Abstract
BackgroundIn Malaysia, leptospirosis is considered an endemic disease, with sporadic outbreaks following rainy or flood seasons. The objective of this study was to develop and validate a new knowledge, attitude, belief and practice (KABP) questionnaire on leptospirosis for use in urban and rural populations in Malaysia.MethodsThe questionnaire comprised development and validation stages. The development phase encompassed a literature review, expert panel review, focus-group testing, and evaluation. The validation phase consisted of exploratory and confirmatory parts to verify the psychometric properties of the questionnaire. A total of 214 and 759 participants were recruited from two Malaysian states, Kelantan and Selangor respectively, for the validation phase. The participants comprised urban and rural communities with a high reported incidence of leptospirosis. The knowledge section of the validation phase utilized item response theory (IRT) analysis. The attitude and belief sections utilized exploratory factor analysis (EFA) and confirmatory factor analysis (CFA).ResultsThe development phase resulted in a questionnaire that included four main sections: knowledge, attitude, belief, and practice. In the exploratory phase, as shown by the IRT analysis of knowledge about leptospirosis, the difficulty and discrimination values of the items were acceptable, with the exception of two items. Based on the EFA, the psychometric properties of the attitude, belief, and practice sections were poor. Thus, these sections were revised, and no further factor analysis of the practice section was conducted. In the confirmatory stage, the difficulty and discrimination values of the items in the knowledge section remained within the acceptable range. The CFA of the attitude section resulted in a good-fitting two-factor model. The CFA of the belief section retained low number of items, although the analysis resulted in a good fit in the final three-factor model.ConclusionsBased on the IRT analysis and factor analytic evidence, the knowledge and attitude sections of the KABP questionnaire on leptospirosis were psychometrically valid. However, the psychometric properties of the belief section were unsatisfactory, despite being revised after the initial validation study. Further development of this section is warranted in future studies.
Highlights
In Malaysia, leptospirosis is considered an endemic disease, with sporadic outbreaks following rainy or flood seasons
There were more than 1 million clinical cases of leptospirosis occur annually, and nearly 60,000 leptospirosis-related deaths occur worldwide, resulting in 2.9 million Disability-adjusted Life Years (DALYs) each year [2]
Questionnaire development and content and face validity The concepts identified in the literature review on leptospirosis were very useful in the selection of items and formation of the relevant KABP sections in the questionnaire
Summary
In Malaysia, leptospirosis is considered an endemic disease, with sporadic outbreaks following rainy or flood seasons. Leptospirosis is considered a major re-emerging zoonosis of global and public health importance, in developing countries due to socioeconomic conditions that favor human exposure and climatic conditions that favor endemicity in animal vectors [1]. There has been an increased trend in reporting leptospirosis cases in the last 10 years in Malaysia [5], where leptospirosis is considered an endemic disease, with sporadic outbreaks following rainy or flood seasons [6]. Previous literature indicated high seroprevalence and poor knowledge of leptospirosis and prevention practices among high-risk occupational groups [6,7,8], pointing to the need for the implementation of an effective intervention program in these groups
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
