USING A KNOWLEDGE, ATTITUDES AND PRACTICES SURVEY TO SUPPLEMENT FINDINGS OF AN OUTBREAK INVESTIGATION - CHOLERA PREVENTION MEASURES DURING THE 1991 EPIDEMIC IN PERU

Background. To assess the effectiveness of the cholera prevention acti vities of the Peruvian Ministry of Health, we conducted a knowledge, a ttitudes, and practices (KAP) survey in urban and rural Amazon communi ties during the cholera epidemic in 1991. Methods. We surveyed heads o f 67 urban and 61 rural households to determine diarrhoea rates, sourc es of cholera prevention information, and knowledge, attitudes, and pr actices regarding ten cholera prevention measures. Results. Twenty-fiv e per cent of 482 urban and 11% of 454 rural household members had dia rrhoea during the first 3-4 months of the epidemic. Exposure to mass m edia education was greater in urban areas, and education through inter personal communication was more prevalent in rural villages. Ninety-th ree per cent of rural and 67% of urban respondents believed they could prevent cholera. The mean numbers of correct responses to ten knowled ge questions were 7.8 for urban and 8.2 for rural respondents. Practic es lagged behind knowledge and attitudes (mean correct response to ten possible: urban 4.9, rural 4.6). Seventy-five per cent of respondents drank untreated water and 91% ate unwashed produce, both of which wer e identified as cholera risk factors in a concurrently conducted case- control study. Conclusions. The cholera prevention campaign successful ly educated respondents, but did not cause many to adopt preventive be haviours. Direct interpersonal education by community-based personnel may enhance the likelihood of translating education into changes in he alth behaviours. Knowledge, attitudes, and practices surveys conducted with case-control studies during an epidemic can be an effective meth od of refining education/control programmes.