Sor Sothy, Higuchi Michiyo, Sarker Mohammad Abul Bashar, Hamajima Nobuyuki
Siem Reap Provincial Health Department, Siem Reap, Cambodia.
2Department of Global and Community Health, Nagoya City University School of Nursing, 1, Kawasumi, Mizuho-cho, Mizuho, Nagoya, 467-8601 Japan.
Trop Med Health. 2018 Jun 8;46:20. doi: 10.1186/s41182-018-0102-0. eCollection 2018.
The rabies incidence and number of dogs in Cambodia are much higher than in nearby countries. Knowledge and behaviors which are related to rabies and/or dogs are considered to be contributing factors for rabies infection control in the community; however, such information in rural Cambodia is limited. This cross-sectional study aimed to assess knowledge and experiences related to rabies as well as dog-related behaviors among people in Siem Reap Province, and to identify the specific factors associated with adequate knowledge.
Four-stage sampling was employed to identify villages and households. In total, 360 respondents were interviewed using a structured questionnaire. Data were descriptively summarized and logistic regression was performed to estimate odds ratios of adequate knowledge related to rabies for respondents' characteristics.
Only 9.7% of respondents had adequate knowledge of rabies. Of the respondents, 86.9 and 18.3% had experienced hearing of or seeing a suspected rabid dog and a suspected rabid human, respectively. More than two-thirds (70.6%) of households had at least one dog, and the ratio of dog to human populations was 1: 2.8. Only a few owners had vaccinated dogs, used a cage, or tied up their dog. Visiting a health center was the first choice of treatment for respondents when bitten by a dog. However, post-exposure prophylaxis (PEP) was not commonly expected as a treatment choice by respondents. Those with higher education were more likely to have adequate knowledge than those with no education (adjusted OR 12.34, 95% CI 2.64-57.99, < 0.01). Farmers and non-poor families were also less likely to have adequate knowledge than those of other professions and poor families (adjusted OR 0.30, 95% CI 0.12-0.76, = 0.01, and adjusted OR 0.13, 95% CI 0.04-0.47, < 0.01, respectively).
High dog population, inadequate knowledge of rabies, low recognition of human rabies, and poor dog management were found to be serious challenges for controlling rabies. Health education related to rabies should be introduced, targeting farmers in particular who easily encounter stray dogs but have little knowledge of rabies risk factors and signs. At the same time, PEP delivery and dog management should be improved.
柬埔寨的狂犬病发病率和犬只数量远高于周边国家。与狂犬病和/或犬只相关的知识和行为被认为是社区狂犬病感染控制的影响因素；然而，柬埔寨农村地区的此类信息有限。这项横断面研究旨在评估暹粒省居民与狂犬病相关的知识和经历以及与犬只相关的行为，并确定与具备充分知识相关的具体因素。
采用四阶段抽样法确定村庄和家庭。总共360名受访者使用结构化问卷进行了访谈。对数据进行描述性总结，并进行逻辑回归以估计受访者特征与具备狂犬病充分知识的比值比。
只有9.7%的受访者对狂犬病有充分的了解。在受访者中，分别有86.9%和18.3%的人曾听说过或见过疑似患狂犬病的犬只和疑似患狂犬病的人。超过三分之二（70.6%）的家庭至少养了一只狗，犬只与人的比例为1:2.8。只有少数主人给狗接种过疫苗、使用笼子或将狗拴起来。被狗咬伤后，去健康中心是受访者的首选治疗方式。然而，暴露后预防（PEP）并非受访者普遍预期的治疗选择。受过高等教育的人比未受过教育的人更有可能具备充分知识（调整后的比值比为12.34，95%置信区间为2.64至57.99，P<0.01）。农民和非贫困家庭比其他职业的人和贫困家庭也更不可能具备充分知识（调整后的比值比分别为0.30，95%置信区间为0.12至0.76，P=0.01；以及调整后的比值比为0.13，95%置信区间为0.04至0.47，P<0.01）。
犬只数量多、狂犬病知识不足、对人类狂犬病认识低以及犬只管理不善被发现是控制狂犬病的严峻挑战。应开展与狂犬病相关的健康教育，尤其针对容易遇到流浪狗但对狂犬病风险因素和症状了解甚少的农民。同时，应改善暴露后预防的提供和犬只管理。
