Assessing hygiene and zoonotic risk perception in the Danube Delta: insights from the pre- and early-COVID-19 periods

Zoonoses, or diseases that are naturally transmitted between animals and humans, are a global public health problem, accounting for over 60% of all infectious and parasitic diseases affecting humans. Therefore, raising awareness of the risks within communities is an activity that must be constant. The issue of zoonoses is of particular importance in regions characterized by high biodiversity, such as the Danube Delta. In this complex ecosystem, the frequency of interactions between the human population, native wildlife, and domestic animals creates favorable conditions for the transmission and spread of zoonotic pathogens, thus amplifying the risks to public health in the area. Despite information campaigns organized by local veterinary and public health authorities to educate communities about zoonotic diseases, feedback on the uptake of this information among residents remains limited. We used two cross-sectional waves (pre-COVID-19, 2019; COVID-19 onset, 2020), administering a questionnaire with 45 items in five domains (context, domestic animals, wildlife hazards, foodborne pathogens, and ticks) to assess awareness levels about zoonoses among respondents in 23 localities in Tulcea County, adjacent to the Danube Delta Biosphere Reserve (DDBR). Descriptive statistics (proportion with 95% Cls) and year-to-year comparisons (chi-square tests) were conducted. A total of 292 adults provided complete or partial responses, 157 respondents in 2019, and 135 in 2020. The results indicated that although the majority of respondents demonstrated a fairly good understanding of zoonotic diseases and applied a range of prevention measures, there are still notable gaps in knowledge and risk-related behaviors, exemplified by the differential trust and cognitive dissonance observed. The emergence of COVID-19 has further highlighted the importance of addressing zoonotic threats and reinforced the role of veterinarians as vital communicators in public health education. Therefore, it is imperative to implement more information campaigns aimed at correcting existing knowledge deficits, improving awareness, and applying prevention measures. Continued community engagement efforts are essential to strengthening public understanding of zoonotic diseases and facilitating effective prevention strategies.