Assessment of Community Knowledge, Attitude and Practice on Zoonotic Disease in and Around Dodola Town, West Arsi Zone, Ethiopia Muluken Gezmu 1, Abrha Bsrat 2* and Abebe Mekuria 3 1 Ethio-Chicken, Addis Ababa, Ethiopia 2 Mekelle University College of Veterinary Medicine, Mekelle, Ethiopia 3 Arsi University College of Health Science, Asella, Ethiopia 1*Corresponding Author: Abrha Bsrat: e-mail: abrhish@gmail.com ABSTRACT A cross-sectional study was conducted from November 2015 to April 2016 in and around Dodola town, west Arsi zone, Ethiopia to assess knowledge, attitude and practice of the community on zoonotic diseases. Purposively selected study participants (n=384) comprised students, jobless settlers, farmers, government and self-employees. Semi structured questionnaire was distributed to collect required information from the respondents. Statistically significant difference (P<0.05) of knowledge and attitude on zoonotic diseases were recorded among the respondents of urban and peri-urban areas. About 76.8% of study respondents were heard about zoonosis. Rabies (68.8%), anthrax (50.8%), Taeniasis (53.1%), bovine tuberculosis (49.5%) and brucellosis (22.7%) were zoonotic diseases listed by the study participants. Bite from infected animals (60.4%), contact (45.6%), ingestion (50.5%) and inhalation (45.1%) were described as mode of transmission of zoonotic diseases by respondents. About 68.5% and 52.3% of respondent consumed raw meat and unpasteurized milk, respectively. Around 34.4% of the respondent shared the same house with animals while 97.4% of the respondents showed use of backyard slaughter. Community education and awareness program is required for further improvement of the knowledge, attitude and practice of the community about the zoonotic diseases. Key words: Attitude, Community, Dodola, Knowledge, Practice, Zoonotic Diseases. INTRODUCTION Historically, zoonotic diseases had a tremendous impact on the evolution of man, especially parallel to development of cultures and societies that domesticated and bred animals for food and clothing. The word 'Zoonosis' (Plural: Zoonoses) was introduced by Rudolf Virchow in 1880 to include collectively the diseases shared in nature by animal and man. Later in 1959, WHO defined that Zoonoses are "those diseases and infections which are naturally transmitted between vertebrate animals and man" (Shiv et al, 2005). In most cases, animals play an essential role in maintaining the zoonotic infection in nature and contribute in varying degrees to the distribution and actual transmission of infection in human and animal populations (WHO, 2005). Worldwide, an estimated 60 70% of emerging infectious diseases in humans are zoonoses (Jones et al., 2008). The greatest burden on human health and livelihood, amounting to about one billion cases of illness and millions of death every year, is caused by endemic zoonoses that are persistent regional health 57
problems around the world (ILRI, 2012). The organisms causing zoonoses include viruses, bacteria, fungi, protozoa and other parasites, with both domestic and wild animals acting as reservoirs for the pathogens. The diseases cause in humans range from mild and self-limiting (cutaneous leishmaniasis) to fatal (Ebola hemorrhagic fever) (DEFRA, 2003) with a variety of animal reservoirs, including wild life, livestock, pet animals, and birds (Nkuchia et al., 2007). A number of zoonoses are oldest known diseases and many are entrenched, particularly in rural agricultural communities. Increasingly, they are also found in urban areas where people keep livestock and live in close contact with their animals. However, their burden is still higher on developing countries top listed at rural poor communities (WHO, 2005; WHO, 2010). Zoonotic diseases can be acquired in a variety of ways such as via air (aerosol), direct contact, contact with an inanimate object that harbors the disease, oral ingestion and insect transmission (Kevin and Nancy, 2009). Zoonotic diseases cause mortality and morbidity in human while also imposing significant economic losses in the livestock sector (Gracey et al., 1999; McDermott and Arimi, 2002; Smits and Cutler, 2004; WHO, 2005). Hence, building of well-governed public health and animal health system, emphasizing the importance of cross-sectoral collaboration and coordination, abandon of traditional behaviors that can prone to zoonotic diseases and commitment of decision makers to obtain the necessary political, legal and financial support are required issues in minimizing of the impact of zoonotic diseases (Swai et al, 2010). To strengthen such preventive activities knowledge, attitude and practice of the community, professionals and decision makers seems crucial. The objective of the current study was therefore to assess knowledge, attitude and practice of the community about zoonotic disease. MATERIALS AND METHODS Study Area The study was conducted from November 2015 to April 2016 in and around Dodola town, West Arsi Zone, Oromia regional state. It is found about 297Km south of Addis Ababa, and locates at latitude and longitude of 6 59 7 N and 39 11 39 E, respectively, with an average elevation of 2464 meters above sea level. Dodola town is characterized by bi-modal rainfall with a mean rainfall of 728mm per annum and annual temperature ranging from 7.2-23.3 C (MoD, 2015). Study Design A cross sectional study with purposive sampling method was used. Semi structured questionnaires supplemented with interview were administered on 384 study participants approached to assess their knowledge, attitude and practice about zoonotic diseases. Study Population and Sample Size Study population of the current study comprised of purposively selected students of different educational level (elementary, high schools, colleges), jobless, farmers, and governmental and self-employees that are found in Dodola town and its surroundings. Data Collection and Analysis Semi structured questionnaire was prepared, pretested and employed in the study participants obtain required information for the study objectives. Questions were focused to determine 58
knowledge, attitude and practices of the community about zoonotic disease. The data was collected, entered into a MS-Excel sheet and analyzed using IBM-SPSS 20 version (2010). Descriptive statistics including Chi-square were used for possible explanation of associations. P- value of less than 0.05 was considered to be significant at 95% level of confidence. RESULTS Socio-Demographic Characteristics of the Respondents Among the total respondents 242 (63.0%) were from urban settlement while 215 (56%) were male. Educational status, occupation and monthly family income of the study respondents were recorded (Table 1). Knowledge of the Respondents on Zoonotic Disease The current study indicated statistically significant difference (P<0.05) on knowledge of the respondents among urban and peri-urban area (Table 2). Majority of respondents 295 (76.8%) were heard about zoonoses with significantly (P<0.05) higher in urban area than peri-urban settlers. Rabies (68.8%), taeniasis (53.1%), anthrax (50.8%), bovine tuberculosis (49.5 %) and brucellosis (22.7%) were commonly listed zoonotic diseases by the respondents while animal bite, contact, ingestion and inhalation were indicated mode of zoonotic transmissions. Attitude of the Respondents on Zoonotic Disease The current investigation indicated significant difference (P<0.05) in the attitude of the respondents among urban and peri urban area (Table 3).About 67.2% respondents had a perception of zoonotic disease transmission from animal to human other ( 32.8%)don t have knowledge about animal s role in zoonotic disease transmission. Practice of the Respondents on Zoonotic Disease Around48.2% respondents showed as they avoid contact with infected animals. Among respondents, 68.5% consumed raw meat while 52.3% respondents revealed consumption of unpasteurized milk. About 34.4% respondents shared the same house with different species of animals while 97.4% used backyard slaughter. DISCUSSION The community in the current study has found with lower knowledge towards zoonotic disease than previous report from Addis Ababa where 100% respondents heard about zoonotic disease (Girma et al. 2012). Furthermore, their source of information was found different from reports recorded by Amenu et al. (2010) from Arsi-Negele district indicated that acquiring of knowledge about zoonotic diseases from elders (34.7%) and their personal observation (32.7%). Furthermore, rate of most frequently mentioned zoonotic diseases in the current study was found lower than study reported by Girma et al. (2012) from Addis Ababa who mentioned as rabies (100 %), anthrax (94.27%), taeniasis (89.06%), bovine tuberculosis (88.54%) and brucellosis (49.48%) as known disease by the respondents. The difference could be due to variation in community s access to information about zoonotic diseases by different means. Addis Ababa is a capital city where information can be assessed more easily than the current study area. 59
Current study revealed relatively low level of knowledge about modes of transmission of zoonotic disease to humans. In contrast, Tesfaye et al. (2013) from Jimma reported that dog bite (94.3%) and raw/undercooked meat consumption (82.3%) as a mode of transmission for rabies and taeniasis, respectively. The might be due to variation on educational status, where about 81.6% of respondents from Jimma were attending basic education. The findings on knowledge about zoonotic disease transmission from animal to human in current study was higher than that reported by Tirsit et al. (2013) to be 15.6% from Mana and Limmukosa Districts of Jimma zone. The difference could be due to variation on educational status, where about 45.4% of the respondents from Mana and Limmukosa Districts didn t attend formal education. In agreement with the current study Amenu et al. (2010) reported 58.20% and 57.1% of study participants from Arsi-Negele district had a habit of consuming raw meat and unpasteurized milk, respectively. In contrary, lower value was reported by Swai et al. (2010) from Arusha and Tanga of Tanzania indicated 40% and 16.3% consumed unpasteurized milk and raw meat, respectively. This variation could be due to their habitat difference (urban and rural) and cultural variation of community from different locality and country on use of food of animal origin. Tirsit et al. (2013) reported lower (18.8%) proportion of respondents was sharing the same shelter with animals in Mana and Limmukosa districts of Jimma Zone. This difference could be due to variation in level of income of the respondents, and difference in awareness towards zoonotic disease. Tirsit et al. (2013) had reported 100% respondents slaughtering of animal in backyard of their house in Mana and Limmukosa districts of Jimma Zone which is in line with the current finding. Backyard slaughtering of livestock is very common in Ethiopia (Avery, 2004). The current study indicated gap on community knowledge about zoonotic disease and its mode of transmission. There was low level of recognition about zoonotic diseases transmission from animal to human and vice versa. The communities in the study area also indicated poor practices which could predispose to most zoonotic diseases. Common practices performed by the community includes; fail to limit contact with infected animals, consumption of raw meat and unpasteurized milk, sharing the same house with animals, backyard animal slaughtering, raw offal feeding to dog and etc. Hence, continues community education and governmental officials` sensitization on mass awareness creation about zoonoses is crucial. ACKNOWLEDGEMENTS The authors are thankful to College of Veterinary Medicine, Mekelle University for support during the study. Community of the study area in general and study participants in particular are highly acknowledged for their voluntary participation in the study. REFRENCES Amenu, K., Thys, E., Regasa, A. & Marcotty, T. 2010. Brucellosis and Tuberclosis in Arsi-Negele District, Ethiopia: Prevalence in ruminants and people s behaviour towards zoonosis. Tropicultura. 28(4):205-210. Avery, A. 2004. Red meat and poultry production and consumption in Ethiopia and distribution in Addis Ababa; Borlaug Ruan World Food Prize. International Livestock Research Institute, Pp. 35-43. 60
CSA. 2017. Central Statistical Agency. The Federal Democratic Republic of Ethiopia; central statistical agency, agricultural sample survey, 2016/17 (2009 E.C.), Volume II: Statistical Bulletin No. 585.CSA, Addis Ababa, Ethiopia, 2017, Addis Ababa, Ethiopia. Pp. 54-61. DEFRA. 2003. Department for Environment, Food and Rural Affairs. Zoonoses Report United Kingdom 2001, London. Pp. 23-27. Girma, S., Zewde, G., Tafess, K. & Jibat, T. 2012. Assessment of awareness of food born zoonosis and its relation with veterinary public health services in and around Addis Ababa. Journal of public health and epidemiology,4 (2):48-51. Gracey, J. F., Collins, O.S. & Huey, R. J. 1999. Meat hygiene, 10th Ed. London, Bailliere Tindall. Pp. 223-260. ILRI, 2012. International Livestock and Research Institute. Mapping of poverty and Likely zoonoses hotspot. Department for international development, UK, Nairobi, Kenya. Pp. 73-82. Jones, K., Patel, N., Levy, M., Storeygard, A. & Balk, D. 2008. Global trends in emerging infectious diseases. Nature, 451: 990-993. Kevin, D. & Nancy, C. 2009. Zoonotic Diseases of Cattle. Virginia Cooperative Extension programs publication. Pp. 400-460. McDermott, J.J. & Arimi, S.M. 2002. Brucellosis in sub-saharan Africa: epidemiology, control and impact. Veterinary Microbiology, 90:111 134. MoD, 2015. Dodola map search engine. Available at: hppt://www.worldmapfinder.com/ En//Africa/Ethiopia/Dodola. Viewed in 15 October, 2015. Nkuchia, M., Ruth, L., Chris, A. & Henriette, V. 2007. Infectious disease surveillance. Blackwell Publishing Inc. USA. Pp. 246-248. Shiv, L., Veena, M., Dipesh, B., Rana, U. & Mala, C. 2005. Zoonotic diseases of public health importance. National institute of communicable diseases.11:54. Smits, H.L. & Cutler, S.J. 2004. Contributions of biotechnology to the control and prevention of brucellosis in Africa. African Journal of Biotechnology.3:631 636. Swai, E., Schoonman, L. & Daborn, C. 2010. Knowledge and attitude towards zoonoses among animal health workers and livestock keepers in Arusha and Tanga, Tanzania. Journal of Health Research.12:4. Tesfaye, D., Fekede, D., Tigre, W., Regassa, A. & Fekadu, A. 2013. Perception of the public on common zoonotic diseases in Jimma, southwestern Ethiopia. International journal of medicine and medical science, 5(6):279-285. Tirsit, K., Benti, D., Fana, A. & Worku, T. 2013. Farmer s awareness and practices on rabies, bovine tuberculosis, taeniasis, hydatidosis and brucellosis in Mana and Limmukosa Distincts of Jimma Zone, Southwest Ethiopia. Journal of World Appilied Science.23 (6):782-787. WHO, 2005. The Control of Neglected Zoonotic Diseases. Report of a joint WHO meeting with the participation of FAO and OIE. Geneva, September 2005. Available at; http://whqlibdoc.who.int/publications/2006/9789 241594301 _eng.pdf. Viewed in 20 October, 2015. WHO, 2010. Managing zoonotic public health risks at the human animal-ecosystem interface. Strong inter-sectoral partnerships in health. Food safety and zoonoses. Available at: hppt:// www.who.int/foodsafety/.viewed in 20 October, 2015. 61
Table 1: Socio-demographic characteristics of the respondents Categories Urban n=242(63.0) Number(%) of respondents Peri-urban n=142(37.0) Total n=384 Sex Male 130(53.7) 85(60.0) 215(56.0) Female 112(46.3) 57(40) 169(44.0) Age 15-19 years 54(22.3) 211(4.8) 75(19.5) 20-29 years 61(25.2) 29(20.4) 90(23.4) 30-39 years 70(29) 48(33.8) 118(30.7) 40-59 years 34(14) 30(21.1) 64(16.7) 60 23(9.5) 14(9.9) 37(9.6) Educational level Illiterate 36(14.9) 40(28.2) 76(19.8) only write and read 30(12.4) 37(26.1) 67(17.4) Elementary 69(28.5) 27(19.0) 96(25.0) Secondary 69(28.5) 28(19.7) 97(25.3) Higher education 38(15.7) 10(7.0) 48(12.5) Occupation Farmer 9(3.7) 47(33.1) 56(14.6) Student 63(26) 34(23.9) 97(25.3) Jobless 44(18.2) 23(16.3) 67(17.4) Government employees 53(21.9) 10(7.0) 63(16.4) Self-employees 73(30.2) 28(19.7) 101(26.3) Monthly family income <500ETB 48(19.8) 24(16.9) 72(18.8) 500-1500ETB 62(25.6) 32(22.5) 94(24.5) >1500ETB 132(54.6) 86(60.6) 218(56.8) 62
Table 2: Knowledge of the respondents on zoonotic disease Number(%) of respondents Categories Heard about zoonoses Urban n=242(63) Peri-urban n=142(37) Total n=384 Yes 198(81.8) 97(68.3) 295(76.8) No 441(8.2) 45(31.7) 89(23.2) Source of information School 40(16.5) 19(13.4) 59(15.4) Media 48(19.8) 17(12.0) 65(16.9) Friends/Relatives 43(17.8) 35(24.6) 78(20.3) More than two source 67(27.7) 26(18.3) 93(24.2) Have no source 44(18.2) 45(31.7) 89(23.2) The zoonotic disease you heard Rabies 183(75.6) 81(57.0) 264(68.8) Anthrax 146(60.3) 49(34.5) 195(50.8) Taeniasis 152(62.8) 52(36.6) 204(53.1) Bovine tuberculosis 150(61.9) 40(28.2) 190(49.5) Brucellosis 75(31.0) 22(15.5) 87(22.7) Animal that transmit zoonotic disease Dog only 26(10.7) 47(33.1) 73(19.0) Cattle only 34(14.1) 31(21.8) 65(16.9) All animals 138(57.0) 19(13.4) 157(40.9) Don't know 44(18.2) 45(31.7) 89(23.2) Mode of transmission Inhalation 136(56.2) 37(26.0) 173(45.1) By contact 137(56.6) 38(26.8) 175(45.6) Ingestion 150(62.0) 44(31.0) 194(50.5) Bite of infected animals 168(69.4) 64(45.0) 232(60.4) Ways of prevention of zoonotic disease Avoiding drinking raw milk 148(61.2) 55(38.7) 203(52.9) Avoiding eating raw meat 147(60.7) 48(33.8) 195(50.8) Vaccinating and treating animals 17(170.7) 66(46.5) 237(61.7) Avoiding contact with suspected 140(57.9) 51(35.9) 191(49.7) animals Washing hands after handling animals 148(61.2) 41(28.9) 189(49.2) P-value 0.002 0.029 < 63
Table 3: Attitude of the respondents on zoonotic disease Number(%) of respondents Urban Peri-urban Total Categories n=242(63) n=142(37) n=384 Do you think zoonotic disease can be transmitted from animal to human? Yes 186(76.7) 72(50.7) 258(67.2) No 12(5.1) 25(17.6) 37(9.6) Don t know 441(8.2) 45(31.7) 89(23.2) Do you think zoonotic disease can be transmitted from human to animal? Yes 147(60.7) 63(44.4) 210(54.7) No 51(21.1) 34(24.0) 85(22.1) Don t know 44(18.2) 45(31.6) 89(23.2) Do you think zoonotic disease can be prevented? Yes 162(66.9) 65(45.8) 227(59.1) No 36(14.9) 32(22.5) 68(17.7) Don t know 44(18.2) 45(31.7) 89(23.2) P-value 64
Table 4: Practices of the respondents on zoonotic disease Categories Number(%) of respondents Urban n=242(63.0) Peri-urban n=142(37.0) Total n=384 Avoid contact to infected animals Yes 135(55.8) 50(35.2) 185(48.2) No 107(42.2) 92(64.8) 199(51.8) Consuming raw meat Yes 177(73.1) 86(60.6) 263(68.5) No 65(26.9) 56(39.4) 121(31.5) Consuming unpasteurized milk Yes 113(46.7) 88(62.0) 201(52.3) No 129(53.3) 54(38.0) 183(47.7) Sharing the same house with animals Yes 42(17.4) 90(63.4) 132(34.4) No 200(82.6) 52(36.6) 252(65.6) Backyard slaughtering of animals Yes 234(96.7) 140(98.6) 374(97.4) No 8(3.3) 2(1.4) 10(2.6) P-value < 0.011 0.004 < Offal feeding to dog Raw 232(95.9) 141(99.3) 373(97.1) 0.052 Cooked 10(4.1) 1(0.7) 11(2.9) Measures taken before milking Washing hand and teat with water 137(56.6) 87(61.3) 224(58.3) Washing hand and teat with soap 80(33.0) 25(17.6) 105(27.3) 0.427 and water Doing nothing 25(10.4) 30(21.1) 55(14.3) Do you vaccinate your animals against zoonotic disease? 0.004 Yes 102(42.1) 39(27.5) 141(36.7) No 140(57.9) 103(72.5) 243(63.3) 0.26 65