Impact of the COVID-19 Pandemic on Knowledge, Attitudes, and Practices Related to Avian Influenza Among Poultry Workers in Cambodia.
Live bird markets (LBMs) are high-risk environments for the amplification and transmission of avian influenza viruses (AIVs). In Cambodia, limited data exist on knowledge, attitudes, and practices (KAP) among poultry workers, who represent a key occupational risk group. This study assessed KAP related to avian influenza (AI) among poultry workers in three major Cambodian LBMs, with a focus on changes before and during the COVID-19 pandemic.
A cross-sectional survey of 100 poultry workers was conducted using a structured questionnaire covering socio-demographics, AI awareness, personal protective equipment (PPE) use, training participation, and preventive behaviors. Comparisons were made between the pre-COVID-19 pandemic and COVID-19 pandemic periods using McNemar's test for dichotomous variables, and the symmetry chi-square and marginal homogeneity tests for variables with more than two categories, to determine whether response distributions changed significantly over time.
The proportion of workers earning below USD 350 per month increased from 41% before the pandemic to 52% during the pandemic (p < 0.001). PPE use declined significantly: Face mask use dropped from 58% to 40% (p = 0.003), while reports of no PPE use rose from 21% to 49% (p < 0.001). Awareness of avian influenza decreased from 81% to 59% (p < 0.001), and participation in influenza-related training fell from 30% to 10% (p < 0.001). Workers primarily relied on informal information channels, with veterinary officers identified as trusted but underutilized sources.
Despite moderate baseline awareness of avian influenza, preventive practices among Cambodian poultry workers were limited and further declined during the COVID-19 pandemic, reflecting broader economic and structural challenges. Supporting affordable access to PPE, strengthening market-based training, and expanding culturally adapted, multiplatform risk communication strategies will be essential. Integrated interventions, combined with enhanced surveillance during peak poultry trade periods, can help reduce occupational exposure and interrupt zoonotic transmission pathways in LBMs.
A cross-sectional survey of 100 poultry workers was conducted using a structured questionnaire covering socio-demographics, AI awareness, personal protective equipment (PPE) use, training participation, and preventive behaviors. Comparisons were made between the pre-COVID-19 pandemic and COVID-19 pandemic periods using McNemar's test for dichotomous variables, and the symmetry chi-square and marginal homogeneity tests for variables with more than two categories, to determine whether response distributions changed significantly over time.
The proportion of workers earning below USD 350 per month increased from 41% before the pandemic to 52% during the pandemic (p < 0.001). PPE use declined significantly: Face mask use dropped from 58% to 40% (p = 0.003), while reports of no PPE use rose from 21% to 49% (p < 0.001). Awareness of avian influenza decreased from 81% to 59% (p < 0.001), and participation in influenza-related training fell from 30% to 10% (p < 0.001). Workers primarily relied on informal information channels, with veterinary officers identified as trusted but underutilized sources.
Despite moderate baseline awareness of avian influenza, preventive practices among Cambodian poultry workers were limited and further declined during the COVID-19 pandemic, reflecting broader economic and structural challenges. Supporting affordable access to PPE, strengthening market-based training, and expanding culturally adapted, multiplatform risk communication strategies will be essential. Integrated interventions, combined with enhanced surveillance during peak poultry trade periods, can help reduce occupational exposure and interrupt zoonotic transmission pathways in LBMs.
Authors
Chan Chan, Sparaciari Sparaciari, Ly Ly, Nguon Nguon, Souv Souv, Colquhoun Colquhoun, Flamand Flamand, Karlsson Karlsson
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