Abstract
BACKGROUND: Cholera, a severe diarrheal disease transmitted through contaminated water and food, poses a significant public health threat, particularly in vulnerable populations. Inadequate knowledge and poor hygiene practices are major drivers of its transmission. This study aimed to assess cholera knowledge and handwashing practices among residents of the Hayayaabe Internally Displaced Persons (IDP) camp in Borama, Somaliland. METHODS: A community-based cross-sectional study was conducted in the Hayayaabe IDP camp (500 households) between April and June 2024. Data were collected from 251 randomly selected participants using structured questionnaires and analyzed using descriptive statistics, chi-square tests, and multivariable logistic regression in SPSS 26 and Stata 16 to identify factors associated with cholera knowledge and handwashing practices. RESULTS: Only 25% of respondents demonstrated good knowledge of cholera, and 26.3% reported good handwashing practices. Multivariable analysis revealed that older age (AOR 0.07, 95% CI: 0.005-0.943), source of information (AOR 0.042, 95% CI: 0.003-0.556), and higher education (AOR 9.129, 95% CI: 0.999-84.29) were significantly associated with cholera knowledge. Factors considerably influencing handwashing practices included older age (AOR: 0.026, 95% CI: 0.002-0.418), sex (AOR: 0.072, 95% CI: 0.014-0.363), family income (AOR: 71.604, 95% CI: 18.787-272.945), and higher education (AOR: 34.97, 95% CI: 20.06-59.039). The high odds ratios suggest model instability due to small subgroup sizes and should be interpreted with caution. CONCLUSION: Targeted interventions by the Ministry of Health and local government, including deploying mobile health teams and engaging community leaders, are crucial for delivering effective health education and improving handwashing practices to prevent disease in this vulnerable community.