title: Household practices related to disease transmission between animals and humans in rural Cambodia.
abstract: BACKGROUND
  Zoonotic diseases are disproportionately affecting poor societies in low-income countries and pose a growing threat to public health and global food security. Rural Cambodian households may face an increased likelihood of exposure to zoonotic diseases as people there live in close association with livestock. The objectives of the study was to identify practices known to influence zoonosis transmission in rural Cambodian households and relate the practices to agro-ecological region, socio-economic position, demographics, livestock management and zoonosis awareness.
  
  
  METHODS
  The study was conducted in three different agro-ecological regions of Cambodia; 10 villages each in the central lowlands, north-west wetlands and on the south coast, where information was obtained in questionnaires administered to 300 households, and 30 village heads and animal health workers.
  
  
  RESULTS
  Descriptive analysis revealed a gender difference in responsibility for livestock and that the main purpose of raising livestock was for sale. Few respondents (6%) perceived a likelihood of disease transmission in their village between livestock, humans and wildlife, despite household practices related to zoonosis transmission being common. More than one-forth of households practised behaviours such as culling sick animals for consumption, eating animals found dead and allowing animals to enter sleeping and food preparation areas. Associations between household practices and possible explanatory factors were analysed with multivariable models using generalised estimation equations to account for clustering of practices within villages. Factors found to influence household practices were agro-ecological region, socio-economic position, number of people in the household, livestock species reared and awareness of zoonoses.
  
  
  CONCLUSIONS
  Cambodia has experienced numerous fatal human cases of zoonotic influenza and extensive influenza information campaigns have been run, yet only a few of the households surveyed here reported the threat of zoonosis to be a concern in their village. Zoonosis awareness was positively related to hand washing behaviour, but other practices associated with an increased or decreased likelihood of exposure to zoonotic pathogens were unaffected by awareness. The findings indicate a knowledge-to-action gap among rural farmers and highlight the necessity for reconstructed interventions in zoonotic disease control.
authors.affiliation: Division of Reproduction, Department of Clinical Sciences, Swedish University of Agricultural Sciences (SLU), Box 7054, SE-750 07, Uppsala, Sweden. kristina.osbjer@slu.se.
authors.forename: Kristina
authors.initials: K
authors.lastname: Osbjer
authors.affiliation: Department of Biomedical Sciences and Veterinary Public Health, SLU, Uppsala, Sweden. sofia.boqvist@slu.se.
authors.forename: Sofia
authors.initials: S
authors.lastname: Boqvist
authors.affiliation: Centre for Livestock and Agriculture Development, Phnom Penh, Cambodia. ssokerya@celagrid.org.
authors.forename: Seng
authors.initials: S
authors.lastname: Sokerya
authors.affiliation: National Institute for Public Health, Phnom Penh, Cambodia. krniph@yahoo.com.
authors.forename: Chheng
authors.initials: C
authors.lastname: Kannarath
authors.affiliation: National Veterinary Research Institute, Phnom Penh, Cambodia. sorn.san@gmail.com.
authors.forename: Sorn
authors.initials: S
authors.lastname: San
authors.affiliation: National Veterinary Research Institute, Phnom Penh, Cambodia. vun.navri@gmail.com.
authors.forename: Holl
authors.initials: H
authors.lastname: Davun
authors.affiliation: Division of Reproduction, Department of Clinical Sciences, Swedish University of Agricultural Sciences (SLU), Box 7054, SE-750 07, Uppsala, Sweden. ulf.magnusson@slu.se.
authors.forename: Ulf
authors.initials: U
authors.lastname: Magnusson
mesh_terms: D000822:Animal Husbandry; D000818:Animals; D002160:Cambodia; D003140:Communicable Disease Control / Q000379:methods*; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D005191:Family Characteristics; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D058751:Livestock; D008297:Male; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D015047:Zoonoses / Q000635:transmission*