Knowledge, Attitude, and Practice Regarding Campylobacter Infection and Associated Risk Factors Among Chicken Handlers in Live Bird Markets, Maiduguri Metropolis, Borno State, Nigeria
This cross-sectional study of chicken handlers in Maiduguri, Nigeria, reveals a critical paradox where positive attitudes toward Campylobacter infection coexist with poor knowledge and deficient practices, identifying years of market experience as the sole protective factor against infection and highlighting the urgent need for structural interventions and targeted education for new handlers.
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In the bustling markets of sub-Saharan Africa, the exchange of live poultry is a daily rhythm of commerce and sustenance. Yet, behind the sale of chickens lies a silent, invisible threat: a common bacterial infection known as campylobacteriosis. This illness, caused by bacteria that live in the guts of birds, is one of the most frequent causes of foodborne sickness worldwide. While most people catch it by eating undercooked chicken, those who handle live birds every day face a different, more direct risk. These workers, who sort, sell, and process chickens in open-air markets, are constantly exposed to feathers, droppings, and contaminated surfaces. For them, the danger is not just a matter of what they eat, but of what they touch and breathe. Understanding how these workers think about this risk, and whether their daily habits protect them or put them in danger, is crucial for stopping the spread of disease from animals to humans.
In the Maiduguri Metropolis of northeastern Nigeria, a team of researchers set out to understand this specific group of workers. They focused on the chicken handlers at six different live bird markets, asking them a series of questions to measure three things: what they knew about the bacteria, how they felt about the risk, and what they actually did to stay safe. The study took place over three months in 2020, involving 212 men and women who work with chickens daily. The researchers used a simple questionnaire, translated into the local Hausa language for those who could not read English, to gather information about the workers' ages, education, how long they had been in the business, and their daily routines.
The results revealed a striking and somewhat confusing picture. When asked about the bacteria, the vast majority of workers, nearly 93 percent, showed a lack of knowledge. They did not understand how the infection spreads or how to prevent it. However, when asked about their feelings toward safety, the mood was completely different. More than 92 percent of the workers expressed a positive attitude, stating that they believed hygiene was important and that they wanted to avoid getting sick. This created a massive gap between what they felt and what they did. While almost everyone agreed that safety mattered, fewer than 4 percent actually practiced good hygiene, such as washing their hands or wearing protective gear. The difference between their positive feelings and their poor actions was so large that it formed an "attitude-practice paradox," a situation where good intentions fail to translate into real-world safety measures.
The researchers looked deeper to see if certain types of workers were more at risk than others. They found that age, marital status, the type of birds handled, and the number of birds a person dealt with all influenced what the workers knew, felt, and did. But the most significant factor was how long a person had been working in the market. The data showed that experience was a powerful shield. Workers who had been handling chickens for five to nine years, and those with fifteen years or more, were far less likely to be infected than those who had been working for less than five years. The newer workers, those just starting out, faced the highest odds of catching the infection. This suggests that over time, even without formal training, workers seem to learn informal ways to protect themselves, perhaps by picking up habits from older colleagues or simply learning through trial and error which practices keep them healthy.
The study concluded that the problem in Maiduguri is not that workers do not care about their safety; they clearly do. The barrier is not a lack of motivation, but a lack of structure. The positive attitudes the workers hold are trapped by a reality where they lack the tools to act on them. There are no handwashing stations, no affordable protective clothing, and no enforced rules to guide their daily work. The researchers found that the most vulnerable group is the new employee, who has not yet had time to learn the unwritten rules of the trade. To fix this, the study suggests that health programs must move beyond simple lectures. Instead, they need to provide the physical infrastructure, like sinks and soap, and offer structured training specifically for new workers. By addressing these structural gaps, the positive desire for safety that already exists in the hearts of these workers can finally be turned into actions that protect them and their communities.
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