Occupational brucellosis among livestock farmers in Northeastern Thailand: A cross-sectional study of knowledge, attitudes, and practices from a One Health perspective

Brucellosis remains a significant occupational zoonotic disease among livestock farmers, with substantial implications for animal health, worker safety, and public health in endemic regions. Effective control at the livestock-human interface depends on understanding farmers' knowledge, attitudes, and practices (KAP) regarding disease prevention. This study aimed to assess determinants of occupational brucellosis prevention behaviors among ruminant farmers in Northeastern Thailand through comprehensive KAP analysis to inform targeted One Health strategies. A cross-sectional survey was conducted from October 2024 to July 2025 across three provinces (Nakhon Ratchasima, Buriram, and Surin) in lower Northeastern Thailand. Structured questionnaires were administered to 385 livestock farmers managing ruminants (beef cattle, dairy cattle, buffalo, goats, or sheep). Knowledge, attitude, and practice domains were scored and analyzed using logistic regression to identify behavioral determinants. Although 65.5% of farmers demonstrated satisfactory knowledge, only 20.0% reported comprehensive favorable preventive practices across personal and farm-level measures. Notably, farmers exhibited selective engagement with prevention: while all avoided raw milk and placental product consumption, only 38.7% used gloves during high-risk activities compared to 61.6% wearing boots. Multivariate analysis identified farm certification, including Good Farm Management as shown by adjusted Odds Ratio (aOR) 2.60 (95% CI: 1.06-6.39), and brucellosis-free certification as shown by aOR 5.35 (95% CI: 1.63-17.54). Awareness of having heard regarding the scientific term "brucellosis" was associated with favorable practices (aOR 2.74, 95% CI: 1.00-7.46). In conclusion, knowledge alone was insufficient to drive consistent preventive behaviors, instead, farm certification, targeted education on transmission routes, and perceived occupational susceptibility emerged as key drivers of practice adoption. Our findings highlight the necessity for integrated interventions combining domain-specific training, formal disease alerts, and structural supports such as certification programs to enhance occupational safety and brucellosis control aligned with One Health principles in Thailand.