Brookes Victoria J, Gill Gurlal S, Singh Balbir B, Sandhu Bhupinder S, Dhand Navneet K, Aulakh Rabinder S, Ward Michael P
Faculty of Science, Sydney School of Veterinary Science, The University of Sydney, Camden, New South Wales, Australia.
Guru Angad Dev Veterinary and Animal, Sciences University (GADVASU), Ludhiana, Punjab, India.
Zoonoses Public Health. 2019 May;66(3):325-336. doi: 10.1111/zph.12568. Epub 2019 Feb 18.
In August 2015, a rabies outbreak occurred in bovines in a Punjab village, India; subsequently, a farmer in the same village died of rabies in October 2015. We surveyed farmers to describe the outbreak, the demographics and rabies prophylaxis administered to householders on case farms, and farmers' knowledge of rabies prevention and treatment. We used multiple correspondence analysis to guide investigation of associations between demographics, farm status and rabies knowledge, attitudes and practices. The number of affected bovines was unusually high; 15 cattle and buffalo died on 13 smallholder farms (attack rate 4%). Post-exposure vaccinations were administered to 24 people (median 2 doses). Affected farms had significantly larger households and were more likely to keep their livestock outside (therefore, accessible by stray dogs), suggesting that the impact of the outbreak was disproportionally borne by households of lower socio-economic status. Primary sources of rabies information were friends and neighbours, not health authorities or media. Women who had not received formal education were less likely to have heard of rabies. Although case farm participants were more likely to have heard about rabies from a veterinarian, their knowledge and practices to prevent rabies did not reflect the level expected considering their contact with a health professional; they were more likely to believe that traditional remedies prevent rabies and less likely to tell their children to avoid playing with stray dogs than participants from other farms. This study highlights knowledge dissemination disparities that, if typical of rural locations, could obstruct attempts to eliminate canine-mediated human rabies in India. Therefore, understanding the pervasiveness and influence of traditional medical beliefs on treatment-seeking behaviour, communication structures within villages and the impact of local practices such as carcass disposal on dog populations will be essential to ensure that rabies control strategies are effective in rural India.
2015年8月，印度旁遮普邦一个村庄的牛群中爆发了狂犬病；随后，同村的一名农民于2015年10月死于狂犬病。我们对农民进行了调查，以描述此次疫情、病例农场户主的人口统计学特征和接受的狂犬病预防措施，以及农民对狂犬病预防和治疗的了解情况。我们使用多重对应分析来指导对人口统计学特征、农场状况与狂犬病知识、态度和行为之间关联的调查。受影响的牛的数量异常之高；13个小农户的15头牛和水牛死亡（攻击率4%）。24人接受了暴露后疫苗接种（中位数为2剂）。受影响的农场家庭规模显著更大，而且更有可能将牲畜饲养在户外（因此易被流浪狗接触到），这表明疫情的影响在社会经济地位较低的家庭中更为突出。狂犬病信息的主要来源是朋友和邻居，而非卫生当局或媒体。未接受过正规教育的女性听说过狂犬病的可能性较小。尽管病例农场的参与者更有可能从兽医那里听说过狂犬病，但他们预防狂犬病的知识和行为并未反映出鉴于他们与卫生专业人员的接触所应有的水平；与其他农场的参与者相比，他们更有可能相信传统疗法可以预防狂犬病，而不太可能告诉孩子避免与流浪狗玩耍。这项研究突出了知识传播方面的差异，如果这在农村地区具有代表性，可能会阻碍印度消除犬介导的人类狂犬病的努力。因此，了解传统医学观念对就医行为的普遍影响和作用、村庄内部的传播结构以及诸如尸体处理等当地做法对狗群的影响，对于确保狂犬病控制策略在印度农村地区有效至关重要。
