Knowledge, attitudes and practices towards rabies prevention among residents of Abuja municipal area council, Federal Capital Territory, Nigeria
Aboyowa Arayuwa Edukugho1,&, Jarlath Udoudo Umoh2, Matthew Diem1, Oyetunji Ajani1, Belinda Uba1, Lilian Okeke1, Elizabeth Adedire1, Adewole Adefisoye1, Caroline Edukugho2, Patrick Nguku1
1Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria, 2Ahmadu Bello University, Zaria, Kaduna State, Nigeria
Aboyowa Arayuwa Edukugho, Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
rabies is a fatal neglected zoonosis killing 55,000 people worldwide annually. It is endemic in Nigeria with 10,000 people exposed annually through dog-bites. To inform adequate intervention due to the rise in reported dog-bite cases, we assessed knowledge, attitudes and practices (KAP).
we carried out a cross-sectional study among 224 residents in Abuja Municipal
Area Council. We used structured questionnaires to collect data on sociodemographic
characteristics, knowledge and attitudes on rabies prevention. Knowledge score
of ≥ 8 points based on ten-point domain question were regarded as satisfactory.
We analyzed data using Epi-Info and Excel for proportions and associations were
determined at 5% significance level.
a total of 123 (55%) respondents owned dogs. One hundred and eighty four (82%) respondents had satisfactory knowledge on rabies prevention, about 87% knew where to get dogs vaccinated and would seek medical treatment from the hospital when bitten by a dog. Majority (58%) did not know the frequency of anti-rabies administration for dogs and 63.3% did not know the appropriate first aid actions following dog-bites. Of 123 dog owners, 35% would allow their dogs roam without restriction and 94% reported vaccinating their dogs against rabies. Dog owners were more likely to have satisfactory knowledge of rabies compared to non-dog owners (OR 7.8, 95% CI 1.0-62.0, p = 0.02).
knowledge on rabies is satisfactory but with gaps in the frequency of dog anti-rabies vaccination, appropriate first-aid following dog bites and non restriction of dog movement. To prevent rabies, these gaps need to be addressed through public enlightenment and enforcement of dog movement restrictions laws.
Rabies is a widely distributed viral zoonotic disease of major public health importance that affects human, domestic and wild animals. It remains incurable and survivors are extremely rare . More than 3 billion people globally are living in countries/territories where dog rabies still exists and are potentially exposed to the disease. In many countries of those continents, few activities are underway to prevent rabies occurrence in humans and to control rabies in dogs, even when the number of human deaths is high . Dog licensing, killing of stray dogs, muzzling, and other measures contributed to the elimination of rabies from the United Kingdom in the early 20th century. More recently, large-scale vaccination of cats, dogs and ferrets has been successful in combating rabies in many developed countries .
Almost all human deaths caused by rabies occur in Asia and Africa. It is estimated that at least 55,000 human rabies deaths occur yearly following contact with rabid dogs. Developing countries with a large number of dogs, most of which movement are not restricted, account for approximately 98 percent of human rabies .
The first documentation of rabies in Nigeria in humans was in 1912 and in dog in 1925  and since then many authors [4-8] have established that the disease is endemic in the country with more recent reports  showing that the prevalence of the disease is on the increase. The dog is the principal host that maintains and transmits the disease to other animals and man in Nigeria [9-13] where an estimated 10,000 people are exposed annually through dog-bites.
Undocumented reports received by the Federal Department of Livestock and Pest Control Services in the Federal Ministry of Agriculture and Rural Development, Abuja, Nigeria seem to suggest an increase in the case of dog bite in the Federal Capital Territory (FCT) Abuja, Nigeria in the last five years. Transmission of rabies to human can be greatly reduced by health information and behaviour of humans towards the disease. Therefore, information on perception of rabies by the residents of FCT has the benefits of enabling the health agencies to better evaluate and plan for a more efficient and effective rabies control program. This study assessed the knowledge, attitudes and practices of the residents of Abuja Municipal Area Council (AMAC) towards rabies.
Study area: this study was conducted in Abuja Municipal Area Council (AMAC) which is one of the six (6) Area councils in FCT Abuja, Nigeria with the population size of 776,298 . It is a well-planned city that is multi-cultural, cosmopolitan and one of the wealthiest cities in Africa. There are 37 registered veterinary practicing premises out of which 2 are government owned while the remaining 35 are privately owned. Health facilities owned by government and privately-owned are spread across the Area Council. These are managed by registered veterinary and health professionals who can adequately respond to and manage cases of dog bites.
this was a descriptive cross-sectional study.
residents of AMAC who were 18 years and above who gave their consent were eligible to participate.
a convenient minimum sample size of 224 was used for the study.
a multistage sampling was employed. Three districts were chosen out of the nine districts through simple random sampling. One street in each district was also randomly picked. The first household was randomly picked, and every other household was selected systematically until the required number was achieved. An eligible member of the household was selected though balloting.
a semi-structured interviewer administered questionnaire with the following sections: socio-demographic, knowledge, attitude and practice was employed.
Data collection methods:
the questionnaire was pre-tested in one of the districts in the study area that was not selected for the study. The questionnaires were then analyzed and changes were made based on the feedback received. Thereafter, two trained interviewers were assigned to each of the selected districts to administer the questionnaire. The first section sought socio-demographic data while the other three sections sought information on the knowledge, attitudes and practices towards rabies prevention. The variables; knowledge, attitudes and practices were graded on a scale into ten domains, a point was scored for correct responses and zero for wrong responses with a maximum score of ten and a minimum score of zero. Total score of 0-4 was graded as poor, 5-7 as fair while 8-10 as satisfactory.
data was entered, cleaned and analyzed using Microsoft Office Excel and Epi Info TM 3.5.3. Univariate analysis was performed for frequencies, means and proportions of socio-demographic characteristics of respondents and KAP of respondents towards rabies. Chi-square test or Fisher's exact test (2-tailed) was used, as appropriate, to evaluate for significance of differences in responses between dog ownership and knowledge and attitude of respondent towards rabies and association between socio-demographic characteristics and knowledge of respondents. A P-value of <0.05 was considered to be significant.
approval was obtained from the Research and Ethics Committee of Ahmadu Bello University, Zaria, Nigeria. Informed consent of the participants in the study were obtained and respondents were assured of confidentiality of information supplied.
A total of 224 respondents were interviewed. Socio-demographic characteristics of respondents showed that the mean age was 39 ± 5 years and 59.8% were below the age of 40 years. Majority of respondents (62.1%) were males, 75% were married, 94.2% had post-secondary education and 47.8% were on government employment. Fifty five percent owned dogs and 83.5% practiced Christianity as a form of religion (Table 1).
Eighty two percent of the respondents had satisfactory knowledge, 18% fair knowledge and none had poor knowledge towards rabies prevention. Respondents attitudes and health seeking behaviour towards rabies prevention showed that 74% had positive attitudes, 24% fair attitudes while only 2% showed negative attitudes. Seventy five percent respondents of the 123 that owned dogs had satisfactory practice, 20% fair practice while 5% had poor practice towards rabies prevention.
All the respondents were aware that bite from a rabid dog is the mode of transmission of rabies, that dogs are the main reservoir of rabies in Nigeria, that rabies is fatal, that rabies can lead to death and that rabies can be prevented by vaccination. Approximately 84% respondents knew that rabies affects both humans and animals, 88.8% knew the signs observed in a rabid dog, 87.1% knew where to obtain rabies vaccination for their pets while 42% knew that rabies vaccination is given annually. Most respondents (77.7%) knew that suspected pet head is submitted to the veterinarian, however only 41.5% knew that rabies cannot be cured after symptoms appear (Table 2).
About 88% would report a case of dog bite to the local authority, 73.7% would be willing to euthanize pet if found to be rabid while 79.5% would not hesitate to send the head of a suspected rabid animal to the veterinarian. More than 84% of the respondents said the presence of stray dog annoyed them while 75% would support euthanizing stray dogs. Eighty seven percent of respondents would seek medical care in the hospital when bitten by a dog while only 36.6% would apply the appropriate first aid treatment in the event of a dog bite (Table 3).
Sixty five percent of dog owners housed their dogs in kennels but sometimes could allow them to freely roam within the compound, 94% patronized veterinary services and had vaccinated their dogs against rabies and other diseases (Table 4).
Dog owners were 7.8 times more likely to have satisfactory knowledge of rabies compared to non-dog owners. Single respondents were more likely to have positive attitudes about rabies than the married (Table 5). Dog owners were 2.6 times more likely to be annoyed by the presence of stray dogs than those without dogs (Table 6).
The knowledge among respondents showed an 82% satisfactory knowledge. All respondents showed an acceptable knowledge on the reservoir of rabies, its fatal nature, the signs observed in dogs and its prevention by vaccination. These and knowledge of the administration of rabies vaccine to dogs and what to do with a suspected dog are similar to studies carried out in other places .
The attitudes and health seeking behavior towards rabies prevention was found to be 74%. The willingness to register pets was expressed by all the respondents and this is consistent with a study conducted in Sri Lanka. More than 84% responded as being annoyed by the presence of stray dogs, 73.7% support euthanizing stray dogs and more than 87.5% said they would report to the appropriate authority when bitten by a dog. These findings contrast with those in a study in Tanzania which reported that the dog in question would be killed to avert further attack on others . However, a similar study reported the same findings . The correct use of first-aid measures was acceptable to 36.6% of the respondents as recommended by WHO  to thoroughly flush wounds with soap and water immediately after a bite injury and povidone iodine or other antiseptic should be applied when available. This figure which is low is however higher than that reported in a study in Ethiopia . More than 86% of the respondents would seek medical care from a hospital or a doctor after being bitten by a dog. This reflects the level of their knowledge on rabies. Another study in Ethiopia also reports that a high number of people would get treated in a hospital . This however contrast to a survey in India where 42% preferred a household treatment such as chili application .
Of the total number of respondents, only 55% owned dogs and these were the only ones that responded to the practice section of the KAP. There was 75% satisfactory practice among dog owners. This is reflected in the measures taken to prevent the spread of rabies. Sixty five percent practiced housing dogs in kennels but would allow them to freely roam at some point. In this case, dogs would only be allowed out of their kennels in the night to provide some sought of security while they remained restricted in the daytime to limit direct contact with humans. This is contrary to the study in Addis Ababa  and Sri Lanka . Only 9.8% would allow their dogs to roam freely without restriction. The practice of allowing dogs to freely roam would facilitate the spread of rabies in human and animal population. Good practice and responsible dog ownership is also exhibited by the number of those who vaccinated their dogs against rabies (94.3%) and other diseases (94.3%). The rabies vaccination figure is similar to another study conducted in Ontario  but contrary to a study in Ethiopia with a very low vaccination rate of 9% . WHO recommends that 80% of total dog population should receive vaccination to give protection against rabies thereby curbing the spread its spread .
Dog ownership was statistically significant with knowledge. Dog owners were eight times more likely to have satisfactory knowledge on rabies than non-dog owners. This finding gives credence to the fact that good number of dog owners would vaccinate their dogs against rabies and other diseases as reported in this study. Marital status had significant association with attitudes towards rabies prevention. The non-married were about three time more likely to have positive attitudes towards rabies prevention than the married. Respondents who owned dogs were more likely to be annoyed by stray dogs than non-dog owners. Dog owners would be more knowledgeable about the dangers and health implications posed by roaming dogs and this may have informed this attitude towards roaming dogs.
Our study showed that knowledge, attitudes and practices with regards to rabies prevention among the residence of AMAC were high. The knowledge and practices of most respondents, irrespective of dog ownership status, were satisfactory with majority also having positive attitudes. The practice of responsible dog ownership was high with majority of the dog owners having their dogs vaccinated against rabies and other vaccine preventable diseases. Rabies vaccine coverage in this study is higher than the recommended WHO coverage of 80% for herd immunity to be achieved. Despite the above, some gaps were observed. They include; not knowing that cure for rabies is not available after symptoms appear, lack of awareness on the first aid measures to be taken after a case of dog bite and danger posed by allowing dogs to stray. Sensitization and awareness campaign to the residents of AMAC is highly recommended to cover these identified gaps to curb the spread and menace of rabies.
What is known about this topic
- Rabies is a viral zoonoses affecting man, domestic and wild animals;
- Mortality of rabies is highest in Asia and Africa;
- Major host of transmission to man and other animals
in Nigeria is the dog.
What this study adds
- The knowledge of rabies among residents of Abuja Municipal Area Council (AMAC) is very high;
- The need to create more awareness on actions to take towards rabies prevention such as the first aid measures to be taken after a dog bite and that the fact that rabies is not curable after symptoms have appeared because of the knowledge gap in these areas that was observed among respondents;
- Rabies vaccination coverage among dog owners is higher than that recommended by World Health Organization (WHO).
The authors declare no competing interest.
Aboyowa Arayuwa Edukugho conducted the study, performed the analysis and prepared the manuscript, Jarlath Udoudo Umoh supervised the research, provided technical support and reviewed the manuscript, Matthew Diem participated in the analysis, Oyetunji Ajani participated in analysis, Belinda Uba reviewed the manuscript, Lilian Okeke reviewed the manuscript, Elizabeth Adedire reviewed the manuscript, Adewole Adefisoye reviewed the manuscript, Caroline Edukugho participated in analysis and review of manuscript, Patrick Nguku supervised, reviewed and approved the manuscript. All the authors have read and agreed to the final manuscript.
We acknowledge and sincerely extends our appreciation to the U.S. Center for Disease Control and Prevention (CDC) for sponsoring the study and the Nigerian Field Epidemiology and Laboratory Training Program (NFELTP) for both administrative and technical support for the project.
Table 1: frequency distribution of respondents according to demographic characteristics
Table 2: knowledge of respondents towards rabies prevention
Table 3: attitudes of respondents towards rabies prevention
Table 4: practices of respondents towards rabies prevention
Table 5: association between socio-demographic characteristics and knowledge
Table 6: association between dog ownership and knowledge and attitude of respondents towards rabies prevention
- Burgos-Cáceres S. Canine Rabies: a looming threat to public health. Anim Open Access J MDPI. 2011; 1(4): 326-42. PubMed | Google Scholar
- World Health Organization (WHO). WHO Expert Consultation on Rabies, 5-8 October 2004. Accessed on 26 Jul 2017.
- Boulger LR and Hardy J. Rabies in Nigeria. West Afr Med J. 1960; 9(6): 223-4.
- Thorne ALC. The problem of rabies in Nigeria. Bull Epizoot Dis Afr. 1954; 2: 265-7.
- Umoh JU and Belino ED. Rabies in Nigeria: a historical review. Int J Zoonoses. 1979; 6(1): 41-8. PubMed | Google Scholar
- Fagbemi AH, Anosa VO, Ezebuiro EO. Hospital records of human rabies and antirabies prophylaxis in Nigeria from 1969-1978. Trans R Soc Trop Med Hyg. 1981; 75(6): 872-6. PubMed | Google Scholar
- Umoh, JU and Belino E. Rabies in Nigeria: a historical review. Int J Zoonoses. 2008; 6(1): 41-8. PubMed | Google Scholar
- Bello M, Lukshi BM, Usman B. A fifteen-year retrospective study of the prevalence of rabies in Bauchi State, Nigeria. Niger Vet J. 2007; 28(2): 18-23. Google Scholar
- Nuru S. Epizootiology of canine rabies and its public health significance in Kano State, Nigeria. Niger Vet J. 1973; 2: 49-54.
- Ezebuiro ED, Fagbami AH, Anosa VO. A survey of rabies in man and animals in Nigeria. Study commissioned by Federal Livestock Department, Federal Ministry of Agriculture, Lagos, Nigeria. 1980.
- Ogunkoya AB, Will AE, Ezeokoli CO. Rabies in Oyo State, Nigeria 1971-1981. Int J Zoonoses. 1984; 11(1): 84-95. PubMed
- Oboegbulem SI. Rabies in man and animals. Fidelity Publishers, Enugu, Nigeria. 1994; 1: 11-21.
- Okoh AEJ. Dog ecology with reference to surveillance of rabies and characterization of rabies virus isolates in Plateau state, Nigeria. PhD Thesis, Ahmadu Bello University, Zaria, Nigeria. 1986.
- City Population. Nigeria: Administrative Division (States and Local Government Areas) - Population Statistics in Maps and Charts. Accessed on
28 July 2017.
- Maria EMDR and Lulu CB. Knowledge attitude and practise of the community regarding animal bite and rabies. PIDS J. 2004; 8(1): 24-32.
- Sambo M, Cleaveland S, Ferguson H, Lembo T, Simon C, Urassa H et al. The burden of rabies in Tanzania and its impact on
local communities. PLoS Negl Trop Dis. 2013; 7(11): e2510. PubMed | Google
- Matibag GC, Ohbayashi Y, Kanda K, Yamashina H,
Kumara WRB, Perera ING, et al. A pilot study on the usefulness
of information and education campaign materials in enhancing the knowledge,
attitude and practice on rabies in rural Sri Lanka. J Infect Developing
Countries. 2009; 3(1): 55-64. PubMed | Google
- Abraham A, Eshetu YA, Desalegn S. A study on knowledge, attitude and practice of rabies among residents in Addis Ababa, Ethiopia. Ethiop Vet J. 2013; 17(2): 19-35. Google Scholar
- Kabeta T, Deresa B, Tigre W, Ward MP, Mor SM. Knowledge, attitudes and practices of animal bite victims attending an aAnti-rabies Health Center in Jimma Town, Ethiopia. PLoS Negl Trop Dis. 2015; 9(6): e0003867. PubMed | Google Scholar
- Agarwal N, Reddaiah VP. Knowledge, attitude and practice following dog bite: a community-based epidemiological study. Health Population. 2003; 26(4): 154-61. Google Scholar
- Tenzin, Dhand NK, Rai BD, Changlo, Tenzin K, Tsheten
K et al. Community-based study on knowledge, attitudes and perception
of rabies in Gelephu, South-Central Bhutan. International
Health. 2012; 4; 210-219. Google
- Matibag GC, Kamigaki T, Kumarasiri PVR, Wijewardana TG, Kalupahana AW, Dissanayake DRA et al.
Knowledge, attitudes, and practices survey of rabies in a community in
Sri Lanka. Environ Health Prev Med. 2007; 12(2): 84-89. PubMed | Google Scholar
- Singh US and Choudhary SK. Knowledge, attitude, behavior and practice study on dog-bites and its management in the context of prevention of rabies in a rural community of Gujarat. Indian J Community Med. 2005; 30(3): 81. Google Scholar
- World Health Organization (WHO). The World Health Report. 1996; 57.