College of Veterinary Medicine, School of Veterinary and Life Sciences, Murdoch University, Western Australia, Australia.
Ashoka Trust for Research on Ecology and Environment (ATREE), Bangalore, India.
PLoS One. 2018 Nov 16;13(11):e0207025. doi: 10.1371/journal.pone.0207025. eCollection 2018.
The lack of awareness regarding rabies amongst rural primary care health staff and their adverse practices towards the management of dog-bite wounds is a major contributor to the high incidence of rabies infection and subsequent human mortality in India. A Knowledge, Attitudes and Practices survey was carried out involving 54 nursing and non-nursing staff working in 18 rural Primary Health centres and sub-centres around Baramati town of Pune district in Western India. Multivariable logistic regression models were constructed to assess factors that influenced knowledge of rabies and practices towards management of dog-bite related wounds. The more experienced and better-educated workers were found to have a good awareness of rabies (OR 3.4, 95%CI 1.0-12.1) and good practices towards dog-bite wound management (OR 5.6, 95%CI 1.2-27.0). Surprisingly, non-nursing staff were significantly more knowledgeable about rabies (OR 3.5, 95%CI 1.0-12.3), but their practices towards dog-bite wound management were inadequate (OR 0.18, 95%CI 0.04-0.8) compared to the nursing staff. It is recommended that a mandatory training module for primary care health staff be developed and implemented to improve their knowledge regarding rabies and management of dog-bite wounds to reduce the incidence of human rabies in rural India.
在印度，农村初级保健卫生人员对狂犬病缺乏认识，以及他们对犬咬伤伤口管理的不当做法，是导致狂犬病感染率高和随后死亡率高的主要原因。在印度西部浦那地区巴拉马蒂镇周围的 18 个农村初级保健中心和分中心，对 54 名护理和非护理人员进行了一项知识、态度和实践调查。构建多变量逻辑回归模型，以评估影响狂犬病知识和犬咬伤相关伤口管理实践的因素。结果发现，经验更丰富和教育程度更高的工作人员对狂犬病有较好的认识（OR3.4，95%CI1.0-12.1），对犬咬伤伤口管理的实践也较好（OR5.6，95%CI1.2-27.0）。令人惊讶的是，非护理人员对狂犬病的了解明显更多（OR3.5，95%CI1.0-12.3），但与护理人员相比，他们对犬咬伤伤口管理的实践不足（OR0.18，95%CI0.04-0.8）。建议为初级保健卫生人员制定并实施强制性培训模块，以提高他们对狂犬病和犬咬伤伤口管理的认识，从而降低印度农村地区人类狂犬病的发病率。
