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

Abstract

Background: This study aimed to assess the extent of knowledge and understanding of rabies disease in rural and urban communities of Pakistan. It also identified malpractices after suspected dog bite that might pose a risk for humans contracting rabies. Methods: A cross-sectional study was conducted (n = 1466) on people having different age groups and educational levels in four different geographic regions of Punjab and Khyber Pakhtunkhwa provinces in Pakistan. Knowledge, attitude, and practices of people were assessed using a structured questionnaire. We used a bivariate and multivariate analysis to study the association between rabies related mortalities in near or extended family members and different risk behaviors. Results: Our results demonstrate that the majority of the juvenile population (less than 18 years of age) were not aware of the clinical signs of rabies in animals. 75% of the total respondents were not vaccinated against rabies, 60% did not seek a doctor's advice after a suspected animal bite, and 55% had inadequate health care facilities for rabies patients in local hospitals. Respondents that had pets at home had not vaccinated (38%; p < 0.05; odds ratio 1.58) themselves against rabies due to lack of knowledge and awareness of pre-exposure prophylaxis for rabies (51%; p < 0.05; odds ratio 1.25). They also tend to not visit doctor after suspected bite (52%; p < 0.05; odds ratio 1.97), which may had resulted in more deaths (65%; p < 0.05; odds ratio 1.73) of someone in their near or extended family due to rabies. Conclusions: Lack of knowledge about the nature of rabies disease and prophylaxis has contributed to increase of rabies related deaths. Inadequate health care facilities and poor attitude of not seeking medical attention after suspected dog bite are the major reasons of rabies related deaths. These findings could help in devising a targeted management strategy and awareness program to control and reduce the incidence of human rabies related deaths in Pakistan.

Supporting control programs on African swine fever in Ukraine through a knowledge, attitudes, and practices survey targeting backyard farmers

“…Knowledge, attitudes and practice (KAP) surveys can be used in disease control programs to identify misconceptions, misunderstandings and behaviours that might constitute barriers in the implementation of interventions (Chenais et al., 2017; Krentel et al., 2006; Matibag et al., 2007). In the context of disease control, KAP surveys are based on the assumption that knowledge leads to behaviour and practices against disease and thus, to changes that lessen the disease impact (Ahmed et al., 2020; Mascie‐Taylor et al., 2003). Therefore, a better understanding of the KAP of stakeholders towards a disease can help to identify if awareness campaigns could be necessary or if stakeholders are likely to comply with measures to reduce the disease spread.…”

Drivers of zoonotic disease risk in the Indian subcontinent: A scoping review

“…Studies in India found some participants had heard about rabies, but knowledge of first-aid following a bite was poor, with application of chillies, turmeric or kerosene and visiting traditional healers recommended [ 33 , 35 , 37 ]. In two Pakistan studies, most participants stated there had been no rabies awareness campaign in their community [ 28 , 38 ], with similar findings in India [ 32 , 35 ]. People reported getting their information from friends, family and neighbours, with women who had received no formal education likely to be less aware of the disease [ 32 ].…”

“…Ahmed and colleagues found people bitten by dogs in Pakistan did not seek post-exposure prophylaxis or vaccinate their domestic dogs even when aware of the existence of vaccination programmes. This was true despite 70% of participants knowing rabies was a vaccine-preventable disease and 75% understanding that it was fatal [ 28 ]. Similar responses were found in Bangladesh, with most participants (32%) not treating bite wounds before attending hospital for post-exposure prophylaxis, 22% applying antiseptic or water, 14% applying soap and water, and 15% applying products such as lime, soda, salt and kerosene oil [ 29 ].…”

“…Fourteen sources described drivers of rabies related to lack of awareness and understanding of the disease, its causes and prevention. Communities often reported low awareness of rabies, in terms of preventing bites and behaviour following a bite or other contact with potentially infected animals [ 28 , 29 , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] ]. Some sources discussed community beliefs and the use of traditional medicines as prevention or post-exposure prophylaxis [ 29 ].…”

Evaluation of the knowledge, attitudes and practices of students at the University of Abomey-Calavi on rabies in Benin Republic, West Africa

“…Compared to the study of Ahmed et al . [ 14 ] in India, where 72.4% of respondents were aware that rabies is a fatal disease, the proportion of recognition in Benin is markedly less.…”