Three Things to Know
Rabies is endemic in southern Bhutan, where children are particularly vulnerable to bites. After delivering a 45-minute presentation and a 30-minute Q&A to two schools, researchers assessed the rabies education program results through the use of a questionnaire.
Children demonstrated significantly improved knowledge immediately after the presentation compared to their baseline.
However, knowledge declined significantly three months later, although it remained higher than baseline, indicating the need for regular reinforcement of rabies education.
For Dog Welfare Practitioners
Given the study’s demonstration of life-saving knowledge gains from rabies education programs, dog welfare organizations in endemic regions should make youth initiatives a core pillar. Aligning with findings from Malawi, this research highlights significant knowledge decay within three months, emphasizing the necessity of sustained, long-term programs.
To optimize engagement, organizations and advocates should adapt innovative approaches from developed countries, such as incorporating rabies awareness into birthday parties, recurring story times, and after-school clubs, tailored to the local context.
The Full Picture
Dog bites are the primary source of rabies transmission, and children are especially vulnerable due to their size, curiosity, and limited ability to recognize dog behavior. They may provoke dogs unknowingly or fail to report bites, sometimes leading to the use of traditional rather than medical treatments.
Due to the prevalence of dog ownership for guarding purposes in Bhutan, dog bites are common, with children aged 5–9 being especially vulnerable. To manage its dog-related problems, the country has actively conducted rabies vaccination campaigns and employed CNVR for population management control.
While awareness programs are conducted yearly, often on World Rabies Day, they tend to focus on urban schools and rely on PowerPoint presentations to large groups, with no formal assessments to evaluate effectiveness. This study, titled “Assessment of the rabies education among middle secondary school students of southeastern Bhutan”, aims to assess the impact of rabies education in two schools in southeastern Bhutan to inform better prevention strategies for school children nationwide.
Study Methods
The study was conducted in two middle secondary schools in Samdrup Jongkhar District, southeastern Bhutan — Orong Central School (OCS) and Samdrup Jongkhar Middle Secondary School (SJMSS) — chosen based on rabies risk and accessibility during the COVID-19 pandemic. SJMSS lies near the Indian border with frequent cross-border dog movement, while OCS is located further north with occasional rabies outbreaks.
Only grade X students were included to minimize age-related bias. One section from each school was randomly assigned to the control group, with the remaining sections forming the intervention group. A total of 94 students were in the intervention group, and 35 in the control group. The intervention consisted of a 45-minute PowerPoint presentation on rabies, delivered in English with local language support, followed by a 30-minute Q&A.
A structured questionnaire was developed to measure the results of the rabies education program. It covered socio-demographic details, rabies knowledge, and understanding of dog behavior and safety. Data collection occurred at three points: before the intervention (T0), immediately after (T1), and three months later (T2). Control group data was collected only at T0 and T2. The same self-administered questionnaire was used across all time points.
Study Results
A total of 129 students completed the questionnaires. Slightly more than half (52.7%) were female. The mean age was 16.4 years.
Baseline Rabies Knowledge
All students (100%) had heard of rabies before the intervention. Main sources of information included animal health workers, family, teachers, and friends. The score between the two groups were expressed below:
| Before Rabies Education Program Results | Intervention Group | Control Group |
|---|---|---|
| Overall Score | 40.55 (total score = 58) | 39.46 (total score = 58) |
| .. Knowledge Score | 19.98 | 20.14 |
| .. Perception Score | 10.77 | 10.17 |
| .. Dog Bite Safety Score | 9.81 | 9.14 |
Researchers did not find meaningful differences in the overall score between the two groups prior to the education program. Students from SJMSS, those with employed mothers, and older adolescents had significantly higher baseline knowledge on rabies.
Rabies Education Program Results
| Intervention Group | Control Group | |
|---|---|---|
| Immediately After Rabies Education Program Results | ||
| Overall Score | 53.87 (total score = 58) | No survey conducted |
| .. Knowledge Score | 26.96 | No survey conducted |
| .. Perception Score | 13.95 | No survey conducted |
| .. Dog Bite Safety Score | 12.97 | No survey conducted |
| Three Months After Rabies Education Program Results | ||
| Overall Score | 47.68 (total score = 58) | 43.29 (total score = 58) |
| .. Knowledge Score | 23.05 | 21.34 |
| .. Perception Score | 12.21 | 11.20 |
| .. Dog Bite Safety Score | 12.41 | 10.74 |
Results showed a significant increase in students’ knowledge immediately after a short PowerPoint-based lesson, which aligned with another study in the Philippines and one conducted in Sri Lanka. Most information were retained — though some decline was noted after three months. Overall, the intervention group showed improved knowledge than the control group after three months.
However, in reviewing the test score, researchers noted that some students continued to hold unsafe beliefs or misunderstood risk behaviors (e.g., thinking it’s safe to feed or play with stray dogs). This suggests a need for more engaging and diverse educational methods beyond slideshows.
Conclusion
This study assessed the immediate impact and retention of rabies education among schoolchildren in Bhutan. It is the first of its kind in the country to evaluate rabies knowledge retention over time. The study recommends frequent, possibly quarterly, rabies education sessions, especially in endemic areas, and suggests integrating rabies education into the school curriculum, as done in other countries.
Miscellaneous
Data From Study:
Street Dogs > Rabies > Education
Year of Publication:
2022
External Link:
Lungten L, Tenzin T, Rinchen S, Chedup K, Wangchuk S, Phimpraphai W, et al. (2022) Assessment of the rabies education among middle secondary school students of southeastern Bhutan. PLoS ONE 17(12): e0276862. https://doi.org/10.1371/journal.pone.0276862