knowledge were significantly more likely to report these unsafe practices (39% vs. 6.7%, P = 0.01). Participants with greater knowledge were also more likely to report safer disposal of aborted animal fetuses. Although most people in the West Bank are familiar with brucellosis, risky habits such as consuming unregulated dairy products or handling animals without proper precautions remain common. The findings indicate that simply knowing about the disease does not guarantee safer choices. Meaningful progress in controlling brucellosis will require more than awareness campaigns. Public health strategies that consider local customs, support safer food preparation, and strengthen connections between veterinary and human health services are likely to have a stronger impact on reducing the disease in Palestine.