Rabies in Uganda: rabies knowledge, attitude and practice and molecular characterization of circulating virus strains

Abstract

Background: Rabies is a deadly preventable viral disease that affects all warm-blooded animals and widespread in many regions including Africa. The disease remains of major public health importance in Uganda. The purpose of this study was to establish Knowledge, Attitude, Practice (KAP) of Rabies in Moyo and Ntoroko districts and to characterize Rabies virus (RABV) strains from seven districts of Uganda with consistent prevalence of rabies. Methods: KAP survey data were collected based on animal biting history by interviewing the head of the veterinary departments, the medical centers and selected households from the study sites. Data were obtained from 84 households in Ntoroko and Moyo districts. Thirty-five (35) brain samples were collected from bovine, dogs, goats, foxes, jackals ad sheep between 2011 and 2013. Samples were tested using fluorescent antibody test (FAT), One step RT-PCR (following RNA extraction) and partial RABV N gene was sequenced by Sanger method before phylogenetic and phylogeographic analyses of sequences. Results: Scarcity of post-exposure prophylaxis services in the health centers was noted. Poor attitude of wound washing and deficiency of knowledge on how to handle wounds related to dog bites and the significance among household participants lacked. There is a high risk of rabies infection due to a limited dog's vaccination. Dog biting episodes in humans were of 75.00 and 62.50% in Moyo and Ntoroko districts respectively. Twenty-seven (27) samples tested positive for rabies by FAT and PCR. Ugandan sequences were closely related (97% nucleotide id) to the rabies virus sequences from Tanzania, Rwanda, Burundi, Nigeria, Central African Republic and Sudan with both the "Africa 1A" and "Africa 1B" RABV clades represented. A putative new clade 1D was also detected.

Knowledge, attitudes and practices towards rabies: A survey of the general population residing in the Harare Metropolitan Province of Zimbabwe

“…Our results showed that 49% of the respondents within the HMP were pet owners (owning a cat, a dog or a combination of the two). This level of pet ownership was similar to what was observed in other studies in Africa, where pet ownership was reportedly between 40% and 58% [ 17 – 19 ]. Within the pet owner sub-population specifically, 60% of the respondents within the HMP reported taking their pet(s) to a veterinary office.…”

“…While respondents in our study were never specifically asked whether they had their pets vaccinated at any point in time, these observations would suggest that approximately 43% of the owned dog population should theoretically have received their annual vaccination against rabies every year. Assuming this to be accurate, the results would be similar to findings from Uganda [ 17 ] and Kenya [ 21 ] where a low percentage of respondents (between 35% and 43%) reported having their pets vaccinated against rabies, and in contradiction to findings from Nigeria [ 18 ], Ethiopia [ 19 ] and Rwanda [ 20 ] where a much higher percentage of respondents (between 74% and 94%) reported having their pets vaccinated against rabies. Furthermore, this speculative vaccination coverage in the HMP (30%) is well below the recommended vaccination coverage of 70% [ 1 ], which could explain the persistence of the disease in the province.…”

“…The result of our study suggested that only 36% of the 798 respondents included in our study had an adequate knowledge of rabies, which was similar to what was observed in Uganda (41%) [ 17 ] but lower than findings reported from elsewhere in Africa, viz . Nigeria (82%) [ 18 ], Ethiopia (56%) [ 19 ], Rwanda (56%) [ 20 ], Kenya (67%) [ 21 ], and Tanzania (96%) [ 16 ].…”

Rabies post-exposure healthcare-seeking behaviors and perceptions: Results from a knowledge, attitudes, and practices survey, Uganda, 2013

“…A more recent KAP survey conducted in the Mbale district of Uganda concluded that of the survey respondents, only 44% has sufficient knowledge of rabies, and authors suggest that, even currently, more educational awareness regarding rabies is needed in Mbale [ 27 ]. Findings from another recent KAP survey conducted in the Moyo and Ntoroko districts of Uganda suggest that dog bites are still high, with 75% and 62.5% of respective bite rates [ 28 ]. Also, in East Africa, a 2015 KAP study from Ethiopia reports a bite rate of 42% among survey respondents [ 22 ].…”

Rabies Virus Infection in Livestock

“…Within samples submitted for rabies diagnosis, those of cattle, goats, sheep, and horses showed a higher percentage of positivity than dog and cat ones [26]. In Namibia, cattle rabies cases are second to dogs during 2011-2017 [50], also in Uganda during 2011-2013 [16]. In South Africa, rabies has been mainly diagnosed in dogs (52%), followed by (34%) cattle [51].…”