Dog ownership practices and responsibilities for children's health in terms of rabies control and prevention in rural communities in Tanzania.

Lwitiko Sikana,Maganga Sambo,Katharina Kreppel,Kennedy Lushasi,Tiziana Lembo,Sally Mtenga,Katie Hampson,Daniel Wight,Jane Coutts,Daniel Leo Horton

doi:10.1371/journal.pntd.0009220

Abstract

Interventions tackling zoonoses require an understanding of healthcare patterns related to both human and animal hosts. The control of dog-mediated rabies is a good example. Despite the availability of effective control measures, 59,000 people die of rabies every year worldwide. In Tanzania, children are most at risk, contributing ~40% of deaths. Mass dog vaccination can break the transmission cycle, but reaching the recommended 70% coverage is challenging where vaccination depends on willingness to vaccinate dogs. Awareness campaigns in communities often target children, but do not consider other key individuals in the prevention chain. Understanding factors related to dog ownership and household-level responsibility for dog vaccination and child health is critical to the design of vaccination strategies. We investigated who makes household decisions about dogs and on health care for children in rural Tanzania. In the Kilosa district, in-depth interviews with 10 key informants were conducted to inform analysis of data from a household survey of 799 households and a survey on Knowledge Attitudes and Practices of 417 households. The in-depth interviews were analysed using framework analysis. Descriptive analysis showed responsibilities for household decisions on dogs’ and children’s health. Multivariate analysis determined factors associated with the probability of dogs being owned and the number of dogs owned, as well as factors associated with the responsibility for child health. Dog ownership varied considerably between villages and even households. The number of dogs per household was associated with the size of a household and the presence of livestock. Children are not directly involved in the decision to vaccinate a dog, which is largely made by the father, while responsibility for seeking health care if a child is bitten lies with the mother. These novel results are relevant for the design and implementation of rabies interventions. Specifically, awareness campaigns should focus on decision-makers in households to improve rabies prevention practices and on the understanding of processes critical to the control of zoonoses more broadly.

Highlights

Zoonotic pathogens shared between human and animal populations are widespread in the developing world
Qualitative data from the key-informant interviews highlighted a number of relevant points to inform further exploration using the quantitative data: Veterinary officers mentioned that “pupils up to standard five are very active on bringing dog(s) for vaccination”. (ID# A 001)
Mothers were cited as those more likely to accompany a child to a health facility: “Often a person who escorts a child to a health facility is a mother” (ID# C 002)

Summary

Introduction

Zoonotic pathogens shared between human and animal populations are widespread in the developing world. The multi-host nature of these pathogens has a dual impact on human and animal health in terms of illness, death and the high costs of care [1]. An understanding of healthcare patterns related to both human and animal hosts is critical for public-health interventions tackling zoonoses. It is a fatal zoonosis caused by a Lyssavirus and can affect all mammals, including humans [2]. The main source of human rabies is a bite from an infected domestic dog (Canis familiaris) [9]

Results

Discussion

Conclusion