The Mnisi community, a livestock-dependent population of approximately 40,000 people in roughly 9,000 households, borders the Great Limpopo Transfrontier Conservation Area in Mpumalanga, South Africa. More than three-quarters of adults presenting with acute febrile illness have evidence of zoonotic pathogen exposure, including Rickettsia spp., Leptospira spp., Bartonella spp., and Coxiella burnetii. Spotted fever group rickettsiosis is the most commonly identified zoonosis, with females having eight times higher odds of seropositivity than males. Previous research indicated that daily livelihood tasks and livestock care were highly gendered, motivating this study to qualitatively explore exposure pathways through a One Health and ecosocial lens.
This qualitative ethnographic study combined household observations and single-gender focus group discussions (FGDs) across three villages: Utha, Athol, and Gottenburg. Data collection occurred over four weeks in July 2019. Twelve household observations (totaling 51.5 hours) were conducted, each lasting approximately two to nine hours and attended by 3–4 study team members including Environmental Monitors as translators. Six FGDs were held, one with women and one with men per village, with group sizes ranging from 4–10 participants (mean 7) and a total of 43 participants (22 men, 21 women). Focus groups were separated by gender to facilitate open discussion of gender-typed roles. A semi-structured questionnaire informed by the One Health framework addressed daily routines, animal care, hygiene, vector exposure, and disease prevention. Transcripts and field notes were analyzed thematically in NVivo 12 Plus using grounded theory approaches, with data triangulated between observations and FGDs.
Demographic data showed 63 adults across observed households (19 male, 44 female), with a mean household size of 8.33 members (SD 3.63). Among adults, 48% (30/63) were unemployed or pensioners and 28% (17/63) were students. In focus groups, 59% (26/44) of participants were unemployed.
Strong gender-typed patterns emerged across household tasks, animal care, and environmental exposure. Women were primarily responsible for cooking, cleaning, sweeping, washing dishes and clothes, childcare, and household hygiene. Women also collected water and firewood and tended to small livestock and poultry. Men were primarily responsible for cattle care, including taking cattle to the bush for grazing in the morning around 7am and collecting them around 4pm, slaughtering cattle and goats, building homes, waste removal, and crop tending. Six mentions of women caring for animals and 13 mentions of men caring for animals were recorded in FGDs. Women in Utha spent 3–4 hours daily in the bush collecting water and washing clothes, compared to less time in other villages.
Water access was identified as a major issue, with sources including community boreholes, rivers, purchased water, and local schools; the major fresh water source, Injaka Dam, is approximately 55 kilometers from Hluvukani. Decreased water availability and overgrazing of surrounding bush forced both men and women to spend more time in bush environments, increasing vector exposure. Tick exposure was noted in winter and mosquitoes in summer. Tick removal methods included using lye, car oil, or insect repellent for animals; five participants described removing ticks from themselves with their nails. Human-wildlife conflict was documented, with hyenas killing domestic animals and stray dogs biting residents.
CLOTHING DIFFERED NOTABLY BETWEEN GENDERS
men working with cattle wore coveralls, long trousers, and closed-toe shoes, while women typically wore shirts, long skirts, and open-toed sandals, even during water and firewood collection. Animal enclosures (kraals) were located on property edges near cooking and cleaning areas where women spent most daylight hours, increasing indirect contact exposure.
**Clinical Implications**
The study identifies gender-specific critical control points for zoonotic disease prevention. Tick-bite prevention should target men through cattle-related exposure reduction and women through personal protective measures during water and firewood collection. Protective clothing interventions for women must align with cultural norms. One Health training programs and clinic-based diagnostic schemes should be tailored to gender-differentiated exposure profiles. Given that zoonoses contribute to 77% of acute febrile illness in this community, addressing these gendered exposure pathways through community-informed, culturally appropriate interventions could substantially reduce disease burden. Future research should incorporate extended seasonal observation, pediatric populations, diarrheal disease, and the impacts of ecological shifts on disease dynamics.