Knowledge, attitudes and practices of dog owners regarding rabies and dog bites in Bicol Region Authors Rona P. Bernales and Ilene S. Basitan Philippines 2015
Knowledge, attitudes and practices of dog owners regarding rabies and dog bites in Bicol Region Authors Rona, P. Bernales 1 and Ilene S. Basitan 2 1- Department of Agriculture, Regional Field Office, San Agustin, Pili, Camarines Sur 2 - College of Veterinary Medicine, Central Bicol State University of Agriculture, San Jose, Camarines Sur Philippines 2015
iii This study was made possible thanks to the financial support received by the OIE through the Australian Government Department of Foreign Affairs and Trade for the implementation of the Stop Transboundary Animal Diseases and Zoonoses (STANDZ) Initiative. All OIE (World Organisation for Animal Health) publications are protected by international copyright law. Extracts may be copied, reproduced, translated, adapted or published in journals, documents, books, electronic media and any other medium destined for the public, for information, educational or commercial purposes, provided prior written permission has been granted by the OIE. The designations and denominations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the OIE concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers and boundaries. The views expressed in signed articles are solely the responsibility of the authors. The mention of specific companies or products of manufacturers, whether or not these have been patented, does not imply that these have been endorsed or recommended by the OIE in preference to others of a similar nature that are not mentioned. The front cover photo is provided from the collection of the late Ms Cecilia Dy. Copyright OIE 2015 Published 2018 World Organisation for Animal Health 12, rue de Prony 75017 Paris, France Tel.: 33-(0)1 44 15 18 88 Fax: 33-(0)1 42 67 09 87 www.oie.int DOI: http://dx.doi.org/10.20506/standz.2790 Cover & design: OIE/Paloma Blandín
iv Executive summary This study was conducted in selected provinces of Bicol Region from April 2015 to May 2015 to describe the knowledge, attitudes and practices (KAP) of dog owners regarding rabies and dog bites. A purposive sampling was used in selecting the respondents of the study. Frequencies were tabulated for all variables. Of the 1,200 respondents, 2,193 dogs were recorded making a 2:1 ratio of dogs to householders in this particular study. Among these dogs 58% were vaccinated against rabies. The majority of the ones taking care of the dogs were female (57.3%) but the primary owner (62.9%) was the head of the family. Only 34.7% of the respondents knew that it is their duty to get their pets vaccinated against rabies. Around one-fourth (20.7%) admitted that someone in their household had been bitten by a dog but most respondents (62.5%) did nothing to the dog. The majority (57.7%) of the bite victims were youths (1-14 years old) and almost all (82.7%) of the wound bites were washed with soap and water. Television (44.9%) was the primary source of knowledge about rabies. The majority of participants (67.3%) said that humans are the main end-hosts that can be infected with rabies. Salivation or drooling (42.7%) and craziness (34.2%) were the main signs cited as behaviour of rabid dogs while craziness (40.2%) and hydrophobia or fear of water (25.4%) were cited for rabid humans. Most (33.9%) do not know the source of rabies but the majority (61.8%) believe that vaccination is the main preventive measure against rabies. The majority of participants (63%) reported that the local ordinances regarding rabies in their locality is about the Local Anti-Rabies Act and almost all (93.2%) admitted that vaccination is the most common anti-rabies program of the government.
v Abbreviations AusAID ABTC ACIAR DFAT GARC KAP LGU OIE OIE SRR-SEA PEP PVS RA RNA SEA STANDZ WHO WSPA Australian Agency for International Development Animal Bite Treatment Center Australian Centre for International Agricultural Research Australian Government Department of Foreign Affairs and Trade Global Alliance for Rabies Control Knowledge, attitudes and practices Local government units World Organisation for Animal Health OIE Sub-Regional Representation for Southeast Asia Post exposure prophylaxis Performance of Veterinary Services Republic Act Ribonucleic acid Southeast Asia Stop Transboundary Animal Diseases and Zoonoses World Health Organization World Society for the Protection of Animals Acknowledgements The authors would like to thank the OIE, the Governement of Australia and the Bureau of Animal Industry for sponsoring this study.
vi Contents Executive Summary........................................................ iv Abbreviations............................................................... v Acknowledgements........................................................ v Contents...................................................................... vi Introduction.................................................................. 1 Objectives............................................................... 1 Materials and methods.................................................... 2 Study design and population............................................. 2 Data collection.......................................................... 2 Importance of the study.................................................. 2 Data analysis............................................................ 2 Results....................................................................... 3 Household information................................................... 4 Dog population and status of vaccination................................. 4 Number of dogs owned and profile of primary owner..................... 4 Duties of the owner towards their dog................................... 4 Practices towards biting incidence....................................... 4 Source of knowledge about rabies and who or what can acquire rabies... 5 Knowledge about signs of rabies in dogs and humans.................... 5 Source of knowledge about rabies....................................... 5 Attitude when one sees a rabid dog...................................... 7 Knowledge on prevention of rabies....................................... 7 Knowledge on local ordinances on rabies................................ 7 Discussion................................................................... 9 Conclusions and recommendations...................................... 11 References................................................................... 12
1 Introduction Rabies is an acute viral encephalomyelitis that principally affects carnivores and insectivorous bats, although it can affect any mammal (Aiello, 1998). It is a fatal viral zoonosis and a serious public health problem (Brown, 2011). The disease is almost always fatal in human beings, and only a few cases of survivors have been recorded (Kumar, 2009). The causative agent is an RNA virus which belongs to the genus Lyssavirus (family Rhabdoviridae). Viruses cannot live independently; they need a living cell for their replication (Kumar, 2009). The virus invades the nervous system of mammals and is primarily transmitted from the rabid animal s saliva when it bites or scratches someone. Licks to wounds or grazed and broken skin, or to the lining of the mouth and nose, can transmit the disease (WHO, 2013). Inhalation is another potential mode of transmission and is implicated in the transmission within caves that harbour millions of bats and have the potential for aerosolized rabies virus in the atmosphere (Kumar, 2009). The most common vector of rabies worldwide according to Kumar (2009) is the domestic dog. They are also the principal reservoir of rabies in the Philippines. Of the animal rabies cases reported in 2011, 85.7% are dogs, 12.7% are cats and 1.6% represents other animals (NRPCP, 2012). More human deaths from rabies occur in Asia than anywhere else in the world, with estimates of human mortality due to endemic canine rabies exceeding 30,000 per annum in 2003 cited by WHO in 2013 reports. Since 2003, the epidemiological situation in many parts of the region has changed, with improvements in rabies control and prevention in many areas, particularly in delivery of PEP. There have, however, been emergences elsewhere. Despite the initiatives of the Philippine government, the SEA Dog Rabies Elimination Strategy in 2013 cited that rabies control in the Philippines continues to be challenged by various constraints including: (1) limited funding for project implementation; (2) lack of support and commitment from local Chief Executives; (3) increasing numbers of dogs and cats roaming the streets; (4) lack of awareness on rabies prevention and control; (5) lack of support from other sectors. Under the STANDZ Rabies Project, OIE initiated a project in September 2014 with a goal to eliminate rabies in Bicol Region and declare it rabies-free in 2016. For the past few years, Bicol had a considerable number of dog biting incidents and deaths due to rabies. This project hopes to eliminate the disease in the region completely. Objectives General Objective To describe the knowledge, attitudes, and practices of dog owners in the Bicol Region regarding rabies and dog bites. Specific Objectives 1. To describe the demographic profile of the respondents; 2. To determine the population of and status of vaccination of dogs; 3. To describe the practices of the respondents when someone has been bitten by a dog; and 4. To describe the knowledge of the respondents regarding rabies. Rabies is clearly a major problem in Asia, mainly affecting the rural poor. Rabies mortality ranks number ten in all infectious diseases worldwide and the Philippines has been consistently among the top five countries in the world as cited by De Ramos and Bravo (2004). Controlling the disease in dogs has pushed the Philippine government to initiate rabies control programs such as the creation of Anti-Rabies Act of 2007 or R.A. 9482 and the National Rabies Prevention Control Program. March was also designated as Rabies Awareness Month. The legislation paved the way for the Zero-Rabies Philippines 2020 campaign. Under this law, the local government units were tasked to ensure that all dogs in their areas are properly immunized, registered and issued a corresponding dog tag. It is also their responsibility to ensure that dogs are leashed or confined within the premises of the owner.
2 Materials and methods Study design and population A Quantitative Descriptive method was employed in this study to determine the KAP of dog owners concerning rabies including dog bites. A purposive sample of 1,200 dog owners divided into 300 respondents each for Camarines Norte, Camarines Sur, Albay and Masbate was employed in the study from April 2015 to May 2015. Importance of the study Knowing the KAP of the community about rabies will help strengthen extension delivery systems in eliminating the disease. It may also be used to address the real needs of the community in terms of their awareness regarding rabies. Through documentation of KAP, the extent of implementation of rabies program in the region can be improved. Data collection The respondents were interviewed one-on-one based on the parameters in the survey questionnaire. The questionnaire sought data on their demographic profile and knowledge, attitudes and practices regarding rabies and animal bites. In some questions, respondents were given the freedom to give multiple answers. The questionnaire was adopted from the Community-Based Questionnaire of the GARC. Data analysis The data was collated and presented using descriptive statistics. Frequency and percentages were used for statistical analysis.
3 Results Household information A total of 1,200 dog owners were interviewed. As to the household number, Table 1 shows that most of the respondents, 416 (34.6%) have a family size of three to four persons. 406 (33.8%) of the respondents have one to two persons ages 6-14 years old who are living with them. Among those respondents who have 6-14 years old in their house, 397 (65%) have one to two who are enrolled in school. As for the number of 0-5 years old living in the house, 289 (24.1%) of the respondents have one to two. At the same time, 118 (35.9%) of the respondents have one to two of this age bracket enrolled in preschool. Table 2 shows the demographic data of the respondents. Regarding the relationship of the interviewed person to the head of the family, 499 (41.6%) of them were a spouse. Table 1. Household Information/Demographic Profile Part 1 Parameters Number Percentage Number of people in the household 1-2 139 11.6 3-4 416 34.6 5-6 363 30.2 7-8 188 15.6 9 and above 94 7.8 Number 6-14 years old living in the house 1-2 406 33.8 3-4 169 14.1 5-6 26 2.6 7-8 10 0.8 9 and above 6 0.5 Currently enrolled in school (6-14 years old) 1-2 397 65 3-4 147 24 5-6 32 5.2 7-8 6 1 9 and above 4 0.6 Number of 0-5 years old living in the house 1-2 289 24.1 3-4 34 2.8 5-6 5 0.4 7-8 1 0.1 Currently enrolled in preschool (0-5 years old) 1-2 118 35.9 3-4 3 0.9 5-6 2 0.6 More than half 688 (57.3%) of the respondents were female and among these females 209 (30.4%) were housewives. Regarding the age group, 460 (38.3%) belonged to the Table 2. Household Information/Demographic Profile Part 2 Parameters Number Percentage Relationship to the Head of Family 462 38.5 Head of the Family Son or Daughter 197 16.4 Spouse 499 41.6 Others (relatives, helpers, etc) 42 3.5 Sex Male 512 42.6 Female (Housewives) 688 (209) 57.3 (30.4) Age Youth (1-14 yrs old) 18 1.5 Young Adult (15-24 yrs old) 122 10.2 Middle Adult (25-44 yrs old) 460 38.3 Older Adult (45-64 yrs old) 456 38 Retirement Age (65-above) 144 12 Marital Status Single 219 18.3 Married 856 71.3 Separated 12 1 Widow/er 75 6.2 Live-in 38 3.2 Occupation None 493 41.1 Student 81 6.7 Self-employed/Proprietor 171 14.2 Labourer 297 24.8 Elected official 60 5 Government employee 66 5.5 Private employee 32 2.7 Highest Educational Attainment Post-Graduate 9 0.7 Post Graduate Level 11 0.9 College Graduate 180 15 College Level 165 13.7 Vocational Graduate 49 4.1 High School Graduate 336 28 High School Level 170 14.2 Elementary Graduate 199 16.6 Elementary Level 76 6.3 Did not go to school 2 0.2 Religion Roman Catholic 1,117 93.1 Born Again/Protestant 46 3.8 Others (INC,JW,Rizalista) 32 2.6 None 6 0.5 House has a fence Yes 815 67.9 No 385 32.1
Results 4 age bracket of 25-44 years old or middle-aged adults. The majority of the respondents 856 (71.3%) were married. As to occupation, 493 (41.1%) did not have jobs. Concerning the respondents highest educational attainment, 336 (28%) graduated from high school. Almost all of the respondents 1,117 (93.1%) were Catholic. Observation revealed that the majority, 815 (67.9%) of the dog owners houses were fenced. Dog population and status of vaccination As of May 2015 as shown in Table 3, the total number of dogs recorded amongst the 1,200 dog owners who were interviewed was 2,193. Among these dogs, 1,272 (58.0%) were vaccinated against rabies while there were 921 (42.0%) that were not yet vaccinated. Based on observation, half (51.2%) of these dogs were allowed to roam free while 48.7% were tethered. The respondents were asked whether their dogs had bitten someone in year 2014 and only 68 biting incidences were recorded. Amongst these biting incidents, the majority (63.2%) of the respondents whose dogs bit someone did not do anything to their dogs while only 36.7% of those whose dogs had bitten someone were observed and tethered. Of these incidences, there were no recorded deaths of the biting dogs and their victims. Table 3. Dog Population and Vaccination Status Parameters Dog population Number Dog population (as of 2015) 2,193 Vaccinated Dogs (as of 2015) 1,272 Unvaccinated Dogs (as of 2015) 921 Allowed to roam free 1,124 Tethered 1,069 Number of Dog that has bitten last 2014 68 Observed and tethered the dog after biting 25 Did nothing 43 Number of dogs owned and profile of primary owner The majority (79.8%) of the respondents own one to two dogs as revealed in Table 4. According to the respondents, the majority (62.9%) of the primary owner of the dog is also the head of the family. As to the highest educational attainment of the primary owner, 384 (32%) have finished high school. Table 4. Number of Dogs Owned and Profile of Primary Owner Parameters Number Percentage Number of Dogs Owned 1-2 958 79.8 3-4 201 16.7 5-6 32 2.6 7-8 4 0.3 9 and above 5 0.4 Primary Owner of the Dog Head of the Family 755 62.9 Spouse 262 21.8 Son or Daughter 152 12.6 Others (relatives, helper) 31 2.58 Highest Educational Attainment of Primary Owner Post-Graduate 6 0.5 Post Graduate Level 14 1.2 College Graduate 179 14.9 College Level 149 12.4 Vocational Graduate 43 3.6 High School Graduate 384 32.0 High School Level 150 12.5 Elementary Graduate 190 15.8 Elementary Level 77 6.4 Did not go to school 8 0.7 Duties of the owner towards their dog Asked about the duties of owners to their dogs, the top five answers of the respondents as revealed in Table 5 are as follows: 417 (34.7%) of the respondents said their dogs should be vaccinated against rabies; followed by not allowing the dog to roam freely (28.5%); feeding the dog at least three times a day (26.6%); bathing the animal regularly (22.7%); and registering the dog (7.6%). Practices towards biting incidence Table 6 shows the attitude of respondents regarding biting incidents. Among the respondents, 248 (20.7%) admitted that someone in their household had been bitten by a dog, of which the biting dog has an owner (46.8%). Most of the
Results 5 Table 5. Duties of owner Parameters Number Percentage Rank Vaccinate against rabies 417 34.7 1 Do not allow the dogs to roam freely (Tether/Put in a cage) 342 28.5 2 Register Dogs 92 7.6 5 Feed (at least 3x a day) 319 26.6 3 Bathe regularly 272 22.7 4 Maintain cleanliness of dog area 22 1.8 Discipline/train the dog 33 2.7 Treat the dog like human 51 4.2 Others (give vitamin supplements, neuter, follow ordinances) 32 2.6 respondents, 155 (62.5%) said that they did nothing to the biting dog while 64 (35.8%) said that the biting dog was observed for 14 days, either whilst allowed to roam free or tethered. The majority (61.7%) of those who were bitten were male while 57.7% of those bitten people fall under the age bracket of youths (1-14 years old). Almost all (92.3%) of the victims were bitten once. Regarding first aid applied to the wound after being bitten, the majority (82.7%) of the respondents said that they washed the wound with soap and water. However, a small percentage (16.9%) of the bite victims applied garlic to the wound and 28.6% of them visited a tandok or tambal, a local healer in the Philippines. After applying first aid to the wound, the majority (51.61%) of the victims were brought to an ABTC. Source of knowledge about rabies and who or what can acquire rabies Almost all (90.7%) of the respondents were familiar with rabies. The top five sources of rabies as shown in Table 7 which are: 489 (44.9%) said that they heard about rabies on television; 267 (24.5%) learned it from their neighbours; 255 (23.4%) heard it from the radio; 205 (18.8%) heard it from barangay health workers; and 183 (16.8%) learned about rabies through biting incidents around their areas, from vaccinators, barangay officials or printed materials such as pamphlets and books. The majority (67.3%) of the respondents said that humans are the main end-hosts who can be infected with rabies, followed by dogs and cats at 53.9% and 24.3% respectively. 100 (9.1%) of the respondents said that those who were bitten only are the ones who can acquire rabies. Other answers on end-hosts included animals such as rats and pigs. Table 6. Biting incidence Parameters Number Percentage Has anybody in the household bitten by a dog? Yes 248 20.7 No 952 79.3 Was the biting dog... With owner 116 46.8 Stray dog with owner 77 31 Stray dog without owner 50 20.2 Others 5 2 What was done to the biting dog? Observed for 14 days (freely roaming/in a cage/tethered) 64 35.8 Killed instantly 21 8.5 Killed and head sample was brought to the lab 1 0.4 Nothing 155 62.5 Others (dog was vaccinated, killed and cooked) Sex of bitten person 7 2.9 Male 153 61.7 Female 95 38.3 Age of bitten person Youth (1-14 yrs old) 143 57.7 Young Adult (15-24 yrs old) 35 14.1 Middle Adult (25-44 yrs old) 38 15.3 Older Adult (45-64 yrs old) 23 9.3 Retirement Age (65-above) 9 3.6 Number of times bitten Once 229 92.3 Two times 10 4.0 Three times and above 9 3.6 What was done to wound after bitten Washed with soap 205 82.7 Applied with garlic 42 16.9 Visited tandok or tambal 71 28.6 Nothing 26 10.5 Others 26 8.9 Done after first aid Consulted ABTC/RHU 128 51.6 Tandok 44 17.7 Treated home 23 9.3 Garlic 3 1.2
Results 6 Table 7. Knowledge about rabies part 1 Parameters Number Percentage Rank Have you heard about rabies? Yes 1,088 90.7 No 112 9.3 How did you know about rabies? Newspaper 53 4.9 7 Radio 255 23.4 3 Relatives 116 10.7 6 Health workers 205 18.8 4 Veterinarians 49 4.5 8 Television 489 44.9 1 Internet 18 1.6 9 Neighbours 267 24.5 2 Others (biting incidents, vaccinators, 183 16.8 5 printed materials like pamphlets tarpaulin and books, school, barangay officials, seminar) Who can get infected with rabies? Humans 732 67.3 1 Cats 264 24.3 3 Dogs 587 53.9 2 Don t know 83 7.6 5 Others (rats, pigs, bitten person only, bitten dog only, monkey, stray dogs only) 100 9.2 4 Table 8. Signs of rabies in dogs and humans Parameters Number Percentage Rank Signs of rabies in dogs Fear of water/hydrophobia 196 18 4 Aggressiveness 174 16 5 Paralysis 15 1.4 9 Convulsion 17 1.6 8 Restlessness/Delirium 100 9.2 6 Salivation/drooling 465 42.7 1 Loss of appetite 73 6.7 7 Don t know 235 21.6 3 Others (crazy, weaknesses) 372 34.2 2 Signs of rabies in humans Fear of water/hydrophobia 277 25.4 3 Aggressiveness 89 8.2 6 Paralysis 28 2.3 9 Change in behaviour 122 11.2 5 Restlessness/Delirium 39 3.6 8 Salivation/drooling 236 21.7 4 Loss of appetite 60 5.5 7 Don t know 320 29.4 2 Others (crazy, fever, convulsion) 438 40.2 1 Table 9. Source of knowledge about rabies Parameters Number Percentage Rank How can dogs acquire rabies? Bitten by a rabid dog 217 19.9 4 Eating dog meat 14 1.3 6 Licked on broken skin 29 2.7 5 Scavenging garbage 256 23.5 3 Don t know 369 33.9 1 Others (dirty/rotten food, dirty environment) 339 31.2 2 How can humans acquire rabies? Bitten by a rabid dog 704 64.7 1 Eating dog meat 52 4.8 4 Licked on broken skin 27 2.5 6 Scavenging garbage 30 2.7 5 Don t know 232 21.3 2 Others (dirty environment) 95 8.7 3 Knowledge about signs of rabies in dogs and humans The respondents were asked theoretically regarding the signs of rabies in dogs and humans. For dogs, the top five answers of the respondents as shown in Table 8 were: 465 (42.7%) answered that salivation is the number one sign of rabies in dogs; followed by 372 (34.2%) who said that dogs become ulol, bungaw or rungaw which all mean craziness or madness. Others admitted that they do not know the signs of rabies in dogs. A small number of respondents (18%) said that fear of water or hydrophobia is a sign of rabies in dogs while 16% said that dogs with rabies are aggressive. Regarding signs of rabies in humans, the top five answers of the respondents were: 40.25% said that craziness, fever, and convulsion are the main symptoms of rabies in humans. However, 29.4% admitted that they do not know the signs of rabies in humans. A small number of respondents (25.4%) said that fear of water or hydrophobia is a sign of rabies in humans. Only 21.7% believed that salivation or drooling is a symptom whilst 11.2% said that change in behaviour is also a sign of rabies in humans. Source of knowledge about rabies Asked about how dogs acquire rabies, the top five answers obtained from the respondents as shown in Table 9 were: 369 (33.9%) of the respondents said they do not know;
Results 7 339 (31.1%) said that dogs acquire it from dirty or rotten food while; 246 (23.5%) answered that dogs get rabies from scavenging garbage; 217 (19.9%) believes that rabies is acquired through the bite of a rabid animal while 29 (2.7%) said that dogs acquire rabies when other dogs lick their broken skin. Regarding how humans get infected with rabies, majority (64.7%) of the respondents answered they obtain it from the bite of a rabid dog. However, 232 (21.3%) did not know the source of rabies in humans. A small percentage of respondents at 8.7% believe that humans may acquire rabies from dirty environments, and 52 (4.7%) said that eating dog meat can be a source of rabies. Attitude when one sees a rabid dog The respondents were asked what they will do when they encounter a rabid dog as shown in Table 10. Most (31.25%) said that they would just avoid the dog or possibly run away from it. Others, 315 (29.0%) said they would report the sight to the authority. In connection to this, when asked about the proper authority to whom they would report the sight of a rabid dog, majority (67.3%) of them said they will directly report to barangay officials while a small percentage of them would report the sighting to the Provincial Health Office, Municipal Agriculture Office or to the police. Knowledge on prevention of rabies Theoretically, the respondents were asked how rabies can be prevented in dogs and this is shown in Table 11. The majority (61.8%) of them answered that dogs should be vaccinated against rabies. Most (34.2%) respondents also answered that rabies can be prevented in dogs when they are fed properly, bathed regularly, or when their area is clean. For those who answered that vaccination is one way of preventing rabies in dogs, the majority (74.4%) of them said that vaccination should be done once a year. However, a small percentage (17.6%)) of the respondents said that vaccination should be done every three months or six months. Knowledge on local ordinances on rabies Asked whether they have heard of a local ordinance about rabies or not, the majority (65.14) of the respondents Table 10. Attitude when one sees a rabid dog Parameters Number Percentage Rank What to do when one sees a rabid dog? Immediately kill the dog 244 22.4 3 Report to authority 315 29.0 2 Capture and observe the dog for 14 days 51 4.7 5 Nothing 162 14.9 4 Others (avoid or run away from the dog) 340 31.2 1 Where to report Provincial Vet Office 30 2.7 2 Barangay Officials 212 19.5 1 Police 6 0.5 5 City/Municipal Agriculture 27 2.5 3.5 Rural Health Unit 19 1.7 4 Others (vaccinators) 27 2.5 3.5 Table 11. Knowledge on rabies prevention Parameters Number Percentage Rank How to prevent rabies Vaccination 672 61.8 1 Don t allow the dog to roam freely 178 16.4 3 Others (feed the dog properly, regular bath, maintain cleanliness of area) 372 34.2 2 Don t know 66 6.1 4 Number of vaccination in a year Every year 500 74.4 1 Others (every 6 mos, every 3 mos) 118 17.6 2 Don t know 54 8.0 1 Table 12. Local ordinances on rabies Parameters Number Percentage Rank Heard of local ordinance on rabies Yes 711 65.4 No 377 34.6 What the local ordinance is all about Local Anti-Rabies Act 448 63.0 1 Responsibilities of biting dog owners 115 16.2 3 Responsible pet ownership 148 20.8 2 Know programs of local government Yes 834 76.7 No 254 23.3 What the program is all about Dog vaccination 777 93.2 1 Rabies Seminar 51 6.1 3 Dog neutering 1 0.1 4 Others 5 0.6 5
Results 8 answered yes. This is seen in Table 12. Among those who answered yes, the majority (63.0%) said that the local ordinance act is all about the Local Anti-Rabies Act. The respondents were also asked whether they are aware of programs regarding rabies that are implemented by their local government. Almost all (93.2%) of the respondents answered that dog vaccination is the most common program. Only 51 (6.1%) said that their local government conducts rabies seminar.
9 Discussion The findings of this study reveal that females (57.3%), particularly housewives, are the most common household members who take care of dogs. Women, most of the time, are the ones taking care of animals as a part of their gender role at home because they are more sympathetic to animals needs (Herzog, 2007). The study further revealed that dog ownership is common to all age groups probably owing to the substantial benefits of pet ownership. For example, children have demonstrated lower stress levels during times of anxiety if a companion animal is present (Bryant, 1990), and lower cardiovascular reactivity has been demonstrated in adults who interact with dogs as well (Vormbrock & Grossberg, 1988) as cited by Austin (2013). The findings show that 24.1% of the respondents have young children ages 0-5, and 33.8% have 6-14 years-olds living with them. The majority (79.8%) of the respondents own one to two dogs that are either tethered or allowed to roam in the backyard. Aside from mothers, children are also given the responsibility for taking care of pets as a part of their household chores. Usually they pet and play with their dogs and sometimes they provoke them into biting when the dog gets hurt due to rough handling by the children (De Ramos and Bravo, 2004). This was confirmed in the study since the majority (57.7%) of the recorded biting incidents occurred in youths aged 1-14 years old. As to the population of dogs, there were 2,193 that were recorded from 1,200 respondents making a 2:1 ratio of dogs to householders in this particular study. The majority (58%) of these dogs were vaccinated against rabies while 42.0% were not yet vaccinated. During the course of the study, the months of April and May was the usual months for mass vaccination in localities since vaccination and registration of dogs are the main roles of LGUs. However, problems also arise in LGU s capability of delivering vaccination especially if they have very few personnel. In addition, some dog owners are apprehensive to have their dogs be vaccinated because they fear that their dogs might die or develop scabies. Most of the respondents (34.7%) recognised their duty of having their dogs vaccinated against rabies and the importance of regular feeding and bathing. Feeding and bathing conforms to the theory of anthropomorphism where humans based the basic needs of their animals according to their own needs (WSPA, 2007). However, a very small percentage of the respondents answered that registering their dog is also one of their duties. Registration is a mandated responsibility of dog owners according to R.A. 9482 or the Anti-Rabies Act of 2007. When the respondents were asked about their action when one of their household members had been bitten by a dog, the majority (62.5%) did nothing to the dog and only 35.8% of them observed the dog for a period of 14 days. It is the responsibility of the owner to observe the dog for a period of 14 days as stipulated in the Implementing Rules and Regulations of R.A. 9482. When it comes to first aid employed to wounds inflicted by dog bites, the majority (62.5%) answered that they washed the wound with soap and water. This conforms to the recommended local wound treatment under R.A. 9482. However, a small percentage of the respondents applied garlic on the wound and some visited a tandok, or tambal because according to the respondents, this type of first aid has always been their practice and the knowledge had been transferred to them by their ancestors. However, under the law, tandok or tambals are not recommended methods of treating rabies. The majority (51.6%) of the respondents brought the victims to the nearest ABTC after applying first aid. Due to the presence of ABTCs in some municipalities of Bicol Region, residents have access to these centres for PEP. However, due to the limited number of ABTCs and their location in urban or sub-urban areas, these are not accessible to people living in rural areas. Almost all (90.7%) of the respondents were familiar with rabies. Their main source of knowledge about this disease was from the television which is the most common appliance in most households. Dog biting incidents in the Bicol Region and around the country are frequently televised thus providing viewers with live information about dog bites and rabies. Other sources of information came from neighbours, radio and barangay health workers. Only a small percentage of the respondents learned about rabies in school and in printed materials such as pamphlets and books. Schools should be the first to inform pupils about rabies because this is their mandate as stipulated in R.A. 9482. As to the source of rabies, the majority (67.3%) of the dog owners know that humans can acquire rabies through the bite of a rabid dog. Most of the respondents believed that dogs and cats can be infected with rabies, as well as other animals such as rats and pigs. Rabies can infect any mammal but the reservoir of this disease in the Philippines is domestic dogs. Unfortunately, most of the respondents do not know how dogs acquire rabies and some believe that dogs obtain it from dirty environments or dirty food. This is an erroneous belief since rabies is caused by a virus which cannot multiply outside the body. From the study, only a small proportion of the population were aware of the signs and symptoms of rabid animals. Only two signs had a relative high occurrence in dogs and these were salivation or drooling (42.7%) and craziness (34.2%) or becoming ulol, bungaw or rungaw. The signs of rabies in humans with with a relative high percentage among the respondents were craziness (40.2%) and hydrophobia or fear of water (25.4%).
Discussion 10 Asked what they would do when they see an alleged rabid dog, 340 (31.2%) of the respondents said they would avoid the dog or run away from it. This is a natural reaction since a rabid dog poses a hazard to the community. Some of the respondents, 315 (29%) also said that they would report the sight to the authority. The main authority to whom they would report this sighting is the barangay officials. Barangay is the smallest unit of the local government to whom communities have direct access especially in cases of dog biting incidents. The majority (61.8%) of the dog owners knew that vaccination prevents rabies. Aside from this, most (34.2%) believe that feeding the animal properly, bathing it regularly and maintaining the cleanliness of the area are key preventive measures against rabies. Most dog owners associate rabies with garbage and dirty environments. However, as previously mentioned, viruses cannot live independently; they need a living cell for their replication (Kumar,2009). Regarding the number of times of vaccination per year to those who answered that vaccination prevents rabies, the majority of the respondents knew that the recommendation for vaccination is once a year. But still, a small percentage of the respondents answered that vaccination should be done every three months or every six months. This could be attributed to the irregular vaccination schemes of local government units that can confuse dog owners. The majority (65.4%) of the respondents said that they have heard of a local ordinance on rabies in their municipalities. Most of them said that the ordinance is the local Anti- Rabies Act. Local government units are mandated by the R.A. 9482 to implement the National Rabies Prevention and Control Program and they can also enact additional local ordinances such as responsible pet ownership. Most (76.7%) respondents are aware of other programs of their municipalities and the foremost activity is dog vaccination (93.2%). Dog vaccination under RA. 9482 is the main responsibility of the LGU. This activity is strengthened when the provinces have their own Provincial Veterinary Offices like in the case of Camarines Norte, Albay, and Masbate. Camarines Sur does not have a Provincial Veterinary Office. Rabies seminars or information dissemination on rabies is the responsibility of the Department of Education, Non- Government Organizations and Academia which includes higher educational institutions.
11 Conclusions and recommendations This study has shown that dog owners in Bicol Region have considerable KAP about rabies and dog bites including their duties towards their pets. However, there are also numerous gaps when it comes to practices towards biting incidences, knowledge on the host of rabies, mode of transmission of the virus, and prevention of the disease. Based on these conclusions, the following recommendations are therefore made: Conduct Focus Group Discussion with implementers of R.A. 9482 such as Municipal Agriculture Officers and barangay officials and stakeholders such as vaccinators, barangay health workers, and tandok about their KAP on rabies. Increase the number of rabies awareness, responsible pet ownership and animal welfare campaigns in schools targeting common myths about the disease. Rabies seminars should also be designed and addressed to barangay officials, health workers and tandoks. Local government units should strictly impose penalties for irresponsible pet ownership.
12 References Aiello SE, et.al. 1998. The Merck Veterinary Manual 8 th Ed. Merck and Co., Inc. USA Austin, JS. Shelter from the Storm: Companion Animal Emergency Planning in Nine States Journal of Sociology & Social Welfare, December 2013, Volume XL, Number 4 Brown, CM.2011. Compendium of Animal Rabies Prevention and Control, 2011 National Association of State Public Health Veterinarians, Inc. (NASPHV). Vol. 60. No.6. US Department of Health and Human Services. Centers for Disease Control and Prevention De Ramos MEM, Bravo, LC. Knowledge, Attitudes and Practices of the Community Regarding Animal Bites and Rabies. PIDSP Journal. 2004. Vol. 8. No. 1. P.30 Herzog, HA. 2007. Gender Differences in Human-Animal Interaction A Review. Anthropozoos. Vol. 20. Issue 1. USA Hugh-jones, ME, Hubbert WT, Hagstad HV. 1995. Zoonoses: Recognition and Control. Iowa State University Press, Ames, Iowa. USA Kumar, PD. 2009. Biographies of Disease:Rabies. Greenwood Publishing Corp., CT. USA.p.22,38,24,25 Republic of the Philippines. National Rabies Prevention and Control Program Manual of Operations 2012 Republic of the Philippines, Anti-Rabies Act of 2007 (Republic Act No. 9482). Congress of the Philippines. Metro Manila. February 2, 2007 WHO Expert Consultation on Rabies: second report. 2013 (WHO technical report series; no. 982) World Society for the Protection of Animals. Module in Animal Welfare. University of Bristol. United Kingdom. 2007
Knowledge, attitudes and practices of dog owners regarding rabies and dog bites in Bicol Region Authors Rona, P. Bernales and Ilene S. Basitan Philippines 2015 Copyright OIE 2015 Published 2018 World Organisation for Animal Health 12, rue de Prony 75017 Paris, France Tel.: 33-(0)1 44 15 18 88 Fax: 33-(0)1 42 67 09 87 www.oie.int DOI: http://dx.doi.org/10.20506/standz.2790