Knowledge, perceptions, and associated factors of marburg virus disease in selected towns and districts of the South Ethiopia Region: an explanatory sequential mixed-methods study

The effectiveness of risk communication and community engagement (RCCE) depends on the population’s baseline knowledge, perceptions, and the sources of information. Therefore, this study aimed to assess community knowledge, perceptions, and associated factors of Marburg virus disease in the South Ethiopia Region. A community-based explanatory sequential mixed-methods study was employed among 614 adults in MVD-affected areas of the South Ethiopia Region from February 16, 2026, to March 10, 2026. Quantitative data were collected using interviewer-administered questionnaires with the Kobo Toolbox data collection software. For qualitative data, focus group discussions were conducted. To identify study participants, a systematic random sampling technique was used. To identify factors associated with knowledge and perception towards MVD, a binary logistic regression was fitted. Statistical significance was declared at a P -value < 0.05. For qualitative data, thematic content analysis was conducted. Among 611 adults who participated in the study, 74.8% (95% CI 71.2%, 78.1%) had good knowledge, and 62.7% (95% CI 58.8%, 66.4%) had positive perception, respectively. Educational status (AOR = 4.40; 95% CI 2.45, 7.89), source of information (AOR = 0.42; 95% CI 0.21, 0.87), and perception (AOR = 2.05; 95% CI 1.28, 3.26) were associated with knowledge. Participants aged 25–59 years (AOR = 0.40; 95% CI 0.21, 0.75), social media utilization (AOR = 5.13; 95% CI 3.12, 8.44), and MVD knowledge (AOR = 2.00; 95% CI 1.31, 3.0) were associated with perception. Health education delivered in multiple channels contributed to increased knowledge, whereas official recognition corrected early misconceptions and changed attitudes. Targeted interventions that focus on lower educational status and wealth, advanced age, and sources of information are essential. Strengthening risk communication and community engagement via trusted platforms is crucial. Strategies that utilize social media for information dissemination, empower housewives, and build positive perceptions are highly recommended.