Background- Decompression Sickness is the greatest danger to the health and wellbeing of diving fishermen, potentially rendering them permanently disabled or dead. Published prevalence of decompression sickness in professional and military divers stand at 3.4% and 2.9% respectively. Artisanal diving fishermen suffer disproportionately more, with prevalence ranging from 20 to 94%. There is paucity of data on the prevalence of decompression sickness in Kenya, on knowledge, attitude, and practices of diving fishermen in Kenya. Study Design- A cross sectional study of a fishing community in Vanga, Kwale County was undertaken from June 2019. Data collection was conducted between July 7th and August 30th, 2020. Methods- Eligible study subjects were identified from the Beach Management Unit register and screened by administration of an adapted Kenya Navy survey tool. A total of 246 randomly sampled diving fishermen were included in the study. Anonymised sociodemographic data was collected, in addition to data on predictor variables of decompression sickness- knowledge, attitudes and practices of diving fishermen. Categorical data analysis was used. R statistical software was used for data analysis and visualisation. Results- All study participants (N=246) were male, the median chronological age being 36, range from 19 to 76 years. Nearly all the study participants (99.2%, n=244) had either no formal education or incomplete primary education. Apprenticeship was the main method knowledge was imparted to majority (66.3%, n=163) of diving fishermen. Significant associations between knowledge and decompression sickness, and attitude of diving fishermen and decompression sickness were found. The prevalence of decompression sickness in this community was 28%. Lack of a local health care worker and distance to Kenya Navy recompression chamber were found to be barriers to healthcare access. Conclusion- This study gives credence to the idea that diving accidents are preventable through training and establishing of standards of safe diving practices. Recommendation- Continuous skills upgrade with a recertification system developed by Kwale County with assistance from Kenya Navy to address dangerous diving practices.

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