Key Findings
Most residents in the towns of Mekelle and Asella of Ethiopia, as well as Kisumu and Siaya of Kenya understood rabies and its canine transmission.
However, a knowledge gap emerged regarding post-bite care and community-wide rabies prevention. Many participants favored culling stray dogs or admitted to having no preventive measures.
Despite awareness of rabies, a significant portion of dog owners allowed their pets to roam freely and neglected regular vaccinations.
Summary
Rabies is a fatal disease claiming over 55,000 lives annually, with Africa accounting for 44% of these deaths. Children, particularly boys, are disproportionately affected due to frequent contact with free-roaming dogs. The escalating number of these dogs in urban areas has contributed to the rising incidence of rabies. Despite its severe impact, rabies remains a neglected public health crisis in East Africa. For instance, Ethiopia’s Tigray region recorded more than 11,000 dog bite cases between 2003/4 and 2014/15, leading to 53 fatalities. Kenya also reported a staggering 146,000 dog bite cases in 2012 alone. With 43 and 52 deaths per million people respectively, Ethiopia and Kenya have among the highest rabies-related mortality rates in Africa.
Effective rabies control hinges on community engagement. However, a dearth of information exists about community perceptions, behaviors, and knowledge (KAP) regarding rabies prevention. Understanding the sociocultural significance of dog ownership is equally crucial for developing tailored control strategies. This study aims to quantify free-roaming dogs in major Ethiopian and Kenyan cities, assess community KAP on rabies and human exposure, and explore the cultural importance of dog keeping.
The study was conducted in four major towns: Mekelle and Asella in Ethiopia, and Kisumu and Siaya in Kenya, from November 2014 to April 2015. Free-roaming dogs were counted using a permanent animal marking spray to prevent recounting, with counts conducted daily from 6:00 to 9:00 AM, when dogs were at rest. Sub-cities and respondents, including dog owners, community members, municipality workers, and veterinary and medical professionals, were randomly selected to participate in the questionnaire. A total of 749 questionnaires were completed: 252 in Mekelle, 146 in Asella, 183 in Siaya, and 168 in Kisumu.
Survey Results
The study revealed a higher population of free-roaming dogs in Ethiopia compared to Kenya. Mekelle and Asella, Ethiopia, recorded 1,606 and 1,385 free-roaming dogs, respectively, while Kisumu and Siaya, Kenya, had 196 and 190. Counterintuitively, the towns in Ethiopia reported significantly fewer dog bite cases. Retrospective data from 2009-2013 showed 1,524 and 429 individuals received post-exposure prophylaxis (PEP) in Mekelle and Asella, respectively. In contrast, Kenya recorded 14,058 and 17,288 animal bite cases in Kisumu and Siaya between 2010-2014.
Dog ownership was widespread across all study sites. While 94.8% of Mekelle residents, 48.6% in Asella, 61.8% in Kisumu, and 71.4% in Siaya owned dogs, the primary purpose was for guarding. Pet ownership was relatively uncommon, with only 6.1% of Mekelle and 1.89% of Kisumu households keeping dogs as pets.
Over 90% of respondents in both countries demonstrated rabies awareness, with dogs identified as the primary carriers by more than 95%. Information sources primarily included schools, friends, and neighbors. A substantial portion of respondents in all areas recognized the role of free-roaming dogs in rabies transmission: 78.8% in Asella, 67.9% in Mekelle, 89.22% in Kisumu, and 74.23% in Siaya.
Post-bite practices varied across regions. While 45.2% of Asella residents washed wounds with soap and water, traditional remedies were more common in Mekelle (38.5%). In contrast, many respondents in Kisumu (52.5%) and Siaya (32.5%) lacked knowledge of appropriate first aid, with only a small percentage resorting to soap and water.
Vaccination emerged as the most common rabies prevention strategy, with approximately 40% of respondents in Asella and Mekelle advocating for it. However, knowledge gaps were evident, as nearly half of Asella residents were unaware of any preventive measures, while a third in Mekelle suggested culling stray dogs. In contrast, Kenya displayed stronger support for vaccination, with 78.5% in Kisumu and 66.9% in Siaya endorsing it. Despite this awareness, vaccination rates among dog owners were inconsistent, with about 20% coverage noted in both Kenyan cities.
Elimination was a commonly mentioned free-roaming dog management measure, with 58% support in Asella, 83.7% in Mekelle, and over 70% in Kenya. This aligns with the common practice of culling in Eastern African countries to manage human and canine rabies.
This study highlights the complex interplay between dog ownership, rabies awareness, and control practices in Ethiopia and Kenya. Despite widespread knowledge of rabies, inconsistencies in prevention behaviors and limited vaccination coverage among both humans and dogs are evident. The suggestion of eliminating free-roaming dogs as a control measure underscores the challenges in implementing more sustainable and humane rabies prevention strategies. Addressing these issues requires comprehensive interventions that combine community education, improved access to vaccination, and responsible dog ownership promotion.
Miscellaneous
Data From Study:
Rabies / Knowledge, Attitude & Practices (KAP) / Ethiopia
Year of Publication:
2018
External Link:
Menghistu, Habtamu Taddele & Thaiyah, Andrew & Bajitie, M. & Bundi, J. & Gugssa, G. & Hailu, Abrha Bsrat & Kirui, Gilbert & Kitaa, Jafred & Tsegaye, Y.. (2018). Free roaming dogs and the communities’ knowledge, attitude and practices of rabies incidence/human exposures: Cases of selected settings in Ethiopia and Kenya. Ethiopian Journal of Health Development. 32. 11-20.
https://www.researchgate.net/publication/324506828_Free_roaming_dogs_and_the_communities%27_knowledge_attitude_and_practices_of_rabies_incidencehuman_exposures_Cases_of_selected_settings_in_Ethiopia_and_Kenya