The Open Public Health Journal

ISSN: 1874-9445 ― Volume 14, 2021

Knowledge, Attitudes and Practices of Multinational Municipal Waste Collectors on Leptospirosis in Penang Island

Fairuz Fadzilah Rahim1, *, Siti Fatimah Kader Maideen1, Abdul Rashid1, Surajudeen Abiola Abdul Rahman2
1 RCSI &UCD Malaysia Campus, Penang, Malaysia
2 Health Education England, East Midlands, Westbridge Place, 1 Westbridge Close, LeicesterLE3 5DR, United Kingdom



Leptospirosis is an important occupational zoonotic disease, but often neglected and under-reported. Municipal waste collectors are at risk due to their nature of work, and could be a unique target for interventions focused at risk reduction.


The study aimed to determine the knowledge, attitudes, and practices (KAP) of municipal waste collectors in Penang towards prevention of leptospirosis, and identify factors associated with the KAP.


A cross-sectional study was conducted using face-to-face interview among 184 municipal waste collectors. They completed a questionnaire on sociodemographics and KAP towards leptospirosis. Multiple linear regression was performed to determine factors associated with KAP towards the leptospira infection.


The majority of participants were Bangladeshi (75.0%) and Indonesian nationals (20.7%), with poor knowledge of leptospirosis (92.93%). The attitudes towards leptospirosis were moderate (59.78%) while preventive practices were good (74.46%). There was an increase in the likelihood of using preventive practices with positive attitudes. Indonesians had significantly better knowledge as compared to other nationals (p<0.001) but had poor practices (p=0.021). Workers with upper secondary school education had better attitudes (p=0.026) and preventive practices scores (p=0.045). Individual monthly income had inverse association with attitudes scores (p=0.036).


Overall, the preventice practices among municipal waste workers were good due to relatively better work behaviour. However, they had poor knowledge on the cause, modes of transmission, symptoms and treatment of leptospirosis. This study suggests that targeted education to increase knowledge and systematic preventive measures to reduce contact with the infection are necessary for this occupation group.

Keywords: Keywords, Leptospirosis, Knowledge, Attitude, Practice, Factor, Weil’s disease, Waste collector.

Article Information

Identifiers and Pagination:

Year: 2021
Volume: 14
Publisher Item Identifier (PII): BMS-TOPHJ-2020-192

Article History:

Electronic publication date: 22/4/2021
Collection year: 2021

© 2021 Rahim et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the RCSI &UCD Malaysia Campus (formerly Penang Medical College), 4, Jalan Sepoy Lines, 10450, George Town, Penang, Malaysia., Tel: +604-217 1973; Fax: +604-228 4285; E-mail:

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