Tschopp Rea, Bekele Shiferaw, Aseffa Abraham
Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
Swiss Tropical and Public Health Institute, Basel, Switzerland.
PLoS Negl Trop Dis. 2016 Feb 22;10(2):e0004471. doi: 10.1371/journal.pntd.0004471. eCollection 2016 Feb.
Rabies is a viral zoonosis that has been described in limited numbers of studies in Ethiopia at large and among pastoralists in particular. This study assessed dog demography, bite wound prevalence and management, potential risk factors of disease transmission and knowledge attitude practice towards rabies among urban dwellers, pastoralists and health workers in Awash, Eastern Ethiopia.
Information was collected by means of structured questionnaires and interviews and through medical and official records from the Agricultural and Health bureaus.
Respondents totaled 539 (471 urban, 49 pastoralists, 19 medical). Dog(s) were owned in 33% urban and 75.5% pastoralist households respectively. Mean dog number per dog owning household was 1.50 (95%CI: 1.40-1.60) in urban and 2.05 (95%CI: 1.51-2.60) in pastoralists sites. Human Dog Ratio in Metahara was 4.7:1. No bite wounds records were kept in medical facilities, where staff recalled around 100 bites per year, 2/3 being in adults. Over 90% of the respondents claimed knowing rabies but up to 79.2% pastoralist did not know how dogs acquire the disease; 37.3% urban and 23% pastoralist did not know the symptoms of rabies in dogs; 36% urban and 44% pastoralists did not know rabies symptoms in people. Eighty percent of pastoralists did not know that the disease was fatal in people if untreated. Over half (58.7%) of pastoralist respondents go to traditional healers if bitten, despite a health extension worker program in place in the study area. Knowledge gaps were also shown amidst medical staff.
The study highlighted overall poor disease knowledge, severe under-reporting of human rabies cases, lack of record keeping and poor collaboration between the public and animal health sectors and communities in rabies control.
狂犬病是一种病毒性人畜共患病,在埃塞俄比亚全国范围内,尤其是牧民群体中,相关研究数量有限。本研究评估了埃塞俄比亚东部阿瓦什地区城市居民、牧民和卫生工作者中犬类种群数量、咬伤伤口患病率及处理情况、疾病传播的潜在风险因素以及对狂犬病的知识、态度和行为。
通过结构化问卷和访谈,以及从农业和卫生局获取的医疗及官方记录收集信息。
受访者共539人(471名城市居民、49名牧民、19名医务人员)。城市家庭和牧民家庭养狗的比例分别为33%和75.5%。城市中每户养狗家庭的平均狗数量为1.50只(95%置信区间:1.40 - 1.60),牧民地区为2.05只(95%置信区间:1.51 - 2.60)。梅塔哈拉的人犬比例为4.7:1。医疗机构没有咬伤伤口记录,工作人员回忆每年约有100起咬伤事件,其中三分之二发生在成年人身上。超过90%的受访者声称了解狂犬病,但高达79.2%的牧民不知道狗是如何感染这种疾病的;37.3%的城市居民和23%的牧民不知道狗的狂犬病症状;36%的城市居民和44%的牧民不知道人的狂犬病症状。80%的牧民不知道该疾病若不治疗会致人死亡。尽管研究地区设有健康推广工作者项目,但超过一半(58.7%)的牧民受访者在被咬伤后会去找传统治疗师。医务人员中也存在知识差距。
该研究突出表明,总体上疾病知识匮乏,人间狂犬病病例严重漏报,缺乏记录保存,以及在狂犬病防控方面,公共卫生部门、动物卫生部门和社区之间缺乏良好合作。