Knowledge, Attitude and Practices on Rabies in Kisumu and Siaya Counties, Kenya

Abstract

Rabies is a neglected viral zoonotic disease that is invariably fatal in humans and other mammals. It affects mainly the low and middle income countries. Domestic dogs are the main vectors of the disease causing 94% of human rabies through bites. The disease not only causes human mortalities and Disability Adjusted Life Years (DALYs) but also a high public health burden, productivity losses, high costs of Post-Exposure Prophylaxis (PEP) and other costs incurred from control and prevention programs. Reliable data on rabies are necessary to understand the epidemiology of the disease, its impact on human and animal populations, and to obtain commitment and support from national authorities in the implementation of preventive and control programs. This study was therefore designed to determine the level of community knowledge, attittude and practices (KAPs) concerning rabies, owned and roaming dog demographics, the socio-cultural value of dog keeping and the number of animal bite cases in the preceeding 5 years in Kisumu and Siaya counties of Kenya. A total of 183 and 168 questionnaires were administered in selected sub-counties of Kisumu and Siaya respectively to determine community KAPs, owned dog demographics and the socio-cultural value of dog keeping. Mark- recapture technique was used to determine roaming dog demographics while a five year retrospective data on dog/animal bite cases were obtained from the health information system. Over 90% of the respondents were aware of rabies, its zoonotic nature and the importance of the domestic dog in its transmission. In both counties, over 75% of the respondents would seek medical attention in case a family member was bitten by a dog. However, a significant number of respondents (52.6% in Kisumu and 32.5% in Siaya) were not aware of the first line xii of action at home level after a person is bitten by a dog. Despite a large proportion of the respondents (78.6% - Kisumu and 66.9% - Siaya) being aware of the importance of dog vaccination in prevention of rabies, only 20.4% and 19.1% of the households in Kisumu and Siaya respectively had up to date vaccination of their dogs. A total of 259 and 299 household dogs were counted in Kisumu and Siaya respectively. In Kisumu, 68.6% of dogs were free to roam 24 hours a day while in Siaya, this proportion was lower at 28.6%. In the roaming population, 196 and 190 dogs were counted in Kisumu and Siaya respectively. In both counties, over 60% of the free roaming dogs were males. The five-year data (2010-2014) revealed a total of 14058 and 17288 animal bite cases in Kisumu and Siaya respectively. The data indicated that the number of bites and their incidence were on the rise over the years, and were higher in Siaya than in Kisumu. The knowledge gaps and negative practices identified by this study show the need to create public education and awareness programs in these counties in an effort to control the disease.