Dog bite histories and response to incidents in canine rabies-enzootic KwaZulu-Natal, South Africa

Abstract

The objective of this paper is to report evaluated observations from survey records captured through a cross-sectional observational study regarding canine populations and dog owners in rabies enzootic KwaZulu-Natal province, South Africa. Our aim was to evaluate respondent knowledge of canine rabies and response to dog bite incidents towards improved rabies control. Six communities consisting of three land use types were randomly sampled from September 2009 to January 2011, using a cluster design. A total of 1992 household records were analyzed using descriptive statistics and regression modeling to evaluate source of rabies knowledge, experiences with dog bites, and factors affecting treatment received within respective households that occurred within the 365 day period prior to the surveys. 86% of the population surveyed had heard of rabies. Non-dog owners were 1.6 times more likely to have heard of rabies than dog owners; however, fear of rabies was not a reason for not owning a dog. Government veterinary services were reported most frequently as respondent source of rabies knowledge. Nearly 13% of households had a member bitten by a dog within the year prior to the surveys with 82% of the victims visiting a clinic as a response to the bite. 35% of these clinic visitors received at least one rabies vaccination. Regression modeling determined that the only response variable that significantly reflected the likelihood of a patient receiving rabies vaccination or not was the term for the area surveyed. Overall the survey showed that most respondents have heard of dog associated rabies and seek medical assistance at a clinic in response to a dog bite regardless of offending dog identification. An in-depth study involving factors associated within area clinics may highlight the area dependency for patients receiving rabies post exposure prophylaxis shown by this model.

Figure 1. Geographical location of KwaZulu-Natal with the six study areas indicated.

Black square = Wembezi (peri-urban, rabies free), black diamond = Umlazi and Esikhawini (urban, rabies enzootic), black circle = Ixopo, Pongola and St. Chad's (rural, rabies enzootic).

Figure 2. Respondent knowledge of rabies by area surveyed (n = 1990).

Responses were recorded as either ‘no’ or ‘some’ knowledge of rabies. Areas are defined as: (Rabies enzootic rural = Ixopo, Pongola, St. Chad's; rabies enzootic urban = Umlazi, Esikhawini; rabies free peri-urban = Wembezi).

Figure 3. Source of rabies knowledge reported by both dog owners and non-dog owners across KwaZulu-Natal (n = 1982).

Figure 4. Dogs identified by victims bitten in bite incidents within a one year period (2011) across KZN (n = 227).

Figure 5. Treatment of bite by area surveyed (n = 227).

(Rabies enzootic rural = Ixopo, Pongola, St. Chad's; rabies enzootic urban = Umlazi, Esikhawini; rabies free peri-urban = Wembezi).

Figure 6. Injections identified as received by clinic patients across the province based upon respondent recall (n = 207).

Figure 7. Interest in surveillance activities by community across the province (n = 1989).

(Rabies enzootic rural = Ixopo, Pongola, St. Chad's; rabies enzootic urban = Umlazi, Esikhawini; rabies free peri-urban = Wembezi).

Figure 8. Responsible parties identified by respondents for reporting community based surveillance activities across the province.

Figure 9. Wildlife sightings across areas surveyed (n = 1990).

(Rabies enzootic rural = Ixopo, Pongola, St. Chad's; rabies enzootic urban = Umlazi, Esikhawini; rabies free peri-urban = Wembezi).

Figure 10. Desire for dog control by area surveyed (n = 1984).

(Rabies enzootic rural = Ixopo, Pongola, St. Chad's; rabies enzootic urban = Umlazi, Esikhawini; rabies free peri-urban = Wembezi).

Figure 11. Respondent desire for laws imposing limitations on dog ownership (n = 1988).

(Rabies enzootic rural = Ixopo, Pongola, St. Chad's; rabies enzootic urban = Umlazi, Esikhawini; rabies free peri-urban = Wembezi).