Urban Community Awareness of Rabies: Insights from a Knowledge, Attitude, and Practice Study
Aug 28, 2024
2024/8/26
A recent community-based cross-sectional study titled “Knowledge, Attitude, and Practice Study on Animal Bite, Rabies, and Its Prevention in an Urban Community” highlights the significant gaps in public awareness about rabies and animal bite management in urban areas of Tamil Nadu, India. The study brings forth the urgent need for public health education to bridge these gaps and improve prevention strategies.
1. The study surveyed 350 participants in an urban field practice area, finding that only 27.7% had good knowledge regarding rabies and animal bites, 34.6% had a good attitude, and just 18.1% practiced the correct preventive measures after an animal bite.
2. Among participants, 76% had heard of rabies, but only 36.2% knew that washing a wound with soap and running water was an appropriate first aid measure. A mere 1.1% knew about the application of iodine or alcohol to prevent rabies infection.
3. Despite 87.5% of bite victims visiting a doctor and 83.3% receiving anti-rabies vaccination (ARV), only 35% completed the full vaccination course, reflecting low adherence to preventive care protocols.
4. Gender, age, and education level were significantly associated with knowledge gaps, with females and older participants more likely to lack awareness of key preventive measures like ARV and first aid for animal bites.
Introduction
Rabies continues to be a significant public health issue in India, where dog bites are responsible for 99% of human rabies cases. This study aimed to assess the knowledge, attitudes, and practices (KAP) related to rabies and animal bite management among residents of Anakaputtur, an urban area in Tamil Nadu. By identifying gaps in awareness and preventive measures, the study provides insights that can help strengthen public health interventions in rabies-endemic regions.
Despite efforts to control rabies through vaccination and awareness programs, the study found that knowledge and proper practices remain low in many communities. This is particularly concerning given that rabies is nearly 100% fatal once symptoms develop. The research highlights the importance of education and the role of healthcare workers in ensuring timely post-exposure prophylaxis and wound care.
Method
This cross-sectional study was conducted among residents aged 20 and above in the urban field practice area of a tertiary care institute in the Kancheepuram district, Tamil Nadu. A sample size of 350 participants was selected using a simple random sampling technique, with participants identified through available family and street data. Data was collected via a structured questionnaire, administered through house-to-house visits by trained interviewers after obtaining informed consent.
The questionnaire was divided into two sections. The first collected demographic information, and the second assessed knowledge, attitude, and practice (KAP) related to rabies epidemiology, first aid for animal bites, and the importance of vaccination. The study also explored associations between demographic variables and KAP scores using the Chi-square test and Spearman’s correlation. Results with p-values less than 0.05 were considered statistically significant.
Ethical approval for the study was obtained from the institutional ethics committee, and all participants were assured of confidentiality. The data was analyzed using Statistical Package for the Social Sciences (SPSS) version 16, and results were expressed as frequencies, with knowledge, attitude, and practice levels categorized based on predefined scoring criteria.
Result
1. Awareness and Knowledge of Rabies
Of the 350 participants, 76% had heard of rabies, but only 63.5% were aware that rabies is a fatal disease. A concerning 37.6% of respondents believed that animals other than dogs could cause rabies, and only 47.4% knew that rabies is caused by a microorganism. More worryingly, just 31.6% recognized that rabies can be transmitted through a bite, scratch, or lick over broken skin. These knowledge gaps are significant, given that rabies is prevalent in India, and misinformation about transmission and prevention can lead to poor health outcomes.
The study found that awareness of proper first aid for animal bites was low. Only 36.2% knew that washing the wound with soap and running water could help prevent rabies transmission. Even fewer (1.1%) were aware that the application of iodine or alcohol could further reduce the risk of infection. These findings indicate the need for targeted education efforts, particularly focusing on the importance of immediate wound care after a bite.
The participants’ knowledge scores were associated with gender, age, and education level, with women and older adults more likely to lack awareness about rabies prevention and first aid. The low level of knowledge regarding rabies transmission and first aid underscores the need for improved public health campaigns in urban communities.
2. Attitudes Toward Rabies Prevention
Attitudes toward rabies prevention were similarly concerning. Only 53.1% of participants disagreed with the statement that rabies is curable, and 57.1% disagreed with the use of indigenous materials (e.g., herbs, oils) on wounds to prevent rabies. While 94.9% agreed that completing an anti-rabies vaccination (ARV) course is necessary after a bite, a significant proportion of participants failed to adhere to this belief in practice.
The study revealed a notable discrepancy between knowledge and attitude scores. While 34.6% of participants had a positive attitude toward rabies prevention, this did not necessarily translate into correct practices. For example, many participants expressed trust in ARV, but only 35% of those bitten completed the full vaccination course.
Factors such as age, gender, and education were significant predictors of participants’ attitudes toward rabies prevention. Younger, more educated participants were more likely to have positive attitudes and to reject misconceptions about rabies treatment. A positive attitude toward rabies prevention is essential, but it must be accompanied by correct practices to reduce rabies transmission.
3. Practices Following Animal Bites
Despite widespread awareness about the availability of ARV, only 35% of bite victims completed the full vaccination schedule. Most victims (87.5%) sought medical care after a bite, and 83.3% received ARV, but adherence to the vaccination protocol was low. This suggests that while initial medical intervention is sought, follow-through remains a challenge, possibly due to lack of education, financial constraints, or access to healthcare facilities.
In terms of first aid, only 37.5% of participants reported washing their wounds with soap and running water, while just 5.6% applied alcohol or iodine. The majority of bites (94.4%) were due to dogs, with stray animals accounting for nearly 60% of incidents. The study highlighted that joint family structures were more likely to delay or avoid seeking medical care, with 35.7% of joint family members not consulting a doctor compared to 6.9% in nuclear families.
Overall, the practice score was the lowest among the three categories (knowledge, attitude, and practice), with only 18.1% of participants exhibiting proper practices following an animal bite. Improving the practical response to animal bites through community education and accessible healthcare services is crucial to reducing the burden of rabies.
Conclusion
This study reveals substantial knowledge gaps and poor adherence to preventive practices related to rabies and animal bite management in an urban community in Tamil Nadu. Strengthening public health education, particularly in first aid and the importance of completing ARV, is essential for reducing the incidence of rabies. The study underscores the need for a multisectoral approach to rabies prevention, involving both healthcare providers and community outreach programs.
Paper URL: https://doi.org/10.4103/jfmpc.jfmpc_1674_20
