A rabies lesson improves rabies knowledge amongst primary school children in Zomba, Malawi

Abstract

Rabies is an important neglected disease, which kills around 59,000 people a year. Over a third of these deaths are in children less than 15 years of age. Almost all human rabies deaths in Africa and Asia are due to bites from infected dogs. Despite the high efficacy of current rabies vaccines, awareness about rabies preventive healthcare is often low in endemic areas. It is therefore common for educational initiatives to be conducted in conjunction with other rabies control activities such as mass dog vaccination, however there are few examples where the efficacy of education activities has been assessed. Here, primary school children in Zomba, Malawi, were given a lesson on rabies biology and preventive healthcare. Subsequently, a mass dog vaccination programme was delivered in the same region. Knowledge and attitudes towards rabies were assessed by a questionnaire before the lesson, immediately after the lesson and 9 weeks later to assess the impact the lesson had on school children’s knowledge and attitudes. This assessment was also undertaken in children who were exposed to the mass dog vaccination programme but did not receive the lesson. Knowledge of rabies and how to be safe around dogs increased following the lesson (both p<0.001), and knowledge remained higher than baseline 9 weeks after the lesson (both p<0.001). Knowledge of rabies and how to be safe around dogs was greater amongst school children who had received the lesson compared to school children who had not received the lesson, but had been exposed to a rabies vaccination campaign in their community (both p<0.001) indicating that the lesson itself was critical in improving knowledge. In summary, we have shown that a short, focused classroom-based lesson on rabies can improve short and medium-term rabies knowledge and attitudes of Malawian schoolchildren.

Implementation of a mass canine rabies vaccination campaign in both rural and urban regions in southern Malawi

“…Improvement in rabies awareness through the development of education campaigns has been recognised as a key factor in order to control the infection [5]. The delivery of these activities has been proven beneficial not only to provide the community with accurate information on disease prevention, but to improve their attitude concerning dog vaccination and engagement with rabies surveillance [13,45,46]. A similar regression analysis also showed that education was positively associated with the owner's intention to vaccinate their dog [44].…”

“…In 2016, the campaign was expanded to the neighbouring Zomba and Chiradzulu districts vaccinating nearly 90,000 dogs [10]. Alongside vaccination, rabies educational campaigns were conducted in schools in the three districts, which has been shown to effectively increase the knowledge of rabies in primary school children [13].…”

A preliminary survey of knowledge, attitudes and practice regarding rabies in West Bengal, India

“…10 Studies conducted in school children have shown improvements in knowledge, attitudes and practices towards rabies management among them. 11,12 This study conducted in Malda District, West Bengal can improve the awareness about rabies in children and provide better medical care.…”

One million dog vaccinations recorded on mHealth innovation used to direct teams in numerous rabies control campaigns

“…Periodic checks through co-supervision by management staff in the field during mass vaccination campaigns were used to correct any variation from standard operating procedures. Further information about the training protocol for education officers and retention of rabies understanding was described by Bailey et al (2018) [ 21 ].…”