Community knowledge, attitudes, and practices toward rabies prevention in North Vietnam

In recent years, despite the accessibility to vaccines (both for humans and animals), rabies remains a problem in many areas of Vietnam. While the number of rabies deaths decreased by 90% from 1994 to 2003, the number of rabies deaths increased from 2004 to 2007. In 2007, the number of rabies victims was 2-3 times higher than in 2003 and 131 people died as a result of rabies. In order to better understand Knowledge, Attitudes, and Practices (KAP) toward rabies in areas of both high and low incidence of rabies mortality in Vietnam, and KAP between pet and non-pet owners, a cross-sectional study was carried out by administering a structured questionnaire to 585 respondents from selected households in Thanh Son District-Phu Tho Province and Viet Yen District-Bac Giang Province, Vietnam. KAP in both high and low incidence areas, especially in groups with pets, need to be improved, particularly regarding treatment practices after a dog-bite and recommended pet care. We recommend not only enhanced IEC activities, but also the development of a Behavior Change Communication Strategy (BCC).     

Household knowledge, attitudes and practices related to pet contact and associated zoonoses in Ontario, Canada

ABSTRACT: BACKGROUND: Many human infections are transmitted through contact with animals (zoonoses), including household pets. Although pet ownership is common in most countries and non-pet owners may have frequent contact with pets, there is limited knowledge of the public's pet contact practices and awareness of zoonotic disease risks from pets. The objective of this study was to characterize the general public's knowledge, attitudes and risks related to pet ownership and animal contact in southern Ontario, Canada. METHODS: A self-administered questionnaire was distributed to individuals at two multi-physician clinics in Waterloo, Ontario, Canada during 2010. A single adult from each household was invited to participate in the study. RESULTS: Seventy five percent (641/853) of individuals approached completed the questionnaire. Pet ownership and contact were common; 64% of participants had a pet in their household and 37% of non-pet owning households had a member with at least weekly animal contact outside the home. Pet ownership was high (55%) for households with individuals at higher risk for infections (i.e., < 5 yrs, > 64 yrs, immunocompromised). Most respondents (64%) indicated that they had never received information regarding pet-associated disease risks. When given a list of 11 infectious pathogens, respondents were only able to correctly classify just over half on their potential to be transmitted from pets to people (mean 6.4); independently, pet owners and those who recalled receiving information in the past about this topic were able to make significantly more correct identifications. Pet (36%) and non-pet owning households (10%) reported dog or cat bites or scratches during the preceding year. Households with individuals at higher risk for an infection did not differ from the remaining households regarding their perceived disease risk of pets, zoonotic disease knowledge, recall of being asked by their medical provider if they owned any pets, or recall of having received information regarding pet-associated disease risks and preventive measures. CONCLUSIONS: These results suggest that there is a need for accessible zoonotic disease information for both pet and non-owning households, with additional efforts made by veterinary, human and public health personnel. Immediate educational efforts directed toward households with individuals at higher risk to infections are especially needed.     

Canine rabies vaccination and domestic dog population characteristics in the developing world: a systematic review

Background

Human rabies remains a significant problem in many developing countries, where canine rabies is the most common means of transmission. Although vaccination of dogs has been shown to be the most effective method of prevention in humans, dog vaccination is often lacking.

Methods

This systematic review examined dog rabies vaccination coverage achieved following mass vaccination campaigns and dog ecology/management factors relevant to rabies control in the developing world. We searched a variety of electronic databases for published articles pertaining to dog rabies vaccination or dog ecology where data were collected utilizing a household cluster survey. We reviewed studies published between January 1, 1980 and present and identified 29 articles for inclusion.

Results

We found the majority of vaccination campaigns were able to achieve the WHO recommended vaccination coverage of ≥70% and calculated weighted mean post-campaign vaccination coverage of 76.5% in urban areas and 73.7% in rural areas. However, we found an absence of studies related to dog vaccination/dog ecology from countries with the greatest burden of rabies such as India, China, and Pakistan. In addition, the majority of dogs in the developing world are very young and short-lived, reducing the effectiveness of vaccination campaigns.

Conclusions

Future studies on canine ecology should be undertaken in countries with high endemic canine rabies. New methods for improving the longevity of dogs and reducing high dog population turnover need to be investigated. Programs which encourage good dog management and promote responsible pet ownership are essential to eliminating canine and human rabies.     

Impact of community-delivered SMS alerts on dog-owner participation during a mass rabies vaccination campaign,Haiti 2017

Haiti has historically vaccinated between 100,000 and 300,000 dogs annually against rabies, however national authorities have not been able to reach and maintain the 70% coverage required to eliminate the canine rabies virus variant. Haiti conducts massive dog vaccination campaigns on an annual basis and utilizes both central point and door-to-door methods. These methods require that dog owners are aware of the dates and locations of the campaign. To improve this awareness among dog owners, 600,000 text messages were sent to phones in two Haitian communes (Gonaives and Saint-Marc) to remind dog owners to attend the campaign. Text messages were delivered on the second day and at the mid-point of the campaign. A post-campaign household survey was conducted to assess dog owner’s perception of the text messages and the impact on their participation in the vaccination campaign. Overall, 147 of 160 (91.9%) text-receiving dog owners indicated the text was helpful, and 162 of 187 (86.6%) responding dog owners said they would like to receive text reminders during future rabies vaccination campaigns. In areas hosting one-day central point campaigns, dog owners who received the text were 2.0 (95% CI 1.1, 3.6) times more likely to have participated in the campaign (73.1% attendance among those who received the text vs 36.4% among those who did not). In areas incorporating door-to-door vaccination over multiple days there was no significant difference in participation between dog owners who did and did not receive a text. Text message reminders were well-received and significantly improved campaign attendance, indicating that short message service (SMS) alerts may be a successful strategy in low resource areas with large free roaming dog populations.     

银川市居民狂犬病防治知识现况调查分析

目的 了解银川市城乡居民狂犬病防治知识知晓情况,为广泛开展狂犬病防治工作及相关健康教育提供依据。 方法 在全市6个县区(市)进行随机抽样调查,共有效调查1200名居民。 结果 银川市居民犬类饲养率达45.17%;27.06%的犬类饲养方式为散养和与人共居;定期给犬类接种动物狂犬病疫苗率为35.06%,城乡犬只免疫率差异具有统计学意义(χ2=27.55,P<0.01)。 结论 我市居民犬只饲养率高,但免疫率极低,居民狂犬病防治意识淡薄,政府有关部门应加强犬只管理及狂犬病健康教育工作。     

湖南省2009年狂犬病监测分析

目的分析湖南省2009年狂犬病监测资料,评价预防处置效果,为预防和控制狂犬病提供依据。方法根据《湖南省狂犬病监测实施方案》,收集全省狂犬病监测资料进行流行病学分析。结果 2009年共报告狂犬病200例,发病率为0.31/10万。Ⅱ级、Ⅲ级暴露者占98.0%,伤口未处理者达65.5%,病例均无暴露前免疫史,暴露后只有13.0%注射了狂犬疫苗,133例Ⅲ级暴露者仅9.77%联合应用了抗狂犬免疫球蛋白或血清。狂犬病门诊监测中,湖南全省共报告267 133例暴露者,Ⅱ、Ⅲ级暴露者占85.60%。暴露者中有94.59%在预防门诊接受伤口处理,97.62%暴露后全程接种了疫苗,Ⅲ级暴露者中42.47%注射了抗狂犬免疫球蛋白或血清。伤人动物主要是犬,全省犬密度为6.309只/100人,兽用疫苗接种率为47.78%,犬只狂犬病毒感染率是0.56%。结论犬密度较高、犬群有较高的感染率,兽用疫苗接种率较低,群众防治意识不强以及暴露后未能得到规范处理是目前狂犬病高发的主要相关因素。加强犬只＂管、免、灭＂,规范暴露后伤口的规范处理,是遏制狂犬病高发行之有效的综合措施。     

Operational performance and analysis of two rabies vaccination campaigns in N’Djamena,Chad

Transmission of rabies from animals to people continues despite availability of good vaccines for both human and animal use. The only effective strategy to achieve elimination of dog rabies and the related human exposure is to immunize dogs at high coverage levels. We present the analysis of two consecutive parenteral dog mass vaccination campaigns conducted in N’Djamena in 2012 and 2013 to advocate the feasibility and effectiveness for rabies control through proof of concept. The overall coverage reached by the intervention was >70% in both years. Monthly reported rabies cases in dogs decreased by more than 90% within one year. Key points were a cooperative collaboration between the three partner institutions involved in the control program, sufficient information and communication strategy to access local leaders and the public, careful planning of the practical implementation phase and the effective motivation of staff.The dynamic and semi to non-restricted nature of dog populations in most rabies endemic areas is often considered to be a major obstacle to achieve sufficient vaccination coverage. However, we show that feasibility of dog mass vaccination is highly dependent on human determinants of dog population accessibility and the disease awareness of dog owners. Consequently, prior evaluation of the human cultural and socio-economic context is an important prerequisite for planning dog rabies vaccination campaigns.     

A survey of attitudes toward responsible pet ownership

The concerns of medical and community officials about responsible pet ownership have increased. Before a practical solution can be found for irresponsible ownership and community health problems associated with pet populations, the public's attitudes on issues related to responsible pet ownership must be determined. Such issues include attitudes on dog and cat overpopulation, potential public health problems associated with pet populations, and methods of controlling pet populations and stray animals. Responses to a questionnaire were used to evaluate the attitudes of 910 pet owners and nonowners toward factors comprising responsible pet ownership. The median age of the respondents was 33 years; 414 (45 percent) were men, and 496 (55 percent) were women. At the time of the study, 18 percent owned a cat and a dog, 35 percent owned only a dog, 11 percent showed only a cat, and 36 percent were nonowners. Not only the sex of the respondent but also the category of pet ownership affected opinions on overpopulation of dogs and cats, nuisance and pollution problems associated with these animals, and methods of controlling pet populations in the community. For example, owners agreed strongly on family planning for pets, but a majority of male owners stated that they would not have their dogs neutered.     

上海市嘉定区居民狂犬病防治知识信念行为调查

目的了解上海市嘉定区居民预防狂犬病知识信念行为及其家庭养犬情况,为有针对性地开展健康教育提供参考。方法按分层抽样的方法,抽取2个村和2个居委进行入户调查。结果共调查641名居民,居民对狂犬病传播途径的知晓率低,只有57.88%知道狂犬病不可治愈,8.58%的被调查居民家中养犬,养犬数与人口总数之比为2.55∶100,犬的免疫率为47.27%,72.97%的人认为没有必要对犬进行免疫。被调查的居民家庭中,一年内有19人被犬咬伤,94.74%的人咬伤后到医疗机构就诊。结论居民狂犬病防治知识知晓率低,家庭养犬率高,犬的免疫率低,被犬咬伤率高,就诊率低,应加强狂犬病防治知识宣传。     

Knowledge,attitudes and practices related to influenza illness and vaccination in children: Role of awareness campaigns in changing parents’ attitudes toward influenza vaccination in Jordan

BackgroundInfluenza infection is associated with a significant health burden in children, especially in developing countries. The influenza vaccine is an important preventive strategy for flu illness. Aim of this study to assess knowledge, attitudes and practices (KAP) related to influenza illness and vaccination in children in the Jordanian population and to study the effect of awareness campaigns on changing the attitudes of parents toward vaccinating their children against influenza.MethodsA cross-sectional study was conducted among families visiting shopping malls and parks in November 2016. A questionnaire was administered via in-person interviews. Answers to KAP questions regarding influenza illness and vaccination were summed, with a total KAP score of 30. Facts about influenza illness and vaccination were explained to parents and provided in printed pamphlets.ResultsThere were 1241 respondents. 10.9% of participants had vaccinated their children during the last season 2015/2016. The mean KAP score (standard deviation) was 16.21 (4.61). People living in urban areas, with high monthly income >600 JD and healthcare workers had higher KAP scores than their counterparts. Compared to other sources of information about the influenza vaccine, health resources correlated most with vaccinating children. Awareness and educational pamphlets changed attitudes positively in 29% of parents who refused the influenza vaccine for their children.ConclusionsAwareness about influenza illness and vaccination is insufficient, and the coverage rate of influenza vaccination in children is low in the Jordanian population. Implementing public health policies is necessary to spread knowledge about influenza illness and vaccination and to promote the practice of receiving the influenza vaccine in children. Educational campaigns are helpful in changing the attitudes of parents toward vaccinating their children against the flu.     

浙江省慈溪市犬类狂犬病病毒携带状况调查及变异研究

目的研究犬类狂犬病病毒的携带状况及变异,为正确有效控制狂犬病疫情提供依据。方法根据狂犬病疫情分布,用分层采样法,采集相关地区犬脑51只,用免疫荧光法、夹心酶联吸附法、小鼠颅内接种试验法及RT-PCR进行检测。分离狂犬病病毒并进行N基因测序。结果在流浪犬只中发现狂犬病毒株(命名CXs)。流浪犬带毒率7.69%,CXs与疫苗株和固定毒株的NJ进化树比较,发现与WZO(H)株100%同源,与狂犬病毒固定毒株相比更接近CTN株(该地区使用的疫苗株)。结论当前使用的狂犬疫苗用于预防狂犬病是可靠的。经狂犬病流行特征和暴露后免疫预防处理分析,加强犬只的管理、免疫,暴露后采用规范清创,正确使用狂犬疫苗,合理使用狂犬免疫球蛋白(或血清)仍是当前防治狂犬病需遵循的原则。     

Epidemiologic surveys of dog and cat bites in the Lyon area,France

The urban pet population has increased considerably in France during the last twenty years. Two main questions need to be answered regarding rabies and other bite transmitted zoonoses: What is the actual incidence rate of dog and cat bites in an urban area; and how sensitive is the animal bite reporting system? To answer these questions, four surveys were conducted in the Lyon area, France, in 1989: 1) an analysis of the consultation reports to the Pasteur Institute and of the bite reports sent by veterinarians to the local veterinary services for 1987 and 1988; 2) a survey of 10 veterinary clinics located in the Lyon area and an analysis of their bite reports for the period May 1987 — April 1989; 3) a questionnaire survey to 175 clients of these veterinary clinics; 4) a street survey of a random sample of the Lyon adult population (310 questionnaires). Bite incidence rates ranged from 10/100,000 persons/year for rabies post-exposure treatments to 37.5/100,000 persons/year for reported bites. However, less than half of the bite reports from the ten veterinary clinics were submitted to the veterinary services. The surveys conducted among pet owners and the general population indicated that, overall, bites were common events (3.4%) and occurred more often in pet owners (8.6%). In 74% of the cases, victims belonged to the pet owner's family and one fourth of the accidents occurred when playing with the pet. However, 12% of the accidents resulted from apparently unprovoked aggressions. According to these data, estimates of the incidence rate of bites for the Lyon area were at least one hundred times higher than the official reported rate of 37.5 bites/100,000 persons/year.     

Factors influencing the antibody response of dogs vaccinated against rabies

Since 2000, there has been a legal requirement in the UK that dogs and cats should have an effective rabies vaccination with demonstrable sero-conversion if their owners wish to avoid quarantine on re-entry to the UK. In 2002, 10,483 rabies titres were determined on dogs at the VLA. Statistical analyses assessed the efficacy of each vaccine within different dog breeds. Animal size, age, breed, sampling time and vaccine had significant effects on pass rates and median titres. Our data suggests that a general relationship between animal size and level of antibody response exists and smaller sized dogs elicited higher antibody levels than larger breeds of dog. It was not however, only the magnitude of response immediately following vaccination but also the duration of immunity that varied between breeds of dog. Another observation was that young animals, less than 1-year of age, generated a lower antibody response to rabies vaccination than adults. Considerably higher failure rates were also observed for different vaccines tested. Regression analysis revealed that two vaccines performed equally well, and significantly better than the others tested. The variation in antibody response relating to length of interval of sampling following vaccination is not unexpected and presumably relates to the response kinetics for primary vaccination. These data need to be placed in perspective in order to minimise the risk of rabies being re-introduced into a rabies-free country, especially in the consideration of removing the requirement for serological testing for rabies vaccinated dogs that participate in pet travel schemes.     

A pilot study of dental caries status in relation to knowledge, attitudes and practices in oral health in Myanmar

This study was to determine the dental caries prevalence among the Myanmar population, and to investigate the correlations between oral clinical indices and knowledge, attitudes and practices (KAP) on oral health. Subjects were randomly selected from 140,000 people residing in the Kyauktan township in a cross-sectional community-based study. The present analysis was confined to 739 subjects (353 males and 386 females) aged 12, 35-44 and 65-74 years, who were divided into two specified groups based on urban or rural location. KAP on oral health data and social demographic information were collected, while dental caries status was assessed by DMFT. The mean number of decayed teeth (DT) in rural areas was higher than that in urban areas, while the mean number of filled teeth (FT) in rural areas was lower than that in urban areas. Mean knowledge and attitude scores for correct answers were also significantly higher for the urban than the rural subjects. There were statistically significant correlations between the correct/incorrect responses to knowledge and attitude questionnaires on oral health and the mean number of DMFT. KAP pertaining to oral health of Myanmar population, especially those of rural subjects, might not be satisfactory and related to threaten their dental caries status.     

Chinese urban–rural disparity in pandemic (H1N1) 2009 vaccination coverage rate and associated determinants: a cross-sectional telephone survey

Objectives

The present study aimed to examine the differences in pandemic (H1N1) 2009 vaccination coverage rate between urban and rural areas in China, and to explore factors associated with any urban–rural differences.

Study design

Cross-sectional study.

Methods

Data were derived from a cross-sectional telephone survey performed in seven urban and two rural areas soon after the pandemic peak in China, concerning pandemic (H1N1) 2009 vaccination and associated knowledge, attitudes and practices among the general population in China. A total of 10 669 participants aged 18 years and above participated in the study.

Results

Vaccination amongst rural residents was less than urban residents (8.9% vs 11.2%, P = 0.002). Among those who have not been immunized, 82.2% of rural respondents showed a willingness to get vaccinated against A/H1N1, significantly higher than that of urban respondents (55.3%). The major barrier to vaccination was reported as ‘not being informed to get vaccination’, of which there was a greater proportion in rural than urban population (71.9% vs 68.8%, P = 0.009). The analysis revealed a number of factors which contribute to this disparity: previous experience of vaccination against flu, degree of awareness of the free vaccination policy, and sociodemographic differences between urban and rural areas.

Conclusions

Significant discrepancies existed in the pandemic (H1N1) 2009 vaccination coverage rate and associated determinants, as well as the intention to get vaccinated between urban and rural residents. To improve the effectiveness of similar vaccination programmes in the future, campaigns for rural people need to be specifically tailored to address disparities in uptake.     

Knowledge,attitudes, and practices regarding ticks and tick-borne diseases,Finland

Tick-borne encephalitis (TBE) and Lyme borreliosis (LB) are endemic in Finland, with tens and thousands of cases, respectively, reported annually. We performed a field survey to investigate people’s knowledge, attitudes and practices (KAP) regarding ticks, tick-borne diseases, and prevention strategies.The KAP were assessed using a pre-validated anonymous questionnaire consisting of 39 questions and statements. On two consecutive days in July 2016, convenience sampling was used in the cities of Parainen and Kotka, located in high-risk areas of tick-borne diseases, particularly of TBE. In attitudes and practices sections, each question was scored and analysed with ordered logistic regression model.In total, 101 individuals responded. The TBE vaccination rate among respondents was 40%. The best known preventive measures were having vaccination against TBE (88%), and wearing long sleeves and pants against ticks (81%). Two-thirds incorrectly identified the ring-like rash as a symptom of TBE. Of all respondents, 78% could not exclude that TBE can be treated with antibiotics; 55% that vaccine protects against LB; and 46% that it protects against ticks. The minority (14%) believed tick repellents to be effective. Among preventive behaviour, the quick removal of an attached tick was most frequently applied (97%). Repellents were used by 21% when visiting tick-infested areas. Significant associations were found between the vaccination status and having a correct belief that the vaccine protects against TBE (P < 0.001) but not against ticks (P < 0.05), or LB (P < 0.001).KAP is a quick and easy tool to get a rough estimation on people’s awareness regarding ticks and tick-borne diseases. We identified gaps in knowledge and misbeliefs. Our results can be used in public health communication tools on tick-borne diseases, especially those on intervention strategies.     

Can rabies be eradicated? The epidemiological basis for urban control in Venezuela

An epidemiological study of the pattern of urban rabies wascarried out in the City of Maracaibo in 1985, which had reported207 cases, or 58% of all canine cases in the country. The neighbourhoodsconsidered at high risk were those that had recently reportedrabies, had a high dog population density, a high proportionof stray dogs and low canine vaccination coverage. The controlprogramme involved the mass vaccination of nearly 100% of thedogs within the high and adjoining medium-risk areas, the eliminationof stray dogs, the quarantine of the area under vaccinationand health education and rabies outbreak control. In order toachieve maximum reduction in rabies incidence, mass vaccinationsshould be carried out over a short period of time, preferablyin less than two months. They should start in the first yearof a rabies cycle, before the onset of the seasonal rise andshould be carried out over three consecutive years. During thethird year, the number of high risk areas should be reduced.If one month-old dogs are known to have rabies, dogs of allages should be included in the vaccination programme. Such arabies control programme has been shown to eliminate rabiesin an urban district over a three-year period.     

A dog rabies vaccination campaign in rural Africa: impact on the incidence of dog rabies and human dog-bite injuries

Despite the availability of safe and effective rabies vaccines, the incidence of dog rabies has been increasing throughout much of sub-Saharan Africa. Here we describe a vaccination strategy that has resulted in successful control of rabies in a rural dog population of Northwestern Tanzania. From October 1996 to February 2001, four central-point dog vaccination campaigns were conducted in villages within Serengeti District with a mean interval between campaigns of 338, 319 and 456 days. Vaccination coverage of the dog population was estimated from household questionnaires as 64.5, 61.1, 70.6 and 73.7% following each of the four campaigns, respectively. The incidence of dog rabies declined significantly in Serengeti District falling by 70% after the first campaign and by 97% after the second campaign. Over the same period, the incidence of dog rabies did not differ significantly in unvaccinated control villages of Musoma District. The incidence of human bite injuries from suspected rabid dogs declined significantly in Serengeti District after dog vaccination but not in adjacent unvaccinated districts. Vaccination of 60-70% of dogs has been sufficient to control dog rabies in this area and to significantly reduce demand for human post-exposure rabies treatment. Dog-bite injuries can provide a valuable and accessible source of data for surveillance in countries where case incidence data are difficult to obtain.     

Human rabies postexposure prophylaxis during a raccoon rabies epizootic in New York, 1993 and 1994.

We describe the epidemiology of human rabies postexposure prophylaxis (PEP) in four upstate New York counties during the 1st and 2nd year of a raccoon rabies epizootic. We obtained data from records of 1,173 persons whose rabies PEP was reported to local health departments in 1993 and 1994. Mean annual PEP incidence rates were highest in rural counties, in summer, and in patients 10 to 14 and 35 to 44 years of age. PEP given after bites was primarily associated with unvaccinated dogs and cats, but most (70%) was not attributable to bites. Although pet vaccination and stray animal control, which target direct exposure, remain the cornerstones of human rabies prevention, the risk for rabies by the nonbite route (e. g., raccoon saliva on pet dogs' and cats' fur) should also be considered.