# Assessment of Butchers' Awareness, Attitude, and Occupational Practices Toward Crimean‐Congo Hemorrhagic Fever (CCHF) in Kabul, Afghanistan: A Cross‐Sectional Study

## TL;DR

This study examines butchers in Kabul, Afghanistan, to assess their knowledge and practices regarding Crimean-Congo Hemorrhagic Fever, finding a gap between awareness and actual safety behaviors.

## Contribution

The study provides insights into butchers' awareness, attitudes, and practices toward CCHF in a high-risk region, highlighting specific misconceptions and unsafe behaviors.

## Key findings

- Only 42.5% of butchers demonstrated good safety practices despite moderate awareness and positive attitudes.
- Significant misconceptions include belief in waterborne and airborne transmission of CCHF.
- Unsafe practices like holding knives in the mouth and inconsistent protective equipment use were observed.

## Abstract

Crimean‐Congo hemorrhagic fever (CCHF) is a viral disease with a fatality rate up to 40%, transmitted through tick bites and infected livestock. Afghanistan's livestock farming and limited public health infrastructure increase infection risks. This study assesses butchers' awareness, attitudes, and practices regarding CCHF in Kabul to identify gaps and inform targeted interventions.

A cross‐sectional study was conducted among butchers in Kabul from August to September 2024 using cluster sampling. Data from 179 butchers across four districts were collected via questionnaires and analyzed with SPSS version 27.

The response rate exceeded 95%. Participants averaged 37 ± 13 years, with 31.8% having over 20 years of experience. Mean scores were 27.7 ± 3.8/38 for awareness, 18.4 ± 2.3/25 for attitudes, and 10.9 ± 2.3/16 for practices. While 41.9% showed good awareness and 61.5% had positive attitudes, only 42.5% demonstrated good practices. Significant misconceptions included belief in waterborne (52.5%) and airborne (31.8%) transmission. Unsafe practices like holding knives in the mouth (4.5%) and inconsistent protective equipment use were observed. A moderate positive correlation existed between attitudes and practices (r = 0.433, p < 0.001).

A substantial gap exists between butchers' knowledge and practices regarding CCHF. Targeted educational interventions addressing attitudes and practical barriers are essential to improve safety practices.