Socioeconomic and Environmental Predictors of Lassa Fever Transmission in Lower Bambara Chiefdom, Kenema District, Eastern Sierra Leone

Abstract Background : Lassa fever (LF), a viral hemorrhagic illness endemic to West Africa, poses significant health challenges due to its high morbidity and mortality rates. This study investigates the complex interplay of socioeconomic, and environmental factors contributing to the spread of LF in Lower Bambara Chiefdom, Kenema District, Eastern Sierra Leone. Methods: A descriptive cross-sectional quantitative design was employed, targeting adult males and females in Lower Bambara Chiefdom. Data were collected through structured interviews focusing on participant demographics, community characteristics, and LF-related factors. Statistical analyses, including Chi-square tests, and bivariate and multivariate analyses were conducted to assess correlations and identify risk factors. Results: The study involved 2,167 participants. Majority were males (54.60%); most dominant age groups were 34-41 years (27.00%) and 42-49 years (22.00%). Over half never attended school (61.70%) and were farmers (64.90%). More than 60% were married (monogamous) and heads of households. Sex, age, education, occupation and relationship to household head except marital status (p=0.08), were statistically significant with LF endemicity (p<0.05). Environmental markers like moderate bushy surroundings (53.90% to 73.50%), mixed farming practices (61.50%), standpipes (40.47%) as major water sources, and waste burning (77.34%) as the primary waste disposal method were identified as significant influencers. Mud walls (72.00%) and zinc roofing (90.00%) were common construction materials used. Almost all (85.5%) consume palm wine were purchased from the market. Logging activities occurred close to residential areas, with an average distance of 14.65 meters. Socioeconomic factors like asset ownership and livelihood activities (farming and palm wine consumption) were also significant. Conclusion: The study found that factors like gender, age, education, occupation, environmental conditions, construction materials, and proximity to logging activities influence LF in Lower Bambara Chiefdom. High palm wine consumption and socioeconomic factors also highlight the need for tailored public health interventions.