Abstract
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.
Highlights
Bhutan is a small Himalayan Kingdom located in South Asia bordered by India in the south, West, and East and the Autonomous region of Tibet in the North
The sub-district of Kanglung under Trashigang district was included in the study as it falls under a rabies low-risk zone in eastern Bhutan [3]
The Chisquare analysis showed that the number of female participants (p
Summary
Bhutan is a small Himalayan Kingdom located in South Asia bordered by India in the south, West, and East and the Autonomous region of Tibet in the North. Cattle (Bos indicus and Bos taurus) are the most commonly reared livestock in Bhutan [2], and they play an important role in sustaining rural livelihoods by serving as a source of food, manure, draught power, and as an immediate source of income. Infectious diseases remain a threat to livestock production resulting in economic losses due to decreased productivity as well as death of affected animals. Common infectious diseases affecting cattle in Bhutan include foot and mouth disease, rabies, hemorrhagic septicaemia, black quarter, and anthrax. Rabies is one of the most important zoonotic diseases in Bhutan. The country continues to experience around 17 outbreaks in animals annually, especially in cattle [3]. The Department of Livestock (DoL) under the Ministry of Agriculture and Forests (MoAF) spearheads rabies control program in animals in Bhutan. Apart from conducting mass dog vaccination and animal birth control campaign, rabies awareness education is regularly disseminated to the public via television and radio programs and by observing World Rabies Day annually
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