Knowledge, Attitudes, Practices, and Risk Perception of MERS-CoV and Other Coronaviruses Among Health Care Workers in Northern Kenya

Abstract

Middle East respiratory syndrome coronavirus (MERS-CoV) remains a global health threat, with frequent hospital outbreaks in the Middle East and Asia. Transmission occurs through contact with dromedary camels, and spillover risk in Northern Kenya is significant due to high camel exposure and growing human mobility. We assessed knowledge, attitudes, practices, and risk perception (KAP-RP) regarding MERS-CoV and other coronaviruses among health care workers (HCWs) in Isiolo and Marsabit counties. A cross-sectional survey was conducted between December 2023 and January 2024. Using two-stage stratified random sampling, HCWs from public health facilities were recruited, covering clinical and nonclinical cadres. Data were collected using a structured, pretested questionnaire on KAP-RP. Scores were classified as sufficient or insufficient. Analyses included descriptive statistics, logistic regression, and Pearson correlations. Of 847 HCWs enrolled (36.4% Isiolo, 63.6% Marsabit), the majority were age 25-34 years, with a male:female ratio of 1.3:1. Clinical cadres made up 56.2%, and 77% worked in rural facilities. Only 28.1% demonstrated sufficient knowledge, 74.7% showed favorable attitudes, 25.1% adhered adequately to preventive practices, and 26.7% had high risk perception. PPE use was reported by 85.5%, but only 49.2% wore it consistently, and 33.3% changed it as required. Knowledge was higher among males, older HCWs, and Isiolo residents. Correlation analysis showed a weak positive association between knowledge and practice, a negative association with attitude, and minimal links with risk perception. Substantial knowledge gaps, inconsistent practices, and low risk perception persist, highlighting the need for context-specific, behavior-focused training to strengthen preparedness in zoonotic hot spots.