Community knowledge, hygiene practices, and predictive factors for rotavirus and wastewater-related health risks in Morogoro, Tanzania

ABSTRACT Wastewater is a potential reservoir for pathogens, and poor management increases the risks of diseases such as rotavirus-associated diarrhea. This study assessed community awareness, hygiene practices and socio-demographic predictors of rotavirus and wastewater-related health risk in Morogoro Municipality and Mvomero District, Tanzania. A cross-sectional survey was conducted between November 2024 and February 2025 among 244 adults residing near wastewater treatment facilities. Data were collected using a structured questionnaire and analysed using descriptive statistics, chi-square tests, and logistic regression. Awareness of rotavirus was low, with only 23.4% (57/244) of respondents reporting prior knowledge, and 20.9% (51/244) understanding its transmission. While 55.0% (134/244) recognized health risks associated with untreated wastewater, only 26.0% (64/244) identified wastewater as a transmission pathway. Unsafe wastewater disposal practices were common, with 52.9% (129/244) discharging wastewater into open drains. Awareness of wastewater risks was significantly associated with improved hygiene practices, including proper disposal (OR = 7.39, P < 0.001) and handwashing behaviors. Education and occupation were significant predictors of awareness and preventive practices (χ2 = 44.77, χ2 = 26.11, p < 0.0001). Overall, substantial gaps exist between knowledge and practice. Strengthening community-based health education and improving sanitation infrastructure are essential to reduce diarrheal disease burden in Morogoro and similar settings.