Knowledge and perception as determinants of CRISPR application for infectious diseases in Sub-Saharan Africa: a multi-country study in Ghana, Nigeria, and Sierra Leone using regression and structural equation models

BACKGROUND AND AIM: Infectious diseases, particularly acquired immunodeficiency syndrome (AIDS) caused by the human immunodeficiency virus (HIV), remain a major global health burden, especially in low- and middle-income countries, despite advances in antiretroviral therapy. Emerging genome-editing technologies, such as CRISPR/Cas systems, hold promise for transforming the diagnosis and treatment of infectious diseases. However, little is known about how these technologies are understood and perceived by individuals in high-burden regions, where significant implementation challenges may limit their adoption. This study assessed knowledge, perceptions, and the potential application of CRISPR technology for infectious disease control in Ghana, Nigeria, and Sierra Leone. METHODS: This multi-center cross-sectional study was conducted among 300 participants, including students, healthcare professionals, and researchers across the three countries. Data was collected using a well-structured questionnaire and analyzed using logistic regression and structural equation modeling (SEM) to identify the predictors of potential CRISPR applications. RESULTS: The study revealed a significant gap, such that the majority (87.0%) of the participants demonstrated inadequate knowledge, with 70.7% exhibiting poor perception of CRISPR technology. Major barriers to implementation included funding constraints (81.7%) and inadequate infrastructure (62.3%). Adjusted multivariable logistic regression identified inadequate knowledge (aOR: 3.90; p < 0.0001) and poor perception (aOR: 1.96; p = 0.0060) as independent predictors of low CRISPR application potential. Structural equation modeling confirmed that knowledge significantly enhances perception (β = 0.55), and both constructs jointly influence the potential application of CRISPR gene editing technology. CONCLUSION: There is a critical deficit in knowledge and perception regarding CRISPR gene editing in Sub-Saharan Africa, which significantly hinders its potential application for infectious diseases. Comprehensive educational strategies and capacity building are essential to foster the adoption of CRISPR technology, especially in resource-limited settings.