Rabies knowledge and practices in selected KwaZulu-Natal communities

Abstract

Knowledge, attitude, and practices (KAP) studies have been widely used to assess gaps in KAP towards rabies. However, there is no evidence of baseline studies that have assessed KAP towards rabies among selected communities in KwaZulu-Natal Province, South Africa. A cross-sectional, questionnaire-based study design was adopted. Participants (n = 768) were selected using systematic random sampling. Data from respondents (≥18 years of age) were collected using a validated questionnaire and analysed using descriptive and inferential statistics. Overall, 26.95% (207/768) of the respondents could name the cause of rabies, while 53.52% (411/768) indicated that they would adhere to post-exposure prophylaxis (PEP), which can include, depending on the category of the bite wound, wound washing, and receiving a dose of human rabies immune globulin (HRIG) and rabies vaccine at the time of the first medical visit. Most respondents (90.10%, 692/768) would seek medical attention following a dog bite. Most dog owners (82.11%, 459/559) owned a vaccination certificate for their pet. Allowing dogs to roam without supervision was widely reported by the respondents. Dog ownership was the only factor significantly associated (p = 0.0001) with knowledge of rabies. Gaps in some aspects of knowledge about rabies were observed, which require awareness creation among residents of the study area, irrespective of whether they own pets.

1. Introduction

Domestic dogs play a significant role in the lives of humans. However, they pose the threat of transmitting rabies to humans [1]. Rabies is an important infectious viral disease [2,3] caused by lyssavirus, from the family Rhabdoviridae [4,5]. All mammals are susceptible to rabies virus infection, which is generally transmitted through the bite of a rabid animal [6].

Dog-mediated rabies infection remains a significant disease from a public health perspective [7] and annually it is responsible for an estimated 60 000 human deaths worldwide [8,9]. Of these, Asia has the highest burden of rabies, followed by Africa, making the two the most affected continents [9,10]. In Africa, over 90% of human rabies deaths are associated with dog bites [11,12]. n Asia, 31 539 human deaths attributed to rabies are reported annually, suggesting a high rate of rabies infection compared to other continents [13]. Furthermore, globally, around 15 million people seek rabies post-exposure prophylaxis (PEP) to minimise the risk of rabies infection following exposure to dog bites [14].

Once symptoms of rabies develop, victims usually succumb to the disease [4]. Moreover, the risk of developing symptoms is high if the victim fails to obtain PEP early following a dog bite [15]. In humans potentially exposed to the rabies virus, PEP usually includes thorough wound cleaning and a combination of treatment with rabies immunoglobulin and vaccination [16]. In the absence of appropriate healthcare interventions, untreated individuals are at increased risk of death. Moreover, the disease is reported to have the highest case fatality of any disease [11]. Details of the treatment prescribed for dog-bite victims to prevent the development of rabies have been described by Bishop et al (2010) [17]. In addition, the WHO Expert Consultation on Rabies, third edition, 2018, provides clear guidelines on the prevention of rabies in humans.