Occurrence of Rabies Suspected cases in Humans and Knowledge, Attitude and Practices of Individuals Visiting Jimma Town Health Center due to Bite of Animals Suspected of Rabies in Jimma Zone and Surrounding areas, South West Ethiopia

Abstract

Rabies, an acute viral disease of the central nervous system, is widespread in many regions of the world and affects all warm-blooded animals including humans. A cross-sectional questioner survey and retrospective studies were conducted from July 2012 to March 2013 in Jimma town health center to address the occurrence of rabies suspected case in humans and assess knowledge, attitude and practice (KAP) of the individuals visiting the health center due to bite of rabies suspected animals from Jimma zone and surrounding areas. According to the retrospective data collected from the health center between 2009 and 2012, 2302 post-exposure prophylaxis (PEP) were given during this period. The highest (20.4%) and the lowest (0.7%) number of cases were recorded from Jimma town and Nonno Benja district of Jimma zone respectively. Most of these cases (90.4%) were due to bite of dogs; and the majorities (52.6%) of the victims were children with less than 15 years and 71.8% of cases were from rural areas. There were statistically significant (P=0.001) variation in the occurrence of the cases with respect to age category, season, residence and districts of Jimma zone. No statistically significant variation (p>0.05) was observed in the incidence of the suspected cases between sex. From, 384 individuals visiting the health center due to bite of suspected rabid animals, 91.7% of them had heard of rabies before exposure, but only 20.1% were able to mention germs as causes of rabies. Most (92%) of the respondents estimated incubation period of rabies in humans and animals to be less than 40 days. More than 90% of the respondents mentioned abnormal behavior, lack of fear and aggressiveness, and excessive salivation as clinical signs of rabid animals. Moreover, altered mental status (nervous signs), headache and hydrophobia were mentioned as clinical sign of rabies in human by 98.4%, 72.4% and 63.8% of the respondents, respectively. Almost all the respondents (99%) mentioned that source of rabies for human is rabid dog; and 76.3% and 71.1% of them mentioned that rabies can also be acquired from the bite of rabid cat and farm animals respectively. Avoiding animals’ bite and stray dogs, and confining dogs were mentioned by the majority of the respondents as a means of rabies prevention. All the respondents believe that rabies is a health risk; and about 75% of them agree that the disease is preventable and traditional healer cure rabies. The greater proportion (57%) of respondent wash wound with water and/or soap as first aid, 53.4% immediately kill dogs, which bite human, and 34.6% slaughter and eat food animals bitten by suspected rabid animals. Forty eight percent of the respondents own one or more dogs and/or cats. However, they rarely vaccinate their pets. Most of the owners (91.4%) kept freely roaming dogs and this might contribute to the widespread occurrence of canine rabies in the area. Though some sociodemographic factors significantly (P<0.05) influenced some knowledge, attitude and practice of respondents, none of these factors has consistently affected all of the KAP parameters considered in this study. The number of rabies suspected cases in retrospective study may be below the actual magnitude of the cases of study areas in the study period. The respondents were aware of the clinical sign of rabies both in animal and human, its means of transmission, and prevention measures to be taken. Most of the respondents had positive attitude as to the public health impact of the disease, but the actual practice in place is not good for the prevention and control of the disease. To this end, it is of paramount importance to work on further awareness creation, assess and map the zonal picture of rabies