A community-based knowledge, attitude, and practice survey on rabies among cattle owners in selected areas of Bhutan

Abstract

Rabies remains a disease of significant zoonotic and economic concern in rabies endemic areas of Bhutan. Rabies outbreaks in livestock threaten the livelihoods of subsistence farming communities and pose a potential public health threat. As a part of identifying approaches to prevent rabies in cattle, a Knowledge, Attitude, and Practice (KAP) survey was conducted among cattle owners in selected rural areas of the southern rabies high-risk zone and low-risk zone in eastern Bhutan. Between March and April 2017, 562 cattle owners (281 in the east and 281 in the south) were interviewed using a questionnaire. Eighty-eight percent of the participants had heard of rabies but only 39% of the participants who had heard of rabies had adequate knowledge about rabies. Multivariable logistic regression analysis showed that residing in the south [OR = 9.25 (95% CI: 6.01–14.53)] and having seen a rabies case [OR = 2.46 (95% CI: 1.6–3.82)] were significantly associated with having adequate knowledge about rabies. Based on our scoring criteria, 65% of the total participants who had heard of rabies had a favorable attitude towards rabies control and prevention programs. The participants residing in the east were two times more likely to have a favourable attitude than their counterparts in the south [OR = 2.08 (95% CI: 1.43–3.05)]. More than 70% of the participants reported engaging in farm activities such as examining the oral cavity of sick cattle and assisting cattle during parturition. Only 25% of the participants reported using personal protective equipment while undertaking these activities. Despite a high level of rabies awareness, we observed that there is a lack of comprehensive knowledge about rabies regarding susceptible hosts, transmission routes, the health outcome of rabies infection in humans, and appropriate health-seeking behaviours. This study highlights the need to strengthen rabies education programs in rural communities to address the knowledge gaps that have been identified.

Knowledge, attitude and practice (KAP) survey of canine rabies in Khyber Pakhtunkhwa and Punjab Province of Pakistan

“…One of the critical findings of this survey is that the majority of the respondents revealed that they did not seek urgent medical care following a dog bite, consistent with similar studies on rabies in Pakistan [22]. However, this is in contrast to previously published studies on rabies in developed nations across the globe [11,13,18,23]. All these factors indicate that population in the study area are at a constant risk of disease because the participants lack sufficient knowledge regarding potential source, prevention, and control of rabies.…”

“…A questionnaire covering three different sections and twenty three questions was prepared and used for data collection. Section 1 included six questions regarding the participants' demographic information, Section 2 nine contained questions related to respondents' knowledge, and Section 3 contained eight questions related with attitude and practices regarding rabies [13]. generated using open source Quantum GIS software specifically for the purpose of this study [13].…”

“…Section 1 included six questions regarding the participants' demographic information, Section 2 nine contained questions related to respondents' knowledge, and Section 3 contained eight questions related with attitude and practices regarding rabies [13]. generated using open source Quantum GIS software specifically for the purpose of this study [13]. The shapefiles for the political boundary of Pakistan including district and sub-district boundaries were obtained from the Pakistan Bureau of Statistic without any specific approval [13] The structured questionnaire was based on previously conducted KAP surveys on rabies in the world.…”

“…generated using open source Quantum GIS software specifically for the purpose of this study [13]. The shapefiles for the political boundary of Pakistan including district and sub-district boundaries were obtained from the Pakistan Bureau of Statistic without any specific approval [13] The structured questionnaire was based on previously conducted KAP surveys on rabies in the world. We sought to include both rural and urban areas representing diverse geographic backgrounds.…”

A Qualitative Risk Assessment of Rabies Reintroduction Into the Rabies Low-Risk Zone of Bhutan

“…In Bhutan, dogs are the primary rabies reservoir, therefore two pathways (stray and pet dogs) were considered for this assesment. In the endemic areas of Bhutan, cattle are the most commonly affected livestock species (36,37). Due to the government's policy of achieving self-sufficiency in livestock produce, in addition to mobilization of cattle within the country, a large number of cattle have been imported from other countries posing risk of disease introduction and spread, inlcuding rabies.…”