title: Social determinants that lead to poor knowledge about, and inappropriate precautionary practices towards, avian influenza among butchers in Kathmandu, Nepal.
abstract: BACKGROUND
  Avian influenza (AI) is a global public health threat. Understanding the knowledge that butchers have about it and the precautionary practices they take against it is crucial for designing future preparedness programs. This study aimed to identify the social determinants of knowledge and precautionary measures of AI among butchers in the Kathmandu district in Nepal.
  
  
  METHODS
  The study was based on a cross-sectional study design using structured interview questionnaires and checklists to observe social determinants and the precautionary measures of 120 butchers aged 15 years and above from the Kathmandu district.
  
  
  RESULTS
  The majority of the respondents were male (69.2%) and more than half (53.3%) were from the age group of 25-39 years (mean: 31.08, SD: ±9.82). Nearly two-thirds (61.3%) of the respondents had a 'poor knowledge', and the remaining had 'some knowledge', about AI. More than half (55.4%) of the respondents were in the category of displaying 'poor practice' towards AI and the remaining half were in the 'satisfactory practice' category. None of the respondents had 'adequate knowledge' or displayed 'good practice'. The respondents in the >25 years of age group were less likely [OR 0.169; 95% CI (0.056-0.512)] compared to those in the <25 years age group to have a poor knowledge about AI; and the respondents with 'primary education' were more likely [OR 3.265; 95% CI (1.326-8.189)] to have a poor knowledge about AI as compared to those who had a secondary or above level of education. Respondents who did not know the correct definition of AI were more likely to follow poor practices [OR 4.265; 95% CI (1.193-15.242)]; and the respondents who did not know the risk groups associated with AI were also more likely to follow poor practices [OR 3.103; 95% CI (1.191-8.083)].
  
  
  CONCLUSIONS
  This study points out the need to address butchers to improve their knowledge of, and more importantly their compliance with, the precautionary measures to prevent avian influenza.
authors.affiliation: Health Right International, Kathmandu, Nepal. mohanpdl@gmail.com.
authors.forename: Mohan
authors.initials: M
authors.lastname: Paudel
authors.forename: Bimala
authors.initials: B
authors.lastname: Acharya
authors.forename: Mandira
authors.initials: M
authors.lastname: Adhikari