Open Access Highly Accessed Research article

Knowledge, attitudes and practices (KAP) relating to avian influenza in urban and rural areas of China

Nijuan Xiang1, Ying Shi12, Jiabing Wu3, Shunxiang Zhang4, Min Ye1, Zhibin Peng1, Lei Zhou1, Hang Zhou1, Qiaohong Liao1, Yang Huai1, Leilei Li5, Zhangda Yu6, Xiaowen Cheng4, Weike Su7, Xiaomin Wu4, Hanwu Ma4, Jianhua Lu4, Jeffrey McFarland8 and Hongjie Yu1*

Author Affiliations

1 Office for Disease Control and Emergency Response, Chinese Center for Disease Control and Prevention, Beijing, China

2 Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, Beijing, China

3 Anhui Provincial Center for Disease Control and Prevention, Hefei, China

4 Shenzhen Center for Disease Control and Prevention, Shenzhen, China

5 Chongqing Medical University, Chongqing, China

6 Huanshan Center for Disease Control and Prevention, Huangshan, China

7 Xiuning Center for Disease Control and Prevention, Xiuning, China

8 Influenza Division, National Center for Immunization and Respiratory Diseases, Center for Disease Control and Prevention, Atlanta, USA

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BMC Infectious Diseases 2010, 10:34  doi:10.1186/1471-2334-10-34

Published: 21 February 2010



Studies have revealed that visiting poultry markets and direct contact with sick or dead poultry are significant risk factors for H5N1 infection, the practices of which could possibly be influenced by people's knowledge, attitudes and practices (KAPs) associated with avian influenza (AI). To determine the KAPs associated with AI among the Chinese general population, a cross-sectional survey was conducted in China.


We used standardized, structured questionnaires distributed in both an urban area (Shenzhen, Guangdong Province; n = 1,826) and a rural area (Xiuning, Anhui Province; n = 2,572) using the probability proportional to size (PPS) sampling technique.


Approximately three-quarters of participants in both groups requested more information about AI. The preferred source of information for both groups was television. Almost three-quarters of all participants were aware of AI as an infectious disease; the urban group was more aware that it could be transmitted through poultry, that it could be prevented, and was more familiar with the relationship between AI and human infection. The villagers in Xiuning were more concerned than Shenzhen residents about human AI viral infection. Regarding preventative measures, a higher percentage of the urban group used soap for hand washing whereas the rural group preferred water only. Almost half of the participants in both groups had continued to eat poultry after being informed about the disease.


Our study shows a high degree of awareness of human AI in both urban and rural populations, and could provide scientific support to assist the Chinese government in developing strategies and health-education campaigns to prevent AI infection among the general population.