Exploring rural households’ knowledge and perception of acute kidney injury in the southern region of The Gambia: a mixed-method community-based cross-sectional study design

Abstract

Background The Acute Kidney Injury (AKI) outbreak in The Gambia is a national tragedy attracting international concern, linked to nearly 100 deaths in children. This situation arose due to the use of contaminated medical products by children in the country.Method We used a mixed-method, cross-sectional study design to assess households’ knowledge and perceptions of AKI in the southern region of The Gambia. A total of 2174 respondents from 123 rural communities were recruited via multistage sampling and were interviewed face-to-face using a questionnaire. Qualitatively, focus group discussions and key informant interviews were conducted. The collected data were analysed as categorical and continuous variables, and thematic areas using SPSS V.26 and NVivo software.Results The mean age was 36 years (SD±14.17) and 70% of the respondents were women. Most respondents had no formal education (45.6%), lived in extended family households (55%) and 91.6% earned a monthly income of less than GMD5000 (Gambian dalasi) (<US$100). Although 80% of the respondents were aware of the AKI outbreak in The Gambia, 90% showed poor knowledge about the disease. Half of the respondents correctly identified contaminated medical products as the cause of AKI. Interestingly, 97.1% of the participants held a moderate perception of AKI in The Gambia and firmly rejected the notion that the outbreak was politically motivated. The AKI outbreak was viewed as a stern lesson and a wake-up call for the Ministry of Health to take the necessary actions.Conclusion A significant deficiency in AKI knowledge exists among rural households, even though their perceptions of health services remain positive and unwavering. AKI is viewed as a widespread health concern rather than a political issue. To maintain this view and enhance trust, a national dialogue involving the Ministry of Health and the population is recommended.