Knowledge, attitudes, and practices of nurses toward Nipah virus infection prevention and control in rural Pangasinan, Philippines: a cross-sectional KAP study
Abstract
Objective
Nipah virus (NiV) is a highly fatal emerging zoonotic disease with expanding bat reservoirs and documented transmission in the Philippines. However, the preparedness of frontline nurses in rural healthcare settings remains insufficiently understood. This study assessed the knowledge, attitudes, and practices (KAP) of nurses regarding NiV infection prevention and control (IPC) in rural Pangasinan, Philippines.
Methods
A cross-sectional KAP survey was conducted among registered nurses working in government and private healthcare facilities in rural municipalities of Pangasinan. A structured, pretested questionnaire assessed socio-demographic characteristics and KAP related to NiV epidemiology, transmission, clinical manifestations, and IPC strategies. Knowledge scores were categorized as good (≥70%) or poor, and attitudes and practices were classified as favorable or unfavorable based on predefined Likert-scale cutoffs. Data were analyzed using descriptive statistics, chi-square tests, and multivariable logistic regression to identify factors associated with good knowledge and good practices. Ethical approval was obtained from the Philippine Region 1 Ethical Review Committee (Protocol No. NURDD827A 2026), and written informed consent was obtained from all participants.
Results
A total of 250 nurses participated (response rate >80%); most were female (60.0%), mid-career, and employed in hospital or rural health unit settings. Overall, 110 nurses (44.0%) demonstrated good knowledge of NiV, while 180 (72.0%) expressed favorable attitudes toward NiV preparedness and 120 (48.0%) reported good IPC practices. Knowledge gaps were most evident regarding specific transmission routes and appropriate use of full personal protective equipment (PPE). In multivariable models, longer clinical experience (>10 years), hospital employment, NiV-specific training, and recent IPC or emerging infection training were independently associated with higher odds of good knowledge. Good practice was independently associated with longer experience, hospital employment, NiV-specific training, IPC training, and good knowledge of NiV.
Conclusions
Rural nurses in Pangasinan demonstrate predominantly positive attitudes but limited knowledge and suboptimal practices regarding NiV IPC, revealing a clear attitude–practice gap. Targeted, context-specific education and regular simulation-based IPC training—particularly for less experienced nurses and those working in smaller facilities—are needed to strengthen preparedness for potential NiV outbreaks in rural Philippine health settings.
© 2026 Fernan Torreno, Frincess Flores, published by Shanxi Medical Periodical Press
This work is licensed under the Creative Commons Attribution 4.0 License.