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

• Published in: PLoS neglected tropical diseases Vol. 13; no. 4; p. e0007305
• Main Authors: Rinchen, Sangay, Tenzin, Tenzin, Hall, David, van der Meer, Frank, Sharma, Basant, Dukpa, Kinzang, Cork, Susan
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01.04.2019; Public Library of Science (PLoS)
• Subjects: Attitudes; Beef cattle; Biology and Life Sciences; Cattle; Control; Disease prevention; Disease transmission; Dogs; Economic aspects; Economics; Ecosystems; Education; Farmers; Farms; Health aspects; Health risks; Infectious diseases; Knowledge; Livelihoods; Livestock; Medicine and Health Sciences; Milk; Oral cavity; Outbreaks; Parturition; Pathogens; People and Places; Personal protective equipment; Physical Sciences; Polls & surveys; Prevention; Protective devices; Protective equipment; Public health; Rabies; Regression analysis; Research and Analysis Methods; Risk factors; Rural areas; Subsistence agriculture; Subsistence farming; Surveying; Transmission; Tropical diseases; Veterinary medicine; Zoonoses; Bhutan; Canada; Alberta Canada; India
• ISSN: 1935-2735; 1935-2727; 1935-2735
• DOI: 10.1371/journal.pntd.0007305

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.