Veterinary Faculty, University Eduardo Mondlane, Maputo, Mozambique.
Agricultural Research Council-Onderstepoort Veterinary Institute, OIE Rabies Reference Laboratory, Pretoria, South Africa.
PLoS Negl Trop Dis. 2022 Mar 7;16(3):e0010202. doi: 10.1371/journal.pntd.0010202. eCollection 2022 Mar.
Rabies is a viral zoonotic disease that kills more than 26,000 people each year in Africa. In Mozambique, poverty and inadequate surveillance result in gross underreporting and ineffective control of the disease in animals and people. Little is known of the role of human attitudes and behaviour in prevention or control of rabies, thus this study was undertaken to assess the knowledge, attitudes and practices amongst selected households and health practitioners in one affected area, the Limpopo National Park (LNP), Massingir district.
A cross-sectional study was conducted among 233 households in eight villages in LNP and among 42 health practitioners from eight health facilities in Massingir district between 2016 and 2018. Consenting household representatives aged 18 years or over were purposively selected. A KAP survey was administered to obtain information on dog ownership and knowledge of rabies, host species affected, modes of transmission, symptoms, recommended treatment and preventive methods. Similar to household study participants, health practitioners were purposively selected and completed the questionnaire during the investigators' visit. The questionnaire sought information on knowledge of rabies, management of bite wounds, vaccination sites and schedules of pre- and post-exposure prophylaxis. Descriptive and inferential data analyses were performed using SPSS software version 18.0.
Approximately twenty per cent (18.9%; 95% CI: 14.3-24.3) and 13.3% (95% CI: 9.4-18.1) of households had good knowledge and practices of rabies, respectively. For health practitioners, only 16.7% (95% CI: 7.5-31.9) had good knowledge, whilst 33.3% (95% CI: 20.0-49.7) adopted adequate attitudes/practices towards the disease.
CONCLUSIONS/SIGNIFICANCE: In conclusion, both households and health practitioners displayed poor levels of knowledge and adopted bad attitudes and practices towards rabies. The former, had more gaps in their attitudes and practices towards the disease. Village location and education level (P < .05) and similarly, sex and occupation, were found to be statistically associated with good knowledge of rabies among households as compared to HPs. Overall, a lack of community-based education and professional retraining courses contribute significantly to poor awareness of rabies in the LNP of Mozambique. Enhancing public health knowledge should consequently reduce dog-mediated human rabies deaths in this country.
狂犬病是一种病毒性人畜共患疾病，每年在非洲导致超过 26000 人死亡。在莫桑比克，贫困和监测不足导致疾病在动物和人群中的报告严重不足和控制不力。人们对预防或控制狂犬病的态度和行为知之甚少，因此，这项研究旨在评估在一个受影响的地区——林波波国家公园（LNP）、马辛吉尔区，选择的家庭和卫生工作者的知识、态度和实践。
2016 年至 2018 年，在 LNP 的 8 个村庄中对 233 户家庭和马辛吉尔区 8 个卫生设施的 42 名卫生工作者进行了横断面研究。选择了年龄在 18 岁或以上的同意的家庭代表。通过 KAP 调查获得有关狗的拥有情况和狂犬病知识、受影响的宿主物种、传播方式、症状、推荐的治疗方法和预防方法的信息。与家庭研究参与者类似，卫生工作者也被有目的地选择，并在调查员访问期间完成了问卷。调查问卷询问了狂犬病知识、咬伤伤口处理、疫苗接种地点和暴露前和暴露后预防的疫苗接种时间表。使用 SPSS 软件版本 18.0 进行描述性和推断性数据分析。
大约 20%（95%CI：14.3-24.3）和 13.3%（95%CI：9.4-18.1）的家庭对狂犬病有良好的知识和做法。对于卫生工作者，只有 16.7%（95%CI：7.5-31.9）具有良好的知识，而 33.3%（95%CI：20.0-49.7）对疾病采取了适当的态度/做法。
结论/意义：总之，家庭和卫生工作者对狂犬病的知识水平都很差，对狂犬病的态度和做法也很糟糕。前者在疾病的态度和做法方面存在更多的差距。村庄位置和教育水平（P<.05）以及性别和职业，与家庭相比，家庭对狂犬病的知识水平存在统计学关联。总体而言，缺乏基于社区的教育和专业再培训课程，这极大地导致了莫桑比克林波波国家公园对狂犬病的认识不足。提高公众健康知识水平应该会相应减少该国犬介导的人类狂犬病死亡人数。
