Investigation Of Knowledge, Attitude And Practice (Kap); And Burden Of Rabies In Gimbi And Nejo Districts Of West Wollega Zone, Western Ethiopia

Abstract

Rabies is a fatal viral zoonotic disease largely transmitted by bites of infected dogs, results in a large economic and public health burden in rabies endemic areas. A cross-sectional and retrospective study was conducted between November, 2018 to August, 2019 to investigate the Knowledge, Attitude and Practice (KAP); and economic and public health burden of rabies in Gimbi and Nejo districts. For KAP assessment, Peasant associations (PAs) were randomly selected using a lottery method based on proportional allocations of PAs per districts, followed by selection of households from each PAs using systematic random sampling. The KAP score was done to rank the level of KAP of the people as good, moderate and poor based on proportion of questions they answered. The strength of association between KAP scores and predictor variables was determined using multinomial Odds ratio. To quantify the economic and health burden of rabies, a one year data (2017-2018) were collected from both district‟s general Hospitals. After identifying the registered victims from Hospitals, the victims were followed and tracked for further information and the nest victims were identified using snowball method. Economic loss estimation was based on costs related to PEP, dog vaccination and control and surveillance and livestock death; whereas human health burden was estimated based on DALYs. Of 150 households interviewed, all were heard of rabies previously. About 42.7% (95% CI: 0.35- 0.51), 40 %( 95% CI: 0.32-0.48) and 63.3% (95% CI: 0.56-0.71) had good knowledge, poor attitude and poor practice about rabies, respectively. Respondents with primary levels of education had 0.05 times less likely a good knowledge compared to tertiary levels (OR=0.053). Males had 8.8 times more likely a moderate knowledge compared to females (OR=8.8), married respondents had 0.41 times less likely a moderate knowledge than unmarried (OR=0.41) and respondents with primary levels of education had 0.05 times less likely a moderate knowledge than tertiatry levels (OR=0.05). The probability of having a good attitude was higher in respondents having tertiary levels of education (OR= 36.9) and health professionals (OR=15.49). Female had 0.2 times less likely a moderate attitude than males (OR=0.2) and Muslims had 17.2 more likely a moderate attitude than orthodox (OR=17.2) respondents. Having tertiary levels of education (OR= 2.9) and being health professional (OR= 15.38) had a higher effect on having a good practice compared to non-formal and farmers. From 63 bite victims interviewed, 71.5% were from dog bites. Statistically significant variation was observed between residence area (χ2 =4.2, P=0.041) and age (χ2 =8.511, P=0.037) of the victims on their rabies or rabies suspected exposure. Of the 63 bite victims, three were died from rabies, resulting in 131.12 DALYs. The estimated economic burden of rabies for a period of one year was 28,513.82 US$, which was a big economic loss for these districts. Generally, rabies is familiar in Gimbi and Nejo districts causing large economic and public health burden to the communities. Hence, further community based health education is needed to raise accurate knowledge and to improve the peoples‟ attitude and practice toward rabies. Moreover, regular dog vaccination and other appropriate preventive measures are better to be implemented to reduce the public health and economic burden from rabies