{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T03:34:44Z","timestamp":1793504084424,"version":"4.5.0"},"reference-count":61,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2018,4,6]],"date-time":"2018-04-06T00:00:00Z","timestamp":1522972800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Higher Education, Malaysia via the Long Term Research Grant Scheme","award":["UPM\/700-2\/1\/LRGS\/5526400"],"award-info":[{"award-number":["UPM\/700-2\/1\/LRGS\/5526400"]}]},{"name":"Ministry of Higher Education, Malaysia via the Long Term Research Grant Scheme","award":["203\/PPSP\/6770003"],"award-info":[{"award-number":["203\/PPSP\/6770003"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Little is known on the knowledge, attitudes and preventive practices (KAP) of leptospirosis worldwide. This study embarked on assessing the KAP of leptospirosis among rural communities in Malaysia. A total of 444 participants (223 male; 221 female) aged between 18 and 81 years old were surveyed by using a self-administered questionnaire. A majority of participants had poor knowledge level (57.0%), unacceptable attitudes (90.3%) and unacceptable preventive practices (69.1%) on leptospirosis, and only 29.7% knew \u201crat-urine disease\u201d as leptospirosis. Only 34.2% of the participants knew the bacteria could enter via wound lesions. Ethnicity and income were strongly associated with knowledge level and preventive practices, respectively (p-values &lt; 0.05). As for attitudes, ethnicity, income and education type were significantly associated (p-values &lt; 0.05). Only 36.5% of the participants were willing to see a doctor and did not mind if their house or surrounding area is dirty (59.7%). Surprisingly, only 32.9% had used rubber boots during floods. By logistic regression analysis, ethnicity was the only significant predictor for both knowledge level (an odds ratio (AOR) = 0.39, 95% confidence interval (CI) = 0.222\u20130.680) and preventive practices (AOR = 1.81, 95% CI = 1.204\u20132.734). Ethnicity (AOR = 0.40, 95% CI = 0.239\u20130.665), income (AOR = 1.58, 95% CI = 1.041\u20132.385) and education type (AOR = 3.69, 95% CI = 1.237\u201310.986) were strong predictors for attitudes. Among the KAP variables, attitude (AOR = 4.357, 95% CI = 2.613\u20137.264) was the only predictor for the preventive practices by logistic regression analysis. The KAP elements on leptospirosis are still lacking and poor health seeking behavior and attitudes are of our utmost concern. Thus, effective strategies should be planned to impart knowledge, and develop proactive approaches and good preventive modules on leptospirosis to this leptospirosis-prone community.<\/jats:p>","DOI":"10.3390\/ijerph15040693","type":"journal-article","created":{"date-parts":[[2018,4,10]],"date-time":"2018-04-10T13:06:08Z","timestamp":1523365568000},"page":"693","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Low Levels of Knowledge, Attitudes and Preventive Practices on Leptospirosis among a Rural Community in Hulu Langat District, Selangor, Malaysia"],"prefix":"10.3390","volume":"15","author":[{"given":"Noramira","family":"Nozmi","sequence":"first","affiliation":[{"name":"Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4299-8676","authenticated-orcid":false,"given":"Suhailah","family":"Samsudin","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surianti","family":"Sukeri","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan 16150, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7023-9717","authenticated-orcid":false,"given":"Mohd","family":"Shafei","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan 16150, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan","family":"Wan Mohd","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan 16150, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zawaha","family":"Idris","sequence":"additional","affiliation":[{"name":"Health Promotion Unit, Penang State Health Department, Floor 7, Bangunan Persekutuan, Jalan Anson, Penang 10400, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan","family":"Arifin","sequence":"additional","affiliation":[{"name":"Unit of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan 16150, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norazlin","family":"Idris","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan 16150, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0115-5912","authenticated-orcid":false,"given":"Siti","family":"Saudi","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nurul","family":"Abdullah","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zainudin","family":"Abdul Wahab","sequence":"additional","affiliation":[{"name":"Health Department of Federal Territory Kuala Lumpur &amp; Putrajaya, Jalan Cenderasari, Kuala Lumpur 50590, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8269-5699","authenticated-orcid":false,"given":"Tengku","family":"Tengku Jamaluddin","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hejar","family":"Abd Rahman","sequence":"additional","affiliation":[{"name":"Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siti","family":"Masri","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2706-1175","authenticated-orcid":false,"given":"Aziah","family":"Daud","sequence":"additional","affiliation":[{"name":"Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan 16150, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5591-3315","authenticated-orcid":false,"given":"Malina","family":"Osman","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6288-3791","authenticated-orcid":false,"given":"Rukman","family":"Awang Hamat","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,4,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Costa, F., Hagan, J.E., Calcagno, J., Kane, M., Torgerson, P., Martinez-Silveira, M.S., Stein, C., Abela-Ridder, B., and Ko, A.I. 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