Assessing Community Knowledge of Yellow Fever in Nigeria’s North East: Implications for Symptom Recognition, Transmission Awareness, and Prevention Practices

Abstract

Background: Yellow fever remains a recurrent public health concern in Nigeria’s North East, where suboptimal vaccination coverage, ecological suitability for mosquito vectors, and health system constraints increase vulnerability to outbreaks. Community knowledge of symptoms, transmission pathways, and preventive measures is critical for early care-seeking, vaccination uptake, and effective vector control. Objective: To assess knowledge of yellow fever among residents of North East Nigeria, focusing on symptom recognition, transmission awareness, and prevention practices, and to examine the association between socioeconomic factors and knowledge levels. Methods: A community-based cross-sectional study was conducted among 563 adults across six states (Adamawa, Bauchi, Borno, Gombe, Taraba, and Yobe). Data were collected using a structured questionnaire comprising 18 knowledge items. Responses were scored using a 5-point Likert scale (1–5), and total knowledge scores were converted to percentages and categorized as good (≥75%), moderate (50–74%), or poor (<50%). Descriptive statistics summarized mean scores and awareness levels, while chi-square and logistic regression analyses examined associations between socioeconomic variables (independent variables) and knowledge level (dependent variable). Statistical significance was set at p < 0.05. Results: Overall knowledge was moderate. Participants demonstrated relatively higher awareness of common symptoms (mean = 2.80, SD = 0.846) and mosquito-borne transmission (mean = 2.85, SD = 0.858) compared to environmental prevention measures (mean = 2.60, SD = 0.658). Vaccination was widely recognized as a preventive strategy (mean = 2.75, SD = 0.663), though gaps persisted regarding comprehensive prevention practices. Lower income, limited education, and reduced access to healthcare were significantly associated with poorer knowledge and lower perceived awareness of transmission pathways (p < 0.05). Conclusion: Knowledge of yellow fever in North East Nigeria is moderate, with notable gaps in comprehensive prevention awareness beyond vaccination. Socioeconomic disparities significantly influence knowledge levels. Strengthened risk communication, expanded vaccination outreach, and community-based vector control education are necessary to enhance preventive practices and outbreak preparedness in the region.