Rats – A West African delicacy or deathtrap? Behavioural insights into Lassa fever transmission, prevention and control in Eastern Sierra Leone

Background Lassa fever is among the top emerging infectious diseases whose effective control depends on behavioural insights regarding its transmission, prevention and control. The study sought to explore behavioural insights - awareness, knowledge, lived experiences and behaviours – to inform Lassa fever transmission, prevention and control efforts in Eastern Sierra Leone. Methods This was a qualitative cross-sectional study conducted through focus group discussions (FGDs) and key informant interviews (KIIs), targeting diverse, information-rich community members. Thematic data analysis in Atlas.ti.22 involved analysis of interview transcripts to derive concepts, the classification and interpretation of these concepts to generate themes, capturing the essence of related behavioural insights. Results Total study participants were 114 - ten FGDs and 14 KIIs. Four themes emerged: knowledge gap on Lassa fever causation and transmission pathways; syndromic overlap between Lassa fever and other diseases; Lassa fever-related cultural and traditional health dilemmas and gendered health paradox. Conclusions Determinants of health behaviour extend beyond awareness, knowledge and understanding, to include crucial aspects like behavioural enablers and cultural factors. A context-aware approach is required wherein Lassa fever-related policies and programs prioritize the generation and utilization of context-specific behavioural data to drive effective health behaviour change.