Knowledge, attitude and practice (KAP) survey of canine rabies in Khyber Pakhtunkhwa and Punjab Province of Pakistan

Background This study aimed to assess the extent of knowledge and
understanding of rabies disease in rural and urban communities of
Pakistan. It also identified malpractices after suspected dog bite that
might pose a risk for humans contracting rabies. Methods A cross-sectional
study was conducted (n = 1466) on people having different age
groups and educational levels in four different geographic regions of
Punjab and Khyber Pakhtunkhwa provinces in Pakistan. Knowledge, attitude,
and practices of people were assessed using a structured questionnaire. We
used a bivariate and multivariate analysis to study the association
between rabies related mortalities in near or extended family members and
different risk behaviors. Results Our results demonstrate that the
majority of the juvenile population (less than 18 years of age) were not
aware of the clinical signs of rabies in animals. 75% of the total
respondents were not vaccinated against rabies, 60% did not seek a
doctor’s advice after a suspected animal bite, and 55% had inadequate
health care facilities for rabies patients in local hospitals. Respondents
that had pets at home had not vaccinated (38%; p < 0.05; odds ratio
1.58) themselves against rabies due to lack of knowledge and awareness of
pre-exposure prophylaxis for rabies (51%; p < 0.05; odds ratio
1.25). They also tend to not visit doctor after suspected bite (52%;
p < 0.05; odds ratio 1.97), which may had resulted in more
deaths (65%; p < 0.05; odds ratio 1.73) of someone in
their near or extended family due to rabies. Conclusions Lack of knowledge
about the nature of rabies disease and prophylaxis has contributed to
increase of rabies related deaths. Inadequate health care facilities and
poor attitude of not seeking medical attention after suspected dog bite
are the major reasons of rabies related deaths. These findings could help
in devising a targeted management strategy and awareness program to
control and reduce the incidence of human rabies related deaths in
Pakistan.