Abstract
BACKGROUND: Nipah virus (NiV) is a zoonotic pathogen with high case-fatality rates, recurring outbreaks, and significant public health implications in Bangladesh, particularly in regions known as the "Nipah belt." This study aimed to assess the knowledge, attitudes, and practices (KAP) of the general population regarding NiV transmission, prevention, and control measures. METHODOLOGY/PRINCIPLE FINDINGS: A cross-sectional survey was conducted from December 2024 to April 2025 among 545 respondents, selected through multi-stage sampling from 48 upazilas across 16 districts. A structured questionnaire, prepared in Bengali and English, covered four domains: sociodemographic characteristics, knowledge, attitude, and practice. Data were collected via face-to-face interviews and reported through KoboToolbox and analyzed using descriptive statistics and logistic regression. Findings revealed that only 29.2% of participants demonstrated good knowledge of NiV infection, while 94.1% showed positive attitudes toward prevention and control. However, correct preventive practices were reported by just 33.0% of respondents. Awareness of bat-to-human transmission was relatively high (66.2%), yet knowledge of the disease's high fatality rate (11.4%) and preventive measures (28.8%) was low. Over half of participants (53.2%) reported consuming raw date palm sap, a key transmission route. Higher education, employment, and proximity to sap collection areas were associated with better knowledge, while younger age, female gender, and higher income were linked to better practices. CONCLUSION/SIGNIFICANCE: This first nationwide community-level KAP survey highlights critical gaps between awareness and behavior, underscoring the need for sustained, culturally tailored interventions, strengthened surveillance, and One Health approaches to reduce NiV spillover and transmission risks in Bangladesh.