1.Community-based Evaluation of Health-seeking Behavior of People with Animal Bite Injuries in a District of Sri Lanka
Gino C. MATIBAG ; Rossana A. DITANGCO ; Taro KAMIGAKI ; Thula G. WIJEWARDANA ; Pallegoda V. R. KUMARASIRI ; Anil W. KALUPAHANA ; D. R. Anuruddhika DISSANAYAKE ; D. D. Niranjala De SILVA ; G. S. Panduka De S. GUNAWARDENA ; Yoshihide OBAYASHI ; Koji KANDA ; Hiko TAMASHIRO
Journal of International Health 2008;23(3):173-179
Introduction
Of the 55,000 deaths per year due to rabies, 56% occur in Asia and 44% in Africa. Despite the existence of the national rabies control program in Sri Lanka, rabies is still prevalent, suggesting that animal bite victims may have failed to observe the proper first aid measures and seek immediate medical treatment. The purpose of this study is to describe the health-seeking behavior among animal bite victims of a selected population in Kandy District, Sri Lanka. The influences of subjects’ demographic characteristics to these behaviors were studied.
Methods
We conducted face-to-face interviews in May 2006 among households with family members having history of animal bite injuries. Data on health-seeking behaviors such as first aid measure application, immediate medical consultation, and completion of post-exposure prophylaxis (PEP) were obtained. The association between behaviors and demographic characteristics were evaluated using Chi-square test or the Fisher’s exact test.
Results
Of the 6968 sample population, 357 (5.1%) had history of animal bites one year prior to the survey. Most of the subjects performed first aid measures (n=297, 83.2%) and sought medical treatment (n=319, 89.4%) within 24 hours (n=295, 82.6%) of the injury. Only 9.8% (n=35) of the subjects completed the PEP. There was no association between health-seeking behavior and demographic characteristics. Two subjects died having symptoms that resembled rabies without completing the necessary PEP, and two animal specimens were sent for laboratory testing that confirmed one case of feline rabies one year prior to the study.
Conclusion
In general, the health-seeking behaviors of the subjects were not influenced by their demographic characteristics which may contribute to greater difficulties in controlling rabies. To strengthen the rabies control program, effective education of both the public and health sectors by thorough and adequate wound washing, and strict adherence with the recommended treatment schedule is of paramount importance.
2.Knowledge, attitudes, and practices survey of rabies in a community in Sri Lanka.
Gino C MATIBAG ; Taro KAMIGAKI ; Pallegoda V R KUMARASIRI ; Thula G WIJEWARDANA ; Anil W KALUPAHANA ; D R Anuruddhika DISSANAYAKE ; D D Niranjala De SILVA ; G S Panduka De S GUNAWARDENA ; Yoshihide OBAYASHI ; Koji KANDA ; Hiko TAMASHIRO
Environmental Health and Preventive Medicine 2007;12(2):84-89
OBJECTIVESThe primary objective of this study was to determine the level of knowledge, attitudes and practices (KAP) of rabies management and control of a sample population. The secondary objective was to compare the KAP with respect to rabies management and control between urban and rural areas and between pet and non-pet owners.
METHODSThis cross-sectional study was carried out by conducting face-to-face interviews using structured questionnaires among 1570 respondents from selected households in the Kandy District, Sri Landa.
RESULTSApproximately 58% of the sample population was pet owners. Among all the respondents, there was a high level of awareness (90%) that dogs are the most common rabies reservoir, that the disease is fatal (79%), and that rabies can be prevented by vaccination (88%). Most of the subjects (96%) would seek treatment from a doctor or a hospital after being bitten by a dog. Although 76% of the respondents said that their pet dogs were vaccinated, only one-half were able to present a vaccination certificate upon request. The subjects from the urban areas would submit the head of an animal for rabies evaluation (69%) compared with those from the rural areas (57%). Pet owners (93%) are more aware that dog rabies vaccines are available from authorized offices than non-pet owners (87%).
CONCLUSIONSThe level of awareness of rabies and the level of receptiveness to rabies control measures are high. There is a difference in the attitudes and pet care practices relevant to rabies control between urban and rural areas. Pet owners tend to be more cooperative to rabies control activities. The attitudes and practices of the respondents may reflect the inaccessibility of facilities and the lack of services that would enable community participation in rabies control.