Risk Factors for Human Contact with Bats in Northern Tanzania

Simple Summary

Bats play a crucial role in maintaining healthy ecosystems, yet frequent human-bat interactions in Tanzania are raising significant public health concerns. This study aimed to understand the factors driving these interactions among people living near bat roosting sites in Northern Tanzania. Through interviews, we gathered insights into the community’s knowledge, attitudes, and practices related to bat contact. Over half of the respondents reported direct contact with bats, while only a small minority recognized that bats can carry diseases like rabies. Key factors associated with higher contact rates included low education levels, dependence on outdoor water sources, older age, and a perception that it is safe to handle bats with bare hands. Notably, those who reported bat contact were often less likely to wash hands after these encounters, increasing health risks from potential zoonotic disease exposure. These findings emphasize the need for educational programs to raise awareness of bat-related health risks, alongside efforts to improve access to safe water and promote hygienic practices. Such initiatives could play a vital role in reducing health risks linked to human-bat interactions in rural communities.

Abstract

Background: Environmental changes impact bat–human interactions, heightening concerns of pathogen spillover and highlighting the need to understand human–bat interactions in the context of ecosystems. The objective of this study was to assess factors associated with human contact with bats in communities living near bat roosts in Northern Tanzania. Methods: A cross-sectional survey was used to investigate the factors associated with human contact with bats. Utilizing a standardized questionnaire administered through face-to-face interviews, relevant data were collected from respondents living in or near regions characterized by high bat density. Descriptive analyses followed by bivariate and multivariate analyses were performed to assess the association between the investigated factors and the outcome variable of interest, contact with bats. Results: Data were collected from 325 respondents. Of the respondents, 57.5% (187/325) reported bat contact, and only 4% believed bats can transmit rabies. The following factors were significantly associated with human–bat contact: being unaware that bats can transmit diseases like rabies (AOR = 8.63, CI = 1.04, 71.43, p = 0.045), feeling safe to handle bats with bare hands (AOR = 3.47, CI = 1.71, 7.05, p < 0.001), not washing hands thoroughly after bat bite or scratch (AOR = 2.43, CI = 1.29, 4.59, p = 0.006), using water from ponds, rivers or wells (AOR = 5.58, CI = 3.17, 9.79, p <0.001), age > 45 years (AOR = 1.77, CI = 1.0, 3.14, p = 0.047) and a low level of education (AOR = 5.86, CI = 2.97, 11.57, p <0.001). Conclusion: The study findings highlight the key factors to be targeted when developing strategies aimed at improving the community’s knowledge of the potential risks of zoonotic infectious diseases associated with bats and reducing the likelihood of human–bat contact and the related public health risks in communities living near bat roosting sites in Tanzania.

1. Introduction

Environmental changes including agriculture expansion, intensified hunting, and infrastructural development can impact bat–human interactions [1]. These activities have led to alterations in bat behavior including adaptation to roosting in buildings and human dwellings [2]. This presents a significant public health risk, as bats are recognized reservoirs for various pathogens globally [3]. Bats are hosts to lyssaviruses, and in developing countries such as Tanzania, infections with lyssaviruses from bats likely occur but may go unnoticed due to lack of surveillance [4,5], and the low level of knowledge on bat-borne zoonotic diseases by the public [6]. Other viruses of concern reported in bats include coronaviruses and filoviruses [7,8]. The transmission of these viruses from bats to humans has been documented through various routes, including transmission though an intermediate host species such as livestock [9], direct exposure through bat bites [10,11], and consumption of water or food contaminated with bat feces [12].

Tanzania is host to a diverse array of bat species, including 105 distinct species across nine families, inhabiting various habitats nationwide [13]. The fruit bats, Eidolon helvum have been documented inhabiting urban areas with trees in the vicinity of hospitals and schools, raising the potential for human–bat interactions [14]. Epomophorus wahlbergi are often sighted near water sources such as rivers, streams, and lakeshores, where they roost in trees with ripened fruits and Rousettus aegyptiacus usually roosts in caves or buildings [13]. The insectivorous bat species including Lavia frons, Macronycteris vittata, Mops pumilus, Chaerephon bivittatus, Mops condylurus and Otomops harrisoni are frequently encountered in lowland habitats due to the abundant insect populations, particularly in areas adjacent to water bodies such as rivers and livestock watering ponds [15,16].

The overlap in ecosystems of bats, humans, and animals can increase the risk of exposure and viral spillover. In Tanzania, an example of virus spillover from bats to humans was the human exposure with Achimota virus 2 (AchPV2) and novel rubulaviruses in the Paramyxoviridae family transmitted from bats in Muheza, Tanzania [14]. The risk of pathogen spillover from bats varies with season, with certain periods such as during reproductive cycles presenting an increased risk [17,18]. Avoiding bats, particularly during mating seasons or seasonal swarming, may help reduce the risk of bat–human interactions [19,20]. The potential public health risk of overlap in ecosystems highlights the need to improve the understanding of human–bat interactions in the context of Tanzania and provide evidence-based strategies to minimize the associated public health risk. The objective of this study was to identify the risk factors for human contact with bats in communities residing around bat roosts in northern Tanzania.

2. Methods

2.1. Study Design

A cross-sectional survey was conducted. A questionnaire was developed, translated into Swahili language, and pretested with 25 respondents residing in a district that shared similar environmental and population characteristics with the selected research sites. The purpose of pretesting was to check if the questionnaire met specific criteria, including clarity, simplicity, and comprehensibility of questions. Subsequently, the questionnaire was further revised based on the feedback received from the pretesting.

2.2. Study Site

The study was conducted in ten villages (Figure 1) namely, Robanda, Bwitengi, Miseke, Sekei, Leguruki, Kiseriani, Mtimbwani, Kiomoni, Ngamiani, and Muheza, located across seven different administrative districts (Serengeti, Arusha urban, Meru, Rural Arusha, Tanga urban, Mkinga, and Muheza) of Tanzania. These villages were selected as representatives of households living near bat roosts in the Mara, Arusha, and Tanga regions. The study villages were chosen based on the potential for animal–human–bat interaction, given the high density of bats in the surrounding national park areas, including the Serengeti National Park, Arusha National Park, Lake Manyara National Park, and Amboni Caves.

The bat species most frequently encountered in these high-density areas in Tanzania include Eidolon helvum, Rousettus aegyptiacus, molossids, Pipistrellus hesperidus, Rhinolophus clivosus, and Nycteris thebaica, as identified in previous studies by [21,22].

2.3. Study Population and Sampling Approach

The target population was individuals in local communities residing in or near areas characterized by a high bat population density. A sample size of 325 participants from the ten villages was estimated assuming at least 30% of the population resides in or near areas with bat roosts, and a desired precision of 5% and confidence interval of 95% was calculated using the formula n = (Z2 × P × (1 − P))/e2, where Z = value from standard normal distribution corresponding to desired confidence level (Z = 1.96 for 95% CI), P is expected true proportion, and e is desired precision. The snowball sampling technique was used to enroll targeted participants. Initially, respondents residing in households near bat roosts were identified through consultations with local leaders in each of the ten villages. The initial respondents were asked to identify and refer others from their neighborhoods or areas where bats were frequently encountered in homes, caves, or tree roots. In turn, the identified respondents identified others.

2.4. Inclusion and Exclusion Criteria

To be eligible, participants had to be adults aged 18 or older and should have lived in the village for at least one year prior to data collection. Individuals were excluded if they were under the age of 18 and were unable to respond to the questionnaire interview (for example, individuals with cognitive impairments affecting their ability to communicate).

3. Data Collection

To prepare for data collection, field researchers who had good knowledge of the local language (Kiswahili) received training in questionnaire administration and conducting interviews. The questionnaire was structured into five sections: demographics (education level, age, gender, and income status), exposure factors (interactions with bats), attitudes, practices, and knowledge related to zoonotic diseases transmitted by bats, with a particular emphasis on rabies. It is important to note that, except for questions regarding the respondent’s name and educational background, all questions in the questionnaire were designed as closed ended, facilitating standardized responses. The administration of the questionnaire was performed using face-to-face interviews and took place between November and December 2022. Enrolled study participants were required to complete both household- and individual-based survey questions. Following the interviews, the collected data were cross-checked for accuracy before analysis using IBM SPSS Software Version 21.

To protect participant confidentiality, we applied data anonymization and de-identification methods throughout the study. Personally identifiable information was excluded from the dataset, and responses were coded to prevent any linkage back to individual participants. During fieldwork, respondents were invited to participate voluntarily, as outlined in the questionnaire (attached as a reference file), and were informed of their right to decline participation at any time without consequences. The ethical agreement on the questionnaire specified that all information provided by participants would be kept confidential, with access limited to authorized study personnel only.

Data Analysis

Following data cleaning, an assessment of the dependent and independent variables was conducted. The data analysis was conducted in two stages: descriptive analysis, and bivariate and multivariate analysis to identify factors associated with human contact with bats. For purposes of this study, ‘human contact with bats’ or ‘bat contact experience’ was considered as the dependent variable of interest and was defined using four variables: bats entering respondents’ living rooms, being scratched by bats, finding dead bats or guano in sources of drinking water, and using bat caves or live bats for traditional medicine.

The descriptive analysis included use of frequency and percentages to summarize data on the demographic and household characteristics, knowledge on bats and infectious diseases, practices of the local community, and mode of disease transmission. Bivariate and multivariate logistic regression analyses were performed to identify potential factors associated with human contact with bats (bat contact experience). Firstly, a bivariate analysis was performed to assess the association of each independent variable (e.g., taking out animals for grazing, having fruit trees at home) with the dependent variable (bat contact experience). Secondly, multivariate logistic regression models using a backward stepwise likelihood ratio approach were developed to assess potential predictors for bat contact experience. Following the bivariate analysis, independent variables with p-values < 0.2 were entered into the multivariate model. The variables gender and age of respondents were entered into the multivariate model regardless of the p value because they can influence human activity, potentially affecting the likelihood and/or frequency of exposure to bats. The potential confounding effects of the variables considered in the multivariate model were examined by adding and excluding each variable from the final model to assess the effect on the beta values. A significance level of p ≤ 0.05 was used to determine statistically significant predictors of bat contact experience. The Hosmer–Lemeshow test was used to assess how well the model fits the data and the Nagelkerke R² statistic was used to assess how well the model explains the variance in the data.

4. Results

4.1. Demographic Data

A total of 355 respondents from 10 villages and seven districts across three regions of Tanzania participated in this study; 30 participants were excluded because they declined to discuss topics related to the bats due to cultural beliefs linked to witchcraft, or the need to prioritize their routine activities instead of completing the survey. The 325 respondents were distributed by village as follows: Muheza (n = 31), Mtimbwani (n = 30), Ngamiani (n = 30), Kiomoni (n = 29), Miseke (n = 30), Bwitengi (n = 26), Robanda (n = 48), Leguruki (n = 32), Sekei (n = 38), and Kiseriani (n = 31) (Figure 1). Most of the 325 respondents were male: 186 males (57.2%) and 139 females (42.8%) (

Table 1. Demographic and household characteristics of the study participants.

Variables	n = 325	%
Sex
Male	186	57.2
Female	139	42.8
Education
Primary education	256	78.7
High school	49	15
High education institution	20	6.1
Age group (years)
18–25	38	11.7
26–35	33	10.1
36–45	67	20.6
46–55	103	31.6
56–65	66	20.2
66–70	18	5.5
Marital status
Married	269	83
Single	56	17.2
How many other members are you living with
1–5 members	59	18.1
6–10 members	185	56.7
11–15 members	81	24.8
Children under 5
1≤	314	96.6
I don’t have	11	3.4
How long have you lived here
>5 Years	69	21.2
12 Months–5 Years	256	78.5
Occupation
Crop Farming	147	45.2
Raising livestock	99	30.7
Guiding tourists through caves	19	5.5
Government employment	60	18.5
Daily income
More than 2500 Tshs (1$)	66	20
Less than 2500 Tshs ($)	259	80
How many rooms do you own in your dwelling
One room	4	1.2
Two rooms	222	68.1
Three rooms and above	99	30.4

n = number of respondents; % = percentage.

). Most respondents were in the age group 46–55 years (31.6%), followed by 36–45 years (20.6%), 56–65 years (20.2%), and 18–25 years (11.7%). Crop farming (45.2%) and raising livestock (30.7%) were the most reported occupations, followed by government employment (18.5%) and guiding tourists through caves (5.5%). Most respondents reported earning less than $1 daily (80%), whereas the rest earned more than $1 per day (20%).

4.2. Bat Contact Experience Among Respondents

In this study, bat contact experience (human contact with bats) was a dependent variable of interest defined based on four variables. A total of 187 respondents in 10 villages reported a bat contact experience during the past 1 year before data collection. Among those respondents, 141 (75.4%) reported bats getting inside their houses, 1 (0.53%) reported being scratched by a bat, 51 (27.3%) found dead bats or guano in a source of drinking water, and 22 (11.7%) reported use of bats caves or use of live bats for traditional medicine (

Table 2. Distribution of 187 respondents who reported bat contact experiences (dependent variable).

Human–Bat Contact Experience	No. of Respondents Who Reported Bat Contact (%) a
Bats getting inside respondents’ living rooms	141 (75.4)
Bitten by a bat	1 (0.53)
Found dead bats or guano in a source of drinking water	51 (27.3)
Use bat caves for religious shrines and tourism guidance or use of live bats for traditional medicine.	22 (11.7)

^a The response allowed for multiple responses because these four variables were combined to create the dependent variable, bat contact experiences; % = percentage.

).

4.3. Knowledge on Bats and Risk of Transmission of Disease to Humans

Most of the 325 respondents (94.5%) had not heard about bats conservation (

Table 3. Knowledge on bats and risk of transmission of disease to humans.

Variables	n = 325	%
Heard about bats conservation?
Yes	18	5.5
No	307	94.5
Do you know some bats eat fruits?
Yes	318	97.8
No	7	2.2
Do you wash fruits before eating them?
Yes	43	13.2
No	282	86.8
Clinical signs ever noticed of family members within the past year
Fever with diarrhea or vomiting	84	25.8
Fever with cough and difficulty breathing	234	72
Biting and sudden change in behavior	1	0.3
Salivation	4	1.2
Hydrophobia	1	0.3
Fever with, bruising or bleeding from body orifices without being injured	1	0.3
Have you ever heard about the use of vaccines following a bat scratch or bite?
Yes	52	16
No	273	84
Is it a good practice to wash the site thoroughly with water after a scratch / bite with a bat, using soap and water?
Yes	81	24.9
No	244	75.1
Can bats be a source of infectious diseases such as rabies?
Yes	13	4
No	312	96
What was the source of information on bats?
Mass media (newspaper, radio/tv)	22	6.8
Government vaccination campaigns	77	23.7
I have not heard any information	225	69.2
What are the possible ways of infections from bats?
Bite only	80	24.6
Bite and saliva contact with open wound	8	2.5
I don’t know	237	72.9
Do bats gets sick?
No	1	0.3
I don’t know	324	99.7
Is it safe to handle dead bats with bare hands?
Yes	260	80
No	65	20
Management system for cats/dogs
Housed in cages	31	9.5
Tied outside the house	47	14.5
Free to roam around	247	76

n = number of respondents; % = percentage.

). However, a significant portion of the population was aware that some bats eat fruits (97.8%), while a smaller proportion reported washing fruits before consumption (13.3%). Few respondents had heard of the use of vaccines following bat scratches or bites (16%). Few respondents (4%) were aware that bats could be a source of infectious diseases such as rabies. Only (20%) of respondents reported that it was not safe to handle dead bats with bare hands.

4.4. Practices of the Local Community Towards Bats, Infectious Diseases Control and Prevention

Table 4. Community practices in relation to contact with bats.

Variables	n = 325	%
Do you consult animal health practitioners in case of animal disease outbreaks?
Yes	120	36.9
No	205	63.1
What season do you see juvenile bats?
July to September	25	7.7
October to December	7	2.2
I can’t distinguish them	293	90.1
Which time/stage of administering anti-rabies vaccine is effective after a bat bite/scratch?
Immediately	76	23.4
Later	1	0.3
Anytime	5	1.5
I don’t know	243	74.7
Do you know that dead or sick bats are dangerous to come in contact with?
Yes	22	6.8
No	303	93.2
If you get scratched by bat, where do you go first?
Stay at home	138	42.5
I go to the health institution	136	41.8
I go to traditional healers	18	5.5
I do nothing	33	10.2
Did you vaccinate your dog against rabies?
Yes	177	54.5
No	148	45.5
Do you have a dog rabies vaccination card?
Yes	66	20.3
No	259	79.7
Which measures do you take to control bats?
Poisoning	205	63.1
Burning of firewood	4	1.2
Cutting of trees	70	21.5
Burning of incense	45	13.8
I don’t do anything	1	0.3
Have you ever noticed massive deaths of bats from their roosts?
No	325	100
How do you dispose a dead bat?
Throw them openly	148	45.5
Give it to the dogs	1	0.3
I don’t know	176	54.1
Do use soap and water to clean hands after handling dead bats/live bats or guano?
Yes	18	5.5
No	307	94.5
Do you use disinfectant to clean your environment after disposing the dead bats?
Yes	12	3.7
No	313	96.3
Would you inform authorities if bitten/scratched by a bat?
Yes	18	5.5
No	307	94.5

n = number of respondents; % = percentage.

describes the practices of the study participants in relation to contact with bats. In terms of the effectiveness of anti-rabies treatment after a bat bite or scratch, many of the respondents (74.7%) admitted not knowing the appropriate timing of treatment, and almost a quarter reported it should be administered immediately (23.4%). Few respondents (6.7%) were aware that handling dead or sick bats is dangerous. In response to a bat scratch, respondents’ actions varied, with some reporting they would choose to stay at home (42.5%), or seek medical attention (41.8%), and a smaller percentage reported that they would go to traditional healers (5.5%) or take no action (10.2%). In terms of dog vaccination against rabies, 54.5% of respondents reported having vaccinated their dogs, whereas 46% had not. Most (94.5%) respondents did not use soap and water to clean their hands after handling bats or guano.

4.5. Beliefs/Attitude

Most of the respondents (76.7%) expressed dislike for bats due to their invasion of dwellings. A significant percentage (11.7%) mentioned disliking bats because of their association with bad luck. A smaller proportion disliked bats because they believed bats invaded their water sources (1.2%), while a few (2.5%) cited the reason as bats eating their fruits. A minority of respondents (7.7%) did not express a dislike for bats (

Table 5. Beliefs towards bats.

Variables	n = 325	%
Do you dislike bats?
Yes, because they eat our fruits	8	2.5
Yes, because they are invading our dwellings	250	76.9
Yes, because they are invading our water sources	4	1.2
Yes, because they are associated with bad luck	38	11.7
No	25	7.7

n = number of respondents; % = percentage.

).

4.6. Factors Associated with Human–Bat Exposure

Nearly half of the respondents (47.4%) reported taking their animals for grazing, while the remaining 52.6% did not. In terms of water sources, 63.4% relied on covered or uncovered water sources, while 36.6% used water taps and 57.8% of respondents reported frequently seeing bats on the roofs of their houses (

Table 6. Factors associated with human–bat exposure.

Variables	n = 325	%
Taking animals for grazing
Yes	154	47.4
No	171	52.6
Where do you get water from?
Covered/uncovered water sources	206	63.4
Water taps	119	36.6
How do you treat water?
No treatment	127	39.1
Boil	198	60.9
Where do you normally see bat roosts?
Abandoned houses	4	1.2
Roof of my house	188	57.8
Trees near my dwellings	4	1.2
Caves	72	22.2
Under foliage	8	2.5
Tree branches	49	15.1
Regular observing bats every evening
Yes	137	42.2
No	188	57.8
Own fruit trees at home
Yes	296	91.1
No	29	8.9
Equipment used if handling bats
Mask	52	16
Clothes	1	0.3
Gloves	11	3.4
I don’t use anything	261	80.3
Have you ever seen your livestock attacked by bats
Yes	4	1.2
I don’t know	321	98.8
Do you eat bats meat?
No	325	100
Noticed bats foraging on crops
Yes	141	43.4
No	184	56.6

n = number of respondents; % = percentage.

).

4.7. Assessing the Relationship Between Selected Variables (Knowledge, Attitudes, Practices, and Perceptions) and the Dependent Variable, Human–Bat Contact Experiences

Following the completion of the descriptive analysis (Table 1, Table 2, Table 3, Table 4, Table 5 and Table 6), a bivariate analysis was conducted to evaluate the association between each independent variable (sociodemographic information, knowledge, attitudes, and practices) and the dependent variable (bat contact experience, as shown in (Table 2)). A cut-off p-value of <0.20 was employed to select variables from the bivariate analysis for inclusion in the multivariate logistic regression analysis. The bivariate analyses unveiled 17 variables with p-values of <0.20 as shown in

Table 7. Bivariate analysis to explore relationship between select variables (knowledge, practices, and perceptions) and human–bat contact experiences.

Variable	Bat Contact Experience		AOR (95% CI)	p Value
	No (n = 138) n (%)	Yes (n = 187) n (%)
Sex
Male	74 (53.6)	112 (59.9)	1.29 (0.82, 2.01)	0.259
Female	64 (46.4)	75 (40.1)	Ref
Age
≤45 years	55 (39.9)	50 (26.7)	Ref
>45 years	83 (60.1)	137 (73.3)	1.81 (1.13, 2.90)	0.013 *
Occupation
Crops farming, livestock rearing and guiding tourists through caves	95 (68.8)	170 (90.9)	4.526 (2.44, 8.37)	<0.001 *
Government employee	43 (31.2)	17 (9.1)	Ref
Daily income
More than 1$	51 (37)	15 (8)	Ref
Less than 1$	87 (63)	172 (92)	6.72 (3.57, 12.63)	<0.001 *
Education
Primary	87 (63)	169 (90.4)	5.50 (3.03, 9.99)	<0.001 *
Other ††	51 (37)	18 (9.6)	Ref
Marital status
Married	104 (75.4)	165 (88.2)	2.45 (1.35, 4.42)	0.003 *
Single	34 (24.6)	22 (11.8)	Ref
Children under 5
1≤	133 (96.4)	181 (96.8)	1.13 (0.33, 3.79)	0.838
I don’t have	5 (3.6)	6 (3.2)	Ref
How long have you lived here?
>5	36 (26.1)	33 (17.6)	Ref
1 Month–5 Years	102 (73.9)	154 (82.4)	1.64 (0.96, 2.81)	0.067
How many rooms do you own in your dwelling? (excluding bathrooms and kitchen?)
One room	2 (1.4)	2 (1.1)	Ref
2≤	136 (98.6)	185 (98.9)	1.36 (0.18, 9.77)	0.760
Do you know some bats eat fruits?
Yes	135 (97.8)	183 (98)	1.01 (0.22, 4.61)	0.983
No	3 (2.2)	4 (2)	Ref
Does your family take animals out for grazing?
Yes	69 (50)	85 (45.5)	0.83 (0.53, 1.29)	0.417
No	69 (50)	102 (54.5)	Ref
Have you ever seen your livestock attacked by bats?
Yes	3 (2.2)	1 (0.5)	0.24 (0.02, 2.35)	0.221
I don’t know	135 (97.8)	186 (99.5)	Ref
How do you treat water?
No treatment	60 (43.5)	67 (35.8)	0.72 (0.46, 1.13)	0.163
Treating by boil, filter, or chlorine/bleach	78 (56.5)	120 (64.2)	Ref
Regular observing of bats every evening
Yes	61 (44.5)	76 (40.6)	0.86 (0.55, 1.34)	0.521
No	77 (55.7)	111 (59.3)	Ref
Do you own fruit trees at home?
Yes	125 (90.5)	171 (91.5)	1.11 (0.51, 2.39)	0.787
No	13 (9.4)	16 (8.5)	Ref
Noticed bats foraging on crops
Yes	65 (47.1)	76 (40.6)	0.76 (0.49, 1.19)	0.245
No	73 (52.9)	111 (59.4)	Ref
Have you ever heard about bat conservation?
Yes	16 (11.6)	2 (1.1)	Ref
No	122 (88.4)	185 (98.9)	12.13 (2.74,53.70)	<0.001 *
Where do you get water from
Covered well/pond/rivers/uncovered well/uncovered sources	55 (39.9)	151 (80.7)	6.33 (3.84, 10.41)	<0.001 *
Water taps	83 (60.1)	36 (19.3)	Ref
Wash fruits before eating
Yes	22 (15.9)	21 (11.2)	0.66 (0.35, 1.26)	0.217
No	116 (84.1)	166 (88.8)	Ref
Have you ever heard about the use of vaccine to prevent disease following a bat scratch or bite?
Yes	28 (20.3)	24 (12.8)	Ref
No	110 (97.7)	163 (87.2)	1.72 (0.95, 3.13)	0.072
Is it a good practice to wash thoroughly with water and soap after a scratch/bite from a bat?
Yes	47 (34.1)	34 (18.2)	Ref
No	91 (65.9)	153 (81.8)	2.32 (1.39, 3.87)	0.001 *
Do you know that dead or sick bats are dangerous to come in contact with?
Yes	15 (10.9)	7 (3.7)	0.31 (0.12, 0.80)	0.016 *
No	123 (89.1)	180 (96.3)	Ref
Is it safe to handle dead bats with bare hands?
Yes	93 (67.4)	167 (89.3)	4.04 (2.25, 7.24)	<0.001 *
No	45 (32.6)	20 (10.7)	Ref
Can the bats be the source of infectious diseases such as rabies?
Yes	12 (8.7)	1 (0.5)	Ref
No	126 (91.3)	186 (99.5)	17.71 (2.27, 137.94)	0.006 *
Do you use water and soap to clean your hands after handling dead bats, live bats or guano?
Yes	13 (9.4)	5 (2.7)	0.26 (0.09, 0.76)	0.014 *
No	125 (90.6)	182 (97.3)	Ref
Do you consult an animal health practitioner in case of an animal death?
Yes	53 (38.4)	67 (35.8)	0.89 (0.56, 1.41)	0.634
No	85 (61.6)	120 (64.2)	Ref
Did you vaccinate your dog against rabies this year?
Yes	71(51.4)	106 (56.7)	1.23 (0.79, 1.92)	0.349
No	67 (48.6)	81(43.3)	Ref
Do you have a vaccination card for your pet?
Yes	40 (28.9)	26 (13.9)	0.853 (0.491, 1.481)	0.572
No	147 (71.1)	112 (86.1)	Ref
Do you use disinfectant to clean your environment after disposing the dead bats?
Yes	8 (5.8)	4 (2.1)	0.35 (0.10, 1.20)	0.097
No	130 (94.2)	183 (97.9)	Ref
Would you inform authorities if scratched by the bat?
Yes	13 (9.4)	5 (2.7)	0.26 (0.09, 0.76)	0.014 *
No	125 (90.6)	182 (97.3)	Ref

Other †† = high school + higher education institution; n = number of participants; AOR = adjusted odds ratio; CI = confidence interval; * = significant at p < 0.05, and ref = reference category.

.

4.8. Potential Predictors for Bat Contact

A subsequent multivariate logistic regression analysis was conducted following the bivariate analysis. A cut-off p-value of <0.20 was employed to select variables from the bivariate analysis for inclusion in the multivariate logistic regression analysis. In the final model for the multivariate analysis, six independent variables exhibited significant associations with human–bat contact experiences (

Table 8. Multivariate logistic regression analysis to identify potential predictors for bat contact experience.

Variable	Bat Contact Experience		AOR (95% CI)	p Value
	No (n = 138) n (%)	Yes (n = 187) n (%)
Age
≤45 years	55 (39.9)	50 (26.7)	Ref
>45 years	83 (60.1)	137 (73.3)	1.77 (1.00, 3.14)	0.047 *
Education
Primary	87 (63)	169 (90.4)	5.86 (2.97, 11.57)	<0.001 *
Other †	51 (37)	18 (9.6)	Ref
Where do you get water from
Covered well/pond/rivers/uncovered well/uncovered sources	55 (39.9)	151 (80.7)	5.58 (3.17, 9.79)	<0.001*
Water taps	83 (60.1)	36 (19.3)	Ref
Is it safe to handle dead bats with bare hands?
Yes	93 (67.4)	167 (89.3)	3.47 (1.71, 7.05)	<0.001 *
No	45 (32.6)	20 (10.7)	Ref
Is it a good practice to wash thoroughly with water and soap after a scratch/bite from a bat?
Yes	47 (34.1)	34 (18.2)	Ref
No	91 (65.9)	153 (81.8)	2.43 (1.29, 4.59)	0.006 *
Can bats be a source of infectious diseases such as rabies?
Yes	12 (8.7)	1 (0.5)	Ref
No	126 (91.3)	186 (99.5)	8.63 (1.04, 71.43)	0.045 *

* = Significant at p < 0.05; other † = high school + higher education institution; n = number of participants; AOR = adjusted odds ratio; and CI = confidence interval.

). The risk of human–bat contact was higher in the following situations: in respondents aged > 45 years (AOR = 1.77, CI = 1.0, 3.14, p = 0.047) compared to those aged ≤ 45 years; in respondents that reported attaining primary education (AOR = 5.86, CI = 2.97, 11.57, p ≤ 0.001) compared to those with higher education; in respondents who reported using water from covered wells, ponds, rivers, uncovered wells, and uncovered sources (AOR = 5.58, CI = 3.17, 9.79, p < 0.001) compared to those respondents that used water taps or piped water; in respondents that reported it was safe to handle dead bats with bare hands (AOR = 3.47, CI = 1.71, 7.05, p < 0.001); in respondents that disagreed it was good practice to wash hands thoroughly with water and soap after a scratch/bite from a bat (AOR = 2.43, CI = 1.29, 4.59, p = 0.006); and in respondents who disagreed that bats can be the source of infectious diseases such as rabies (AOR = 8.63, CI = 1.04, 71.43, p = 0.045). The Hosmer–Lemeshow goodness-of-fit test yielded a chi-square value of 4.602 and a p-value of 0.596, implying that the model fits the data well. The model explained 42.5% (Nagelkerke R²) of the variance in bat contact experience and correctly classified 85.6% of respondents as ‘Yes’ for bat contact experience.

5. Discussion

This study enhances our understanding of the community’s knowledge of the potential risks of zoonotic infectious diseases associated with bats and the factors associated with bat–human interactions within communities residing near bat roosts in Tanzania. Most respondents exhibited a lack of knowledge concerning bats and related infectious diseases such as rabies. The limited knowledge about human–bat interactions and bat-borne pathogens suggests that human–bat contact exposures may go unnoticed by communities living near bat roosts, especially in developing countries [23,24]. Similar results were reported in Guatemala, where 90% of respondents admitted limited or no knowledge about rabies in bats despite the presence of bats rabies cases in the Americas [25]. A report in neighboring Kenya also suggests limited knowledge in the region. In a fatal human lyssavirus case caused by the Duvenhage virus in Kenya, postexposure prophylaxis was not used following bat–human contact, suggesting limited/lack of knowledge about bat pathogen exposure [11].

The participants reported a rabies vaccination coverage rate of 54.5% in dogs, which is below the recommended coverage of 70% in rabies-endemic areas. The low coverage may be due to several reasons including insufficient community involvement in dog vaccination campaigns, limited awareness of dog behavior and handling, along with a heightened fear of dogs. Similar patterns were observed in separate studies of 25 districts in southeastern Tanzania, where an average dog vaccination coverage of 50% was reported [26,27]. The findings from the current study highlight the need for increased dog vaccination efforts to align with the global target of eliminating human deaths from dog-mediated rabies by 2030.

Exposure to bats in communities near bat roosts was common, with 57.5% of respondents reporting contact with bats in the year preceding the study. The bat contact experiences included finding live bats in living rooms, utilizing bats or bat caves for religious shrines and traditional medicine, and encountering guano or deceased bats in drinking water sources. The consumption of bats as food was not reported in the current study. This finding may indicate reduced interest in bat bush meat among mainland Tanzanian communities, as observed in the study by Mickleburgh et al. [28]. Another plausible explanation is that respondents refrained from disclosing information on bat meat consumption due to regulations against illegal wildlife hunting. Alternatively, a significant portion (92%) of respondents expressed aversion to bats; bats are often associated with bad luck, as such, the cultural effect may also explain the above finding. This finding however differs from West Africa, where there is active human involvement in the hunting, handling, processing, and consumption of bat meat [29].

The frequency of reported bat bites in the present study was relatively low, at 0.53%. Additionally, approximately 83% of respondents had never heard about the use of vaccines following a bat bite or scratch, which can pose a significant risk for human exposure to bats. This may be due to the minor nature of skin trauma caused by bat bites, often going unnoticed [30,31].

The risk of human–bat contact was higher among respondents with only primary education compared to those with education above primary level (such as high school or higher education). These results are consistent with a similar study conducted in Sierra Leone, which showed that low education and livelihood activities, such as subsistence farming, were associated with limited knowledge of bat-borne zoonotic diseases, subsequently increasing the risk of human–bat contact [6]. Additionally, those above the age of 45 years had a higher risk of human–bat contact compared to those below 45 years. Older adults often engage in traditional practices involving bats or bat caves for religious shrines and traditional medicine, increasing the risk of human–bat contact. This finding is similar to a study in Ghana which reported that older age and male sex were significantly associated with visiting bat caves [32]. In this study, socio-economic factors such as low education and income were associated with informal occupations, crop farming, livestock rearing and cave entry as factors for bat exposure compared to formal occupations, which is consistent with findings by Kamins et al. in Ghana [33] This association is notable, as 75.4% of human–bat contact in this study occurred indoors, where structural vulnerabilities in homes allowed bats into living spaces.

In the current study, it was observed that most respondents rely on water sources such as rivers or ponds, whether covered or uncovered. In addition, the risk of human–bat contact was five times higher in respondents who reported using water from covered wells, ponds, rivers, uncovered wells, and uncovered sources compared to those respondents that used water taps or piped water. These water sources are susceptible to contamination by bats during bat drinking and feeding activities [34]. Individuals in the study areas reported engaging in activities such as utilizing water sources for human–animal drinking and for irrigation purposes. For example, in the current study, water contamination by bats was reported in the Mkulumuzi river located 2.5 km from two villages, Kiomoni and Mtimbwani. The river water is used by villagers for irrigating vegetables and for other household purposes. The Amboni caves located along the river serve as roosts for bats such as Eidolon helvum, and bat guano contaminates the water, which is then used for the aforementioned purposes. A similar study in Ghana’s Volta region reported bat–human contact through water; respondents observed rainwater discoloration due to bat droppings from bat roosts [35]. This finding underscores the potential need to educate community residents to avoid consuming untreated water from wells, open sources, or ponds, in addition to facilitating a government and community provision of safe water sources.

The risk of human–bat contact was three times higher in respondents that reported it was safe to handle dead bats with bare hands compared to those that reported it was not safe. To avoid human–bat contact, the general guidance has always been for the public to avoid handling bats without using personal protective equipment [36]; however, the majority of respondents (260/325, 80%) in this study said it was okay to handle bats with bare hands, indicating poor knowledge of factors associated with human–bat exposure. This contrasts with a study carried out in Bundibugyo district, Uganda, where more than half of the respondents (261/384, 67.97%) believed that touching a bat can lead to disease transmission [37]. This may be due to Uganda’s experience with six Sudan Ebola Virus (SUDV) outbreaks since 2000 [38], which has increased community knowledge and fostered a positive attitude toward Ebola Virus Disease (EVD) control and prevention. Studies also indicated that most respondents are aware that contact with infected patients and consumption of non-human primates and bats can cause outbreaks or spillovers [39].

The risk of human–bat contact was two times higher in respondents that disagreed it was good practice to wash hands thoroughly with water and soap after a scratch/bite from a bat. This indicates a lack of knowledge about post-exposure management strategies after being bitten or scratched by a bat. This is in line with findings from a study in Makurdi, Nigeria, which showed that only 15% of individuals who experienced bat bites sought medical care, while 85% did not. In the present study, this finding was of concern because some respondents reported bat roosting in their homes or close to homes.

The risk of human–bat contact was eight times higher in respondents who disagreed that bats can be a source of infectious diseases such as rabies. The limited or lack of awareness of disease risks associated with bats has been strongly linked to higher rates of human–bat contact. For example, a similar study found that residents of Tioman Island in South China Sea had limited knowledge about bats, particularly regarding their potential to transmit infections. The lack of awareness has been linked to Nipah virus outbreaks, suggesting that improved knowledge on human–bats contact is associated with reduced bat exposure [40]. A comparable study conducted in Thailand found that awareness of bat rabies was notably low, with only 10% of participants recognizing bats as a potential source of rabies [30]. Our findings highlight the need to increase public awareness about the risk of infectious diseases associated with bat exposures. Special attention should be given to communities living close to bat roosts or with bats in their homes, where bat droppings are commonly found in roofs and the air [41]. School-based educational programs targeting students from such communities may be given priority, as well as the promotion of preventative practices such as thorough wound washing and seeking healthcare after bat bites and scratches.

The current study had limitations. The possible limitation is some respondents may have withheld information related to the study. For example, respondents that associated bats with bad luck, witchcraft or other cultural beliefs may have been reluctant to answer certain questions, which may have impacted the responses obtained. Another limitation was that the study was conducted only in the Northern region. Understanding the factors that contribute to a higher risk of human–bat exposure across the entire country requires further investigations in other regions with bat roosting sites.

6. Conclusions

This study identified factors that could potentially lead to contact between humans and bats in communities residing near bat roosting sites. These factors included feeling comfortable handling bats with bare hands, using water from ponds, rivers or wells for human consumption or drinking, and being unaware that bats can transmit diseases like rabies. The findings from this study can be used to inform and guide strategies aimed at improving the community’s knowledge of the potential risks of zoonotic infectious diseases associated with bats and reducing the likelihood of human–bat contact and the related public health risks in communities living near bat roosting sites in Tanzania.