Comparisons of Risk Behaviors and Factors Associated with Poor Knowledge and Attitudes Toward Zoonotic Infection Among Hill Tribe People in Northern Thailand.

backgroundZoonotic infection in daily life activities leads to severe health consequences, especially for individuals who live in agricultural sectors and have poor educational attainment. The hill tribe and stateless people living in the border area in northern Thailand are vulnerable to zoonotic diseases through daily behaviors. The aim of this study was to understand the behaviors and determine the factors associated with poor knowledge and attitudes toward zoonotic infection among hill tribe people in northern Thailand.

methodsA cross-sectional study was conducted to collect data from participants aged 18 years and over living in hill tribe and stateless villages located in border areas of Thailand, Myanmar, and Laos. A structural questionnaire was used to collect general characteristics and risk behaviors related to and knowledge and attitudes toward zoonotic infection. Stepwise logistic regression was used to detect associations at a significance level of α = 0.05.

resultsA total of 600 people were included in the analysis: 71.9% were aged 36-65 years, 57.3% were females, 73.2% were Buddhists, 49.0% had never attended school, 64.5% were farmers, and 44.8% had an annual income under 30,000 baht ($860). More than one-third (38.7%) of the participants used alcohol, 21.2% smoked, 30.5% ate uncooked chicken meat, 48.8% ate local raw meat salad, 35.5% ate fermented fish, and 55.0% ate wild animal meat. More than half (64.8%) of the participants had poor knowledge, and 33.0% had poor attitudes toward zoonotic disease prevention and control. Different tribes had different risk behaviors related to zoonotic infection, and a large proportion of Hmong people ate raw chicken meat. Five variables were found to be associated with poor knowledge of zoonosis prevention and control: being Buddhist (OAR = 1.68; 95% CI = 1.31-2.50), never attending school (AOR = 1.80; 95% CI = 1.18-2.73), being unemployed (AOR = 3.49; 95% CI = 1.66-6.16), using alcohol (AOR = 2.11; 95% CI = 1.44-3.09), and eating raw pork (AOR = 2.08; 95% CI = 1.41-3.06). Two variables were found to be associated with poor attitudes toward zoonosis prevention and control: having an annual family income of 30,000-50,000 baht and over 50,000 baht (AOR = 1.65, 95% CI = 1.09-2.50; and AOR = 2.28, 95% CI = 1.42-3.67, respectively) and using alcohol (AOR = 1.92, 95% CI = 1.32-2.78).

conclusionThe hill tribe and stateless people living in the border areas of northern Thailand have several risk behaviors for zoonotic infection, with different risks in different tribes. Implementing health education to improve the knowledge and attitudes of these people toward zoonosis prevention and control by focusing on educational attainment, alcohol use, employment, and Buddhist practices, is necessary.