Date of Award

January 2023

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

James Hassell

Second Advisor

Elsio Wunder


Introduction: Since the discovery of Lassa fever in 1969 in Nigeria, the disease has become endemic in many West African countries. An estimated 500,000 cases of Lassa fever virus occur each year, leading to approximately 5,000 deaths annually. Liberia continues to record outbreaks almost every subsequent year in regions once considered non-endemic. With no effective vaccines, many studies have underscored the importance for residents in Lassa-endemic regions to have good knowledge and good prevention practices in place to prevent Lassa fever.

Methods: A cross-sectional data extracted from a longitudinal, observational, cohort study conducted using voluntary participant self-reported and study visits data from the ENABLE study in central Liberia. Generalized Estimating Equation (GEE) model was used to perform a regression analysis to measure the association between 1,700 adult participants’ Lassa fever knowledge and Lassa fever infection, and between Lassa fever prevention practices and Lassa fever infection, considering correlations among family members in the same household.

Results: Univariate regression analyses were performed to measure the association between knowledge and infection and between practices and infection. The study found no significant association between response and the outcome (Lassa fever infection), which indicates that people's knowledge and prevention practices of Lassa fever did not have a significant association with their likelihood of acquiring Lassa fever infection. However, formal education and community were found to be significantly associated with the outcome. Significant findings were defined by p <0.05.

Conclusion: The study’s findings emphasized the importance of conducting KAP evaluations in rural communities to generate and improve evidence-based knowledge and proper prevention practices to prevent and control Lassa fever outbreaks. Further, the study demonstrates that while good knowledge and prevention practices are integral to preventing Lassa fever in rural communities, KAP studies should seek to understand the impacts of other factors including poverty and socioeconomic status, overcrowding, environmental sanitation, and housing characteristics.


This is an Open Access Thesis.

Open Access

This Article is Open Access