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. 2020 Jan;26(1):70–80. doi: 10.3201/eid2601.190220

Table 5. Comparison of participant knowledge of Crimean-Congo hemorrhagic fever between CCHF-endemic villages and non–CCHF-endemic villages, Kazakhstan*.

Information about CCHF
CCHF-endemic villages, n = 442
Non–CCHF-endemic villages, n = 506 p value
No. participants† % Participants (95% CI) No. participants† % Participants (95% CI)
Heard of CCHF 420 95.6 (93.8–99.9) 371 2.0 (61.7–79.3) <0.001
Source* n = 420 n = 371
Village, community meetings 262 62.1 (28.0–87.3) 110 46.9 (16.2–80.1)
School 77 18.9 (8.8–35.9) 25 4.1 (1.5–11.1)
Television 196 60.5 (42.7–75.9) 333 87.4 (77.9–93.2)
Radio 34 8.1 (3.7–16.7) 10 2.1 (0.7–6.1)
Newspaper, magazine 153 43.6 (28.7–59.6) 117 32.7 (25.1–41.3)
Pamphlets 240 72.5 (51.2–86.9) 248 79.5 (61.7–90.3)
Posters 225 69.6 (43.8–87.0) 185 66.1 (45.9–81.8)
Education campaign 18 4.0 (1.3–11.4) 0 0
Training course 3 90.6 (0.1–3.4) 7 2.8 (0.9–8.6)
Healthcare worker 329 89.0 (78.8–94.6) 175 62.0 (31.2–85.5)
Know someone with CCHF 12 3.2 (1.2–8.5) 30 4.7 (3.1–7.0)
Other, friend, family member
8
2.2 (0.7–6.9)

1
1.0 (0.2–5.5)

Transmission
Tick bite 415 99.6 (98.5–99.9) 367 99.4 (97.8–99.9)
Mosquito bite 0 0 0 0
Flea bite 5 0.05 (0–0.4) 3 0.4 (0.1–2.7)
Crushing tick with bare hands 218 53.8 (21.4–83.3) 96 31.3 (15.5–53.0)
Contact with blood from an infected animal 50 9.10 (3.5–21.7) 91 21.0 (7.1–48.1)
Contact with birthing tissue of infected animal 16 2.0 (0.6–6.4) 66 16.1 (5.1–40.7)
Eating or touching raw meat of infected animal 12 1.3 (0.4–4.5) 49 12.4 (4.1–32.0)
Contact with blood from infected human 186 41.6 (28.2–56.3) 183 45.0 (30.2–60.9)
Contact with persons sick with CCHF 135 37.8 (19.3–60.6) 204 67.9 (47.3–83.3)
Unpasteurized milk 7 0.3 (0.1–1.7) 10 1.9 (0.5–7.3)
Correctly identified >1 transmission route
413
99.6 (98.5–99.9)

367
99.6 (97.8–99.9)
0.90
High-risk activities
Working with livestock 386 94.7 (86.6–98.0) 168 52.8 (30.4–74.1)
Gardening or fieldwork 144 50.1 (27.5–72.7) 89 30.4 (17.0–48.2)
Being in a woody area 115 30.6 (13.0–56.5) 152 55.1 (33.6–74.9)
Crushing ticks with bare hands 261 62.2 (30.8–85.8) 132 39.3 (26.4–53.9)
Shearing animals 231 53.7 (29.0–76.7) 102 37.2 (18.4–60.7)
Butchering meat 79 16.7 (7.4–33.6) 50 14.7 (5.0–35.9)
Working in healthcare 67 14.3 (5.6–31.8) 51 6.4 (4.1–9.7)
Slaughtering animals 35 7.5 (3.8–14.3) 17 4.1 (1.6–10.2)
Being a veterinarian 120 28.5 (12.7–52.1) 76 29.1 (11.2–57.2)
Contact with sick humans 222 55.2 (33.8–74.8) 266 77.8 (66.6–86.1)
Don’t know 9 0.8 (0.2–3.0) 2 0.04 (0–0.3)
Correctly identified at >1 high-risk activity
378
95.8 (89.8–98.3)

248
75.9 (49.1–91.1)
0.001
Signs and symptoms in humans
Fever 398 96.8 (92.7–98.6) 312 93.0 (79.4–97.8)
Headache 302 74.5 (44.0–91.6) 297 88.7 (71.0–96.2)
Nausea, vomiting 183 55.8 (36.8–73.2) 86 25.0 (13.8–41.1)
Diarrhea 75 22.4 (12.4–37.2) 59 20.3 (11.6–33.3)
Muscle pain 190 48.0 (26.1–70.6) 81 19.3 (8.5–38.1)
Joint pain 222 59.8 (46.3–72.1) 158 47.6 (32.7–62.9)
Fatigue 224 66.3 (52.8–77.6) 240 66.0 (51.5–77.9)
Cough, respiratory involvement 53 12.9 (5.1–29.0) 26 5.6 (1.3–21.6)
Congestion 110 27.2 (14.6–44.8) 15 4.5 (1.4–13.4)
Bruising 115 27.7 (15.2–45.1) 59 10.1 (4.4–21.4)
Bleeding, hemorrhage 251 57.2 (42.6–70.7) 129 26.4 (15.3–41.7)
Red eyes 55 14.1 (7.5–24.9) 6 0.6 (0.2–2.3)
Coma 21 4.6 (2.1–10.0) 3 0.3 (0.1–1.7)
Death 73 17.0 (6.8–36.4) 13 1.2 (0.3–4.7)
Don’t know 19 1.5 (0.5–4.6) 10 0.7 (0.1–3.9)
Correctly identified >1 symptom in humans
395
98.0 (94.6–99.3)

346
97.0 (90.6–99.1)
0.57
Signs and symptoms in animals
None (correct response) 69 20.0 (3.4–64.0) 35 16.0 (2.0–64.3) 0.84
Fever 149 36.5 (10.5–73.9) 203 44.0 (14.9–78.0)
Aggression, agitation 64 13.3 (4.7–32.6) 130 31.1 (10.3–63.8)
Vomiting 84 27.2 (7.1–64.6) 30 7.0 (1.3–30.9)
Lethargy 87 23.0 (6.6–56.0) 151 28.5 (10.2–58.3)
Abortion, stillbirth 77 20.5 (6.1–50.4) 46 9.8 (2.7–29.9)
Reduced appetite 75 22.1 (6.3–54.4) 145 33.0 (11.8–64.3)
Hair loss 60 16.3 (4.6–44.0) 34 7.2 (1.5–28.5)
Weight loss 55 15.3 (4.2–42.3) 38 6.6 (1.3–26.6)
Reduced milk production 54 15.7 (4.8–41.0) 26 5.0 (1.3–17.5)
Respiratory problems 29 7.7 (2.4–21.8) 18 2.2 (0.5–9.4)
Bleeding, hemorrhage 52 11.1 (3.6–28.9) 47 9.4 (3.2–24.7)
Eye problems 13 3.1 (0.6–15.2) 3 0.3 (0.04–2.7)
Death 12 1.3 (0.4–3.8) 2 0.2 (0.04–1.1)
Don’t know 71 13.8 (5.4–30.7) 2 1.0 (0.2–5.4)

*>1 response possible in each category. CCHF, Crimean-Congo hemorrhagic fever.
†Percentage weighted by calculating the inverse probability of selection and applying a post-stratification adjustment to each stratum to account for nonresponses.