Risk factors and determinants of Lassa fever transmission in Eastern Sierra Leone

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Abstract
Background: Lassa fever is one of the top emerging infectious diseases that requires contextual insights on risk factors and transmission determinants to effectively interrupt the spread. We investigated contextual risk factors and determinants of Lassa fever transmission to inform behaviour change and response efforts. Methods: This was a descriptive cross-sectional study composed of a random sample size of 1033 household head participants from 2 hotspot districts of Eastern Sierra Leone. Data was collected through structured questionnaires and analysed in SPSS® version 29 to generate relevant frequencies and associations. Results: Male gender (adjusted odds ratio, AOR = 0.69; 95% CI: 0.51–0.94; p < 0.05) and male gender roles (p < 0.05), younger age (p < 0.05), lower educational level (AOR = 2.25; 95% CI: 1.23–4.13; p < 0.05), lower wealth status (p < 0.05), traditional belief-based burial practices (AOR = 8.69, 95% CI: 5.39–14.01; p < 0.05) were associated with poor practices. Again, existence of geographic, financial, provider-related and family influence barriers were associated with poor practices (p < 0.05 respectively). Awareness of recommended public health measures for Lassa fever, knowledge of how Lassa fever is transmitted, and its signs and symptoms were associated with good practices (p < 0.05). Conclusions: To effectively combat Lassa fever, policies and programs must integrate behavioural insights, foster intersectoral collaboration, and adopt a comprehensive approach that addresses the interconnectedness of risk factors and determinants of transmission, prevention and control.

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