Knowledge and perceptions about brucellosis among high risk groups are crucial in influencing the health seeking behavior of patients as well as controlling its transmission in animals and humans in communities. Our study, that aimed at assessing these aspects on brucellosis, found that 197 (53.1%) had moderate overall knowledge on brucellosis symptoms, transmission, treatment, prevention and risk factors among the participants. A majority of the participants (99.3%) in our study had ever heard about brucellosis (commonly known as ‘brucella’). The main source of information about the disease was from friends (42.4%). Contrary to this finding, a study in central Asia  found that 31% of the respondents had heard about brucellosis from human doctors. The different sources of information highlight a need for multiple communication channels to transmit and improve public knowledge about brucellosis through the media, social gatherings and schools as well as ensuring that knowledge being transmitted is standardized through frequent follow-up with health education talks on biomedical knowledge of the disease from health and veterinary.
In regard to perceptions about brucellosis, although most of the participants (311, 84.7%) believed that the disease does not segregate between age groups and sex, (243, 66.2%) believed it is not seasonal but occurs throughout the year. two thirds of the participants (251, 67.7%) mentioned that close proximity to wild animals is the major factor that contributes to the increase of brucellosis in the study areas and the majority of the participants (89.8%) believed that brucellosis became a health problem from around the year 2000 when wildlife–human–domestic animal interaction increased as a result of drought in the area. This increasing frequency and severity of drought, particularly in the semi-arid areas of the cattle corridor has resulted in a lack of water and natural pasture . From our study area, the Lake Mburo National Park Authority in 2009 reported that farmers, mostly from Sanga, Kanyaryeru, and Nyakashashara sub-counties, moved over 15,000 cows to the park that competed with wild animals for food and water and increased the risk for the transmission of animal diseases . Wild animals such as: buffaloes, impalas and zebras are common in grazing areas, mixing freely with livestock. Brucellosis prevalence in buffaloes has been reported from Egypt (10.0%) and Pakistan (5.05%) . With this increasing interaction that poses a threat to both humans, domestic animals and wild animals, there is need for collaborative efforts from the health and veterinary sectors, the Uganda Wildlife Authority as well as the communities in order to control brucellosis by implementing restrictions on animal movements.
All participants had a high level of knowledge of the clinical signs of brucellosis in humans, mostly recurrent fever and joint and muscle pains (Table 3). This finding is similar to that seen in a study in Central Asia  where 84% of owners of small ruminants mentioned joint ache and other limb problems; and half of them mentioned fever as a symptom of brucellosis in humans. Our findings may be due to the fact that the study area is an endemic setting, thus the participants have basic knowledge of the disease. Contrary to this, a study done among herdsmen in Ghana  found that only 4.5% knew at least one symptom of brucellosis in humans. A majority (77%) of the participants in our study were aware that brucellosis presents like other common illnesses and 64% reported that its symptoms were similar to those of malaria. This is crucial because in humans, brucellosis is often easily misdiagnosed as other febrile syndromes such as malaria and typhoid fever, thereby resulting in underreporting and hence misdirected treatments .The ability of our respondents to identify symptoms of brucellosis in humans as well as other febrile illnesses is crucial in seeking health care and minimizes misdiagnosis of the disease as well as unwarranted treatment. With this increased knowledge, there is need to increase the effective demand for services by highlighting prompt treatment for brucellosis as well as the provision of equipped health facilities to address the demand.
Conversely, very low knowledge of the symptoms of brucellosis in animals was depicted by the respondents. Only 70 (19%) knew the symptoms of brucellosis in animals. A small proportion (14%) mentioned that abortion in animals was a major sign of the disease, findings similar to studies done in cattle keeping communities of Nigeria () and Central Asia , where abortion was mentioned by 11% of the participants. This low knowledge may be due to the different perceptions that pastoralists have concerning infertility, reduced milk production and abortions since perception of a risk is influenced by such factors as life experience and culture  as well as inadequate knowledge of the disease in animals. Contrary to the above, a study done in Egypt  found high knowledge (94.4%) of the clinical signs (abortions and low milk production) in animals and concluded that this finding was consistent with the endemic situation in Egypt. Since low knowledge of brucellosis in animals poses a zoonotic threat to public health, it is important to provide health education on animal brucellosis since the source of human infection resides in domestic or wild animal reservoir and therefore, prevention of human brucellosis depends predominantly on the control of the disease in animals .
Participants were knowledgeable on transmission routes of brucellosis which were; consumption of unpasteurized dairy products (97%) and eating of raw or half-cooked meat in humans (91.4%) while in animals eating contaminated pasture (97.4%). Additionally, most participants (87.3%) were aware that eating game meat was a source of transmission from wild animals to humans. The increasing wildlife–human–domestic animal interface, including the consumption of game meat around the world has recently attracted concerns and is challenging  since 75% of emerging infectious diseases are zoonoses that are predominantly associated with wildlife  which clearly highlights an increasing threat arising from these animal species. However, other animal to human and within animal transmission routes such as direct contact with infected birth products or aborted materials like placentas , and inhalation of contaminated dust, animals mating with infected animals and through artificial insemination  were less known by the study participants. Similar studies elsewhere have shown less community knowledge and understanding regarding such hazards as infected placental materials and contaminated products, as was seen in Central Asia  and in Ghana , where only 12.9% of the respondents knew the transmission from cattle to humans. There is a need for increased public health education and behavioral change communication with emphasis on various modes of transmission from animal to animal (both domestic and wild animals) and from animal to humans in order to better control the disease in endemic areas.
Almost all the participants were knowledgeable about treatment of brucellosis in both humans and animals. They reported use of modern drugs in humans (95%) and seeking veterinary care for animals (84%) as the best options. We view this as a good indicator that would influence better health care seeking behavior and uptake of public health messages. Furthermore, most of the participants (89.8%) were aware that brucellosis is preventable in both humans and animals. However, only two methods of prevention from animals to humans and within animals were commonly mentioned: pasteurization of dairy products (88.9%) and proper cooking of meat (86.0%) to prevent transmission to humans; and isolation of infected animals (62.0%) from healthy ones as well as testing animals before mating and artificial insemination (52.3%). Ironically, it was noted that majority of the participants did not practically isolate the sick animals because of lack of facilities for isolation of suspected and/or infected animals, yet this is one of the major risk factors for disease transmission between animals as susceptible animals can be infected via contact with sick animals or contact with aborted materials or products of parturition .
Although participants were aware of the importance of testing animals for brucellosis before mating and vaccination of healthy animals, they cited high costs as a hindrance. This is compounded by the fact that there is no vaccine that has been proven to be safe and to provide significant degree of protection in wild animals species , hence a risk remains for spill-over from wild to domestic animals as a result of interaction in marginal grazing areas. A previous study investigating patient perceptions of brucellosis in Greece  found that around 44% of farmers would not allow veterinary investigation for fear of undesirable effects on their herds. This indicates that underreporting is likely to be a problem hindering brucellosis control in the communities. This difference between knowledge and actual practice indicates that high knowledge of a disease does not necessarily go hand in hand with accurate behavior and practices, as other factors may come into play. Therefore, there is need for continuous innovative preventive and control strategies such as laboratory-backed surveillance, equipped laboratories, training, education and communication on brucellosis in the communities in order to reduce transmission.
In our multivariate logistic regression analysis, agro-pastoralism as an occupation was a predictor of high overall knowledge of brucellosis. Studies in similar settings of pastoralist [33, 34] and agro-pastoral communities  in Tanzania found that agro-pastoralism as an occupation was predictive of high biomedical overall knowledge of pulmonary tuberculosis (PTB). The similarity in our study maybe as a result of sedentarization of pastoralists in Uganda’s cattle corridor , where this change of lifestyle may have brought about to improve access to health and social services  as well as veterinary extension services. The cattle corridor occupies a significant proportion of approximately 44% of Uganda’s total land area. It stretches from the south through the districts of Ankole and northern parts of Buganda to the north central part of Uganda . This area is semi-arid, and has suitable climatic conditions that make it conducive to cattle rearing.
Mobility in pastoralist communities has been cited as a great hindrance to access to knowledge as well as health care and veterinary extension services because of the geographical, social and cultural environment . This may be curbed by bringing health and veterinary services such as mobile clinics and social services closer to the people who do not easily access them.
Participants who knew that brucellosis was a health problem in the area was significantly associated with overall knowledge of brucellosis.There is need for more health education on brucellosis for better prevention and control of the disease in the communities.
At sub scale analysis for each domain of knowledge, high knowledge of choice of effective treatment as modern drugs was associated with being female. Conversely, contrary findings were found in a study in pastoral communities in Ethiopia which found an association between males and high knowledge of choice of treatment with modern tuberculosis drugs . Findings in our study may be as a result of differences in health seeking behaviour between females and males and/or economic independence between the genders in these communities. However, low knowledge of symptoms in animals among all study participants was also associated with the age group 30–59 years although this was not significant when analyzing overall knowledge. This result may be due to different perceptions on symptoms of the disease in terms of age and experience. Therefore, health education on brucellosis targeting age groups and both sexes is crucial in order to change the perceptions of the people to more biomedical knowledge for better management and control of the disease.
A possible limitation to this study is that the selection of participants was based on systematic sampling which may have brought in errors and biases. However, we believe that this was controlled for in the selection process since households were homogenous in nature. The second limitation was during data collection where some respondents (household heads) were away with their herds in search of water and pasture since it was a dry season. This was minimized by making appointments and for those who were not available; their spouses were interviewed after consenting to the study. We recommend a future study to explore ways of promoting health education on brucellosis in the communities as a control strategy of the disease.