Rabies And Treatment Following Dog Bites: Knowledge Among Adults Residing In A Semi-Urban Medical Officer Of Health Area In Sri Lanka

Abstract

Introduction: Rabies is a zoonotic disease that is endemic in Sri Lanka and the main vector of human rabies is the dog. The county invests a huge portion of its annual health budget to prevent this deadly disease. The treatment following dog bite has an important place in the prevention of human rabies, which consists of the provision of first aid and Post Exposure Therapy (PET). The objective of the study was to describe knowledge on human rabies and treatment following dog bites (TFDB) and their associated factors among persons aged 20-59 years in a semiurban Medical Officer of Health area in Sri Lanka Method- A community-based cross-sectional study was carried out among a random sample of 340 participants, aged 20-59 years in a semi-urban Medical Officer of Health area, Sri Lanka by using probability proportionate to the population size cluster sampling technique. Data were collected by using a pre-tested interviewer-administered questionnaire by two trained pre intern doctors and analyzed using SPSS 22 software. Results- Response rate was 94.7% (322/340). The mean age was 38.1 years (SD=11.2 years).Of the participants, 94% were Sinhalese (n=303): 87% Buddhists (n=280); 74.2% married (n=239); 64.6% employed (n=208); 82% lived in own house (n=264) with a median income of Rs. 38,000.00 (IQR=Rs. 38,000/=). Only 11.5% (n=37) were dog owners. Overall knowledge on rabies was good in 64.9%, (n=209): 70.8% (n=228) knew the route of entry of virus but < 45% knew cat & bat are also reservoirs. The factors associated with good knowledge on rabies were Sinhala (OR=3.4, 95% CI- 1.3 -8.9,p=0.01); having higher level of education (OR=18.7, 95% CI- 9.7 -35.8 ,p<0.001), being employed (OR=2.3, 95% CI- 1.4 -3.6 p<0.001), having a higher income level (OR=4.8, 95% CI- 2.9 -7.9, p<0.001);owning dog (OR=2.7, 95% CI- 1.6 -4.4, p<0.001). Overall knowledge on treatment following dog bite was good in 61.2 %,(n=197):89.6%,(n=288) on first aid but < 30% knew the importance of noticing offending dog’s health, observability, and what to do if a dog is suspected to have rabies. The factors associated with knowledge on the treatment following dog bite were: ever-married(OR=1.7, 95% CI- 1.1 -3.2, p=0.02); having a higher level of education (OR=13.3, 95% CI- 7.5-23.5, p<0.001); having a higher level of monthly income (OR=3.0, 95% CI-1.9 -4.8, p<0.001); being employed (OR=2.2, 95% CI- 1.4 -3.5, p<0.001); owning a dog (OR=27.7, 95% CI-3.7 -205.0, p<0.001). Conclusions and Recommendations: The majority of the study participants had good overall knowledge of rabies and treatment following a dog bite. In general, knowledge on non-canine reservoirs of rabies and treatment following dog bites on specific events were deficient. There is a need to give holistic knowledge with regard to rabies as well as treatment following a dog bite to the general public. Keywords—rabies, treatment following dog bites, knowledge, Sri Lanka