Key Clinical Message These two cases highlight some of the many challenges encountered when handling dog bite and rabies exposure. They also provide examples of the many barriers, and while highlighting only two individuals, they are likely representative of large numbers of the over 59 000 people that die every year from this preventable disease.
The aim of this study was to evaluate the knowledge, attitudes, and practices regarding rabies in the El Jadida region, Morocco. We conducted a cross-sectional survey using a structured questionnaire among randomly selected residents across 24 study sites. In total, 407 respondents took part in the survey. The majority (367, 92%) were male and had no formal education (270, 66%). Some (118, 29%) believed that rabies does not affect humans. Most respondents (320, 79%) were aware that vaccination could prevent rabies, but nevertheless did not vaccinate their dogs (264, 64.9%) and allowed their dogs to roam freely in search of food. Some (52.8%) would visit traditional healers for treatment in the event of a dog bite incident. Age and educational level were found to be significantly associated with knowledge, attitudes, and practices (p < 0.05). Although respondents demonstrated some level of knowledge about rabies, overall this study reveals critical gaps in their attitudes and practices. These shortcomings may be associated with a low level of education. Therefore, decision-makers need a new approach to control rabies, with a special focus on public awareness and health education, in order to sustain rabies control programs.
Understanding the socioecology of domestic dog populations is essential for effective disease control, especially canine rabies. In Morocco, since 1986, the control efforts and plans put in place by the government have failed to eradicate this disease; this is because the management of the canine population was not taken into account during the establishment of these plans. It is against the background that this study was designed to estimate the dog population and determine its socioecological characteristics, as well as investigate the attitude of the inhabitants towards the dogs. A stratified random sampling was conducted using a structured questionnaire from May to December 2016. A total of 1931 households were interviewed, comprising 27.4% in urban areas and 72.6% in rural areas. A total of 3719 dogs were counted alongside a human population of 11302 for a dog : human ratio of 1 : 2.42 in rural areas and 1 : 46.58 in urban areas. The majority of dogs (92%) in rural areas were not vaccinated against rabies. In urban areas, about 88.5% were vaccinated against rabies. In addition, 78.5% of dogs in rural areas were free roaming, with more than 53% of births being abandoned by their owners, resulting in a large stray and feral dog population and increasing the potential for continued transmission of rabies virus. There was strong association between breed and rabies vaccination (p<0.05) and confinement with body condition score.
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