Community Awareness, Knowledge, Attitudes, and Perceptions Toward Viral Disease Outbreaks in Dar es Salaam, Tanzania

The frequency and scale of viral disease outbreaks are increasing globally, with communities in sub-Saharan Africa disproportionately affected due to structural, social, and health-system vulnerabilities. Community knowledge, attitudes, and perceptions (KAP) play a critical role in outbreak prevention, control, and response. This study assessed KAP related to viral disease outbreaks among adults in Dar es Salaam, Tanzania, following recent outbreaks, including COVID-19, Mpox, and Marburg virus disease.

A cross-sectional study was conducted among 104 adult visitors attending Muhimbili National Hospital between October and November 2025. Participants were recruited using consecutive sampling. Data were collected using a structured questionnaire capturing sociodemographic characteristics, knowledge of viral disease transmission and treatment, intended preventive practices, sources of health information, stigma-related attitudes, and vaccine perceptions. Data were analyzed using descriptive statistics, chi-square (χ ²) tests, and regression analyses to explore associations between KAP domains and participant characteristics.

General awareness of viral disease outbreaks was high (87.5%); however, substantial gaps were identified in specific knowledge. Only 33.7% of participants correctly recognized that antibiotics are ineffective against viral infections, and fewer than half (46.2%) rejected the misconception that viral diseases are spread only by foreigners. A notable belief-action gap was observed regarding vaccination: Although 71.2% believed vaccines are effective, only 59.6% expressed willingness to be vaccinated. Stigmatizing attitudes were prevalent, with 81.7% of respondents reporting discomfort with welcoming a recovered outbreak survivor into their home. Social media platforms were the primary source of outbreak-related information (51.9%), whereas official national public health communication channels were among the least utilized (22.1%). Knowledge levels showed no significant association with sociodemographic characteristics; however, lower educational attainment was significantly associated with higher levels of stigma (p = 0.02). Vaccine hesitancy was primarily driven by concerns about vaccine efficacy and fear of side effects rather than overall knowledge deficits.

Despite high general awareness of viral disease outbreaks, this study identifies critical weaknesses in specific knowledge, persistent stigma, and vaccine hesitancy that pose challenges for urban healthcare-seeking populations in Dar es Salaam. These findings underscore the need for a strategic shift from broad awareness campaigns to precision public health interventions, including targeted myth-busting, community-led anti-stigma initiatives, and proactive digital engagement to address misinformation, build trust, and strengthen collective outbreak response.