The Menace of Schistosomiasis in Nigeria: Knowledge,Attitude, and Practices Regarding Schistosomiasis among Rural Communities in Kano State

Background

Schistosomiasis is one of the most common neglected tropical diseases, especially in the developing countries in Africa, Asia and South America, with Nigeria having the greatest number of cases of schistosomiasis worldwide. This community-based study aims to evaluate the knowledge, attitude and practices (KAP) regarding schistosomiasis among rural Hausa communities in Kano State, Nigeria.

Methods

A cross-sectional study was carried out among 551 participants from Hausa communities in five local government areas in Kano State, North Central Nigeria. Demographic, socioeconomic and environmental information as well as KAP data were collected using a pre-tested questionnaire. Moreover, faecal and urine samples were collected and examined for the presence of Schistosoma mansoni and S. haematobium eggs respectively.

Results

The overall prevalence of schistosomiasis was 17.8%, with 8.9% and 8.3% infected with S. mansoni and S. haematobium respectively, and 0.5% had co-infection of both species. Moreover, 74.5% of the participants had prior knowledge about schistosomiasis with 67.0% of them how it is transmitted and 63.8% having no idea about the preventive measures. Three-quarters of the respondents considered schistosomiasis a serious disease while their practices to prevent infections were still inadequate, with only 34.7% of them seeking treatment from clinics/hospitals. Significant associations between the KAP and age, gender, education and employment status were reported. Multiple logistic regression analysis revealed that age, gender, history of infection and educational level of the respondents were the most important factors significantly associated with the KAP on schistosomiasis among this population.

Conclusions

Schistosomiasis is still prevalent among Hausa communities in Nigeria and participants’ knowledge about the disease was poor. Mass drug administration, community mobilization and health education regarding the cause, transmission and prevention of schistosomiasis and education about good personal and sanitary hygiene practices should be considered in order to significantly reduce the prevalence and morbidity of infection within these communities.     

Generation of Domestic Solid Waste in Rural Areas: Case Study of Remote Communities in the Brazilian Amazon

The Brazilian rural population is estimated to be around 30 million people and many rural areas do not have universal access to basic infrastructure services, including those related to solid waste. There are very few scientific studies on rural domestic solid waste and more investigative work is needed to provide information for appropriate solid waste management policies. This paper aims to characterize rural domestic solid waste in terms of quantity and quality. Amazonian rural communities were chosen for our case study. The issue of domestic solid waste was characterized both by means of interviews, at household level, and by a study of industrialized products traded in the communities located along the banks of the Juruá River, in the Brazilian Amazon. Quantitative results have shown that generation of solid waste in these rural communities reaches 0.5 kg/person/day. Organic matter represents 90 % of domestic solid waste generation and is mainly reused to feed animals and/or is composted using a method called paú. Inorganic solid waste (10 %) is either reused, burned or inadequately dumped in open sites. Based on these data, the annual production of solid waste is 437 tons per year in these communities. Since infrastructure services are virtually non-existent in this rural context, even this amount of solid waste may have a serious environmental impact, with negative effects on the population’s health, particularly in terms of hazardous waste. Even though solid waste management solutions for rural populations might not always be based on economic efficiency, decision makers responsible for development and planning should present solutions that are socially, technologically, environmentally and economically suitable for this context.     

Poverty and Inequality in the Rural Brazilian Amazon: A Multidimensional Approach

This paper analyses poverty and inequality dynamics among smallholders along the Transamazon Highway. We measure changes in poverty and inequality for original settlers and new owners, contrasting income-based with multidimensional indices of well-being. Our results show an overall reduction in both poverty and inequality among smallholders, although poverty decline was more pronounced among new owners, while inequality reduction was larger among original settlers. This trend suggests that families have an initial improvement in livelihood and well-being which tends to reach a limit later—a sign of structural limitations common to rural areas and maybe a replication of boom and bust trends in local economies among Amazonian municipalities. In addition, our multidimensional estimates of well-being reveal that some economically viable land use strategies of smallholders (e.g., pasture) may have important ecological implications for the regional landscape. These findings highlight the public policy challenges for fostering sustainable development among rural populations.     

Selenium Levels in the Whole Blood of Children and Teenagers from Two Riparian Communities at the Madeira River Basin in the Western Brazilian Amazon

Selenium (Se) is an essential micronutrient that exerts multiple functions in the organism, and both its deficiency and excess can cause health impairments. Thus, it is important to monitor its levels in the population, especially in vulnerable groups, such as children from the Brazilian Amazon region, where there is a lack of information in this regard. The aim of this research was to study Se levels in the whole blood of children and teenagers (5–16 years old) from two riparian communities at the Madeira River (Cuniã RESEX and Belmont). Se level variations related to the communities’ location, seasonality, diet, and body mass index (BMI) were assessed. Blood samples were collected in both communities for Se determinations, using ICP-MS and hemogram analyses, during May and September of 2011. Food frequency questionnaires were applied to assess consumption rates of specific food items. Non-parametric tests and linear multiple regressions were applied in the data analyses. Median Se levels were significantly higher during May (Cuniã RESEX 149 μg L^?1; Belmont 85 μg L^?1) compared to September (Cuniã RESEX 79 μg L^?1; Belmont 53 μg L^?1). No significant differences were found between the communities regarding BMI measurements and anemia prevalence. However, Se blood levels were significantly higher at the Cuniã RESEX compared to Belmont. In addition, the former showed higher fish and Brazil nut intakes, which may be the main Se sources for this community. These results contribute to a better understanding of Se reference levels for children and teenagers of Western Amazon riparian communities.     

15N natural abundance in forest and pasture soils of the Brazilian Amazon Basin

The natural abundance of ¹⁵N was examined in soil profiles from forests and pastures of the Brazilian Amazon Basin to compare tropical forests on a variety of soil types and to investigate changes in the sources of nitrogen to soils following deforestation for cattle ranching. Six sites in the state of Rondônia, two sites in Pará and one in Amazonas were studied. All sites except one were chronosequences and contained native forest and one or more pastures ranging from 2 to 27 years old. Forest soil ¹⁵N values to a depth of 1 m ranged from 8 to 23 and were higher than values typically found in temperate forests. A general pattern of increasing ¹⁵N values with depth near the soil surface was broadly similar to patterns in other forests but a decrease in ¹⁵N values in many forest profiles between 20 and 40 cm suggests that illuviation of ¹⁵N-depleted nitrate may influence total soil ¹⁵N values in deeper soil where total N concentrations are low. In four chronosequences in Rondônia, the ¹⁵N values of surface soil from pastures were lower than in the original forest and ¹⁵N values were increasingly depleted in older pastures. Inputs of atmospheric N by dinitrogen fixation could be an important N source in these pastures. Other pastures in Amazonas and Pará and Rondônia showed no consistent change from forest values. The extent of fractionation that leads to ¹⁵N enrichment in soils was broadly similar over a wide range of soil textures and indicated that similar processes control N fractionation and loss under tropical forest over a broad geographic region. Forest ¹⁵N profiles were consistent with conceptual models that explain enrichment of soil ¹⁵N values by selective loss of ¹⁴N during nitrification and denitrification.     

Fire in the Brazilian Amazon

Regenerating forests have become a common land-cover type throughout the Brazilian Amazon. However, the potential for these systems to accumulate and store C and nutrients, and the fluxes resulting from them when they are cut, burned, and converted back to croplands and pastures have not been well quantified. In this study, we quantified pre- and post-fire pools of biomass, C, and nutrients, as well as the emissions of those elements, at a series of second- and third-growth forests located in the states of Pará and Rondônia, Brazil. Total aboveground biomass (TAGB) of second- and third-growth forests averaged 134 and 91 Mg ha^–1, respectively. Rates of aboveground biomass accumulation were rapid in these systems, but were not significantly different between second- and third-growth forests, ranging from 9 to 16 Mg ha^–1 year^–1. Residual pools of biomass originating from primary forest vegetation accounted for large portions of TAGB in both forest types and were primarily responsible for TAGB differences between the two forest types. In second-growth forests this pool (82 Mg ha^–1) represented 58% of TAGB, and in third-growth forests (40 Mg ha^–1) it represented 40% of TAGB. Amounts of TAGB consumed by burning of second- and third-growth forests averaged 70 and 53 Mg ha^–1, respectively. Aboveground pre-fire pools in second- and third-growth forests averaged 67 and 45 Mg C ha^–1, 821 and 707 kg N ha^–1, 441 and 341 kg P ha^–1, and 46 and 27 kg Ca ha^–1, respectively. While pre-fire pools of C, N, S and K were not significantly different between second- and third-growth forests, pools of both P and Ca were significantly higher in second-growth forests. This suggests that increasing land use has a negative impact on these elemental pools. Site losses of elements resulting from slashing and burning these sites were highly variable: losses of C ranged from 20 to 47 Mg ha^–1; N losses ranged from 306 to 709 kg ha^–1; Ca losses ranged from 10 to 145 kg ha^–1; and P losses ranged from 2 to 20 kg ha^–1. Elemental losses were controlled to a large extent by the relative distribution of elemental mass within biomass components of varying susceptibilities to combustion and the temperatures of volatilization of each element. Due to a relatively low temperature of volatilization and its concentration in highly combustible biomass pools, site losses of N averaged 70% of total pre-fire pools. In contrast, site losses of P and Ca resulting from burning were 33 and 20% of total pre-fire pools, respectively, as much of the mass of those elements was deposited on site as ash. Pre- and post-fire biomass and elemental pools of second- and third-growth forests, as well as the emissions from those systems, were intermediate between those of primary forests and pastures in the Brazilian Amazon. Overall, regenerating forests have the capacity to act as either large terrestrial sinks or sources of C and nutrients, depending on the course of land-use patterns within the Brazilian Amazon. Combining remote sensing techniques with field measures of aboveground C accumulation in regenerating forests and C fluxes from those forests when they are cut and burned, we estimate that during 1990–1991 roughly 104 Tg of C was accumulated by regenerating forests across the Brazilian Amazon. Further, we estimate that approximately 103 Tg of C was lost via the cutting and burning of regenerating forests across the Brazilian Amazon during this same period. Since average C accumulations (5.5 Mg ha^–1 year^–1) in regenerating forests were 19% of the C lost when such forests are cut and burned (29.3 Mg ha^–1), our results suggest that when less than 19% of the total area accounted for by secondary forests is cut and burned in a given year, those forests will be net accumulators of C during that year. Conversely, when more than 19% of regenerating forests are burned, those forests will be a net source of C to the atmosphere.     

Long‐term Changes in Bird Communities after Wildfires in the Central Brazilian Amazon

We examined long‐term responses of an Amazonian bird assemblage to wildfire disturbance, investigating how understory birds reacted to forest regeneration 1, 3, and 10 years after a widespread fire event. The bird community was sampled along the Arapiuns and Maró river catchments in central Brazilian Amazonia. Sampling took place in 1998, 2000, and 2008 using mist‐nets in eight plots (four burned, four unburned sites). Species richness did not change significantly in unburned sites. In burned sites, however, we found significantly lower richness in 1998, higher richness in 2000, and similar richness in 2008. Multi‐dimensional scaling ordination showed consistent differences in bird communities both within burned sites sampled in different sampling years, and between burned and unburned sites in all years. Of the 30 most abundant species, 12 had not recovered 10 years after the fires, including habitat specialists such as mixed flocks specialists and ant‐followers. Fire‐disturbance favored three species (two hummingbirds and a manakin) in the short term only. All other species were either favored throughout the study (seven species of omnivores and small insectivores) or did not show a clear response (eight species). In burned sites, we also found significantly lower abundance of species sensitive to disturbances and habitat specialists over the entire study period. Although the bird community seems to be recovering in terms of richness, the overall community composition and abundance of some species in post‐burned and unburned sites remain very different, and have not recovered after 10 years of forest regeneration.     

Knowledge,Attitudes and Practices Related to Visceral Leishmaniasis in Rural Communities of Amhara State: A Longitudinal Study in Northwest Ethiopia

Background

In the northwest of Ethiopia, at the South Gondar region, there was a visceral leishmaniasis (VL) outbreak in 2005, making the disease a public health concern for the regional health authorities ever since. The knowledge on how the population perceives the disease is essential in order to propose successful control strategies.

Methodology/Principal findings

Two surveys on VL knowledge, attitudes and practices were conducted at the beginning (May 2009) and at the end (February 2011) of a VL longitudinal study carried out in rural communities of Libo Kemkem and Fogera, two districts of the Amhara Regional State. Results showed that VL global knowledge was very low in the area, and that it improved substantially in the period studied. Specifically, from 2009 to 2011, the frequency of proper knowledge regarding VL signs and symptoms increased from 47% to 71% (p<0.0001), knowledge of VL causes increased from 8% to 25% (p<0.0001), and knowledge on VL protection measures from 16% to 55% (p<0.0001). Moreover, the improvement observed in VL knowledge was more marked among the families with no previous history of VL case. Finally, in 2011 more than 90% of the households owned at least an impregnated bed net and had been sprayed, and attitudes towards these and other protective measures were very positive (over 94% acceptance for all of them).

Conclusions/Significance

In 2009 the level of knowledge regarding VL was very low among the rural population of this area, although it improved substantially in the study period, probably due to the contribution of many actors in the area. VL patients and relatives should be appropriately informed and trained as they may act as successful health community agents. VL risk behavioural patterns are subject to change as attitudes towards protective measures were very positive overall.     

Quality of Life and Health Perceptions Among Fish-Eating Communities of the Brazilian Amazon: An Ecosystem Approach to Well-Being

Mercury (Hg) contamination in the Brazilian Amazon constitutes a serious environmental and public health issue. This study is part of the CARUSO Project, which uses an ecosystem approach to human health to examine the sources, transmission, and effects of Hg in the Brazilian Amazon, with a view to developing preventive intervention strategy. To date, studies have focused on measures of Hg exposure through fish consumption in relation to health effects; little attention has been given to quality of life (QoL). The objective of this study was to examine the relations between QoL and health perceptions, Hg exposure, sociodemographics, living conditions, and lifestyle in communities along the Tapajós River. A total of 456 adults from 13 villages were interviewed and provided hair samples for Hg analysis. Results showed that perceptions of QoL and health are relatively positive, despite elevated Hg exposure. Logistic regression analyses showed that a positive perception of QoL was associated with the absence of chronic illnesses, not smoking, fruit consumption, residing on the banks of the Tapajós, and living in an in-migrants’ community. The positive perception of health was associated with younger age, the absence of reported symptoms of chronic illnesses, and drinking alcoholic beverages. Cluster analysis revealed that the group that reported the highest QoL had a traditional lifestyle, involving daily fishing and high fish consumption. However, this traditional lifestyle is associated with elevated Hg levels and early reported symptoms potentially linked to Hg exposure. These findings underline the importance of understanding the factors underlying QoL to develop adequate strategies to reduce Hg exposure and promote well-being.     

The Same,but Different: Indigenous Knowledge Retention,Erosion, and Innovation in the Brazilian Amazon

This study explores how indigenous knowledge (IK) might be retained and/or changed among contemporary indigenous peoples. Through semi-structured interviews and quantitative analyses of long-term changes in artistic knowledge among three geographically displaced Kaiabi (Kawaiwete) we found an association between language proficiency and gender with greater IK retention, and formal schooling with IK erosion. Six mechanisms of innovation in knowledge of basketry and textiles among men and women were documented. A mixed mode of collaborative learning and knowledge transmission involving diverse actors emerged from community workshops and group forums. Innovative mechanisms for cultural transmission have taken advantage of media, technology, and non-indigenous support organizations to expand weaving knowledge of basketry designs. Our results illustrate how indigenous peoples actively shape cultural transmission and change, as well as the role that public policies and academic research may play in these processes.     

Impacts of Cash Transfer Programs on Rural Livelihoods: a Case Study in the Brazilian Amazon Estuary

We conducted a large household survey in a region of the Amazon estuary in Brazil to investigate the dependence of small farming households on government cash transfers and to identify the main factors that lead to better livelihood outcomes. The study examined the factors that contribute to heterogeneous household livelihoods and patterns of dependence on cash transfer programs. Multinomial logistic regression was used to evaluate household attributes affecting the level of dependence on cash transfers. Results indicate that households engage in a diversity of livelihood strategies, and vary in dependence on cash transfers. Lower levels of dependency are associated with higher levels of education and income from off-farm activities as well as larger property sizes and holdings in the várzea. Recognition of the causes and potential range of dependence on cash transfer programs adds decision-making capacity for policy makers seeking avenues to reduce dependence and increase program effectiveness.     

Deforestation and land use in the Brazilian Amazon

Deforestation in the Brazilian Amazon was less than 1% before 1975. Between 1975 and 1987 the rate increased exponentially. By 1985, world opinion and attention to the destruction of the richest biome on earth led to elimination of some of the major incentives that had fueled deforestation. Favorable credit policies for cattle ranchers, rather than population growth, explains the process of deforestation in the Brazilian Amazon. The paper suggests other actions that may be taken to reduce deforestation, and examines the rapid growth rates of secondary successional species in a colonization area.     

Natural abundance of 15N in soils along forest-to-pasture chronosequences in the western Brazilian Amazon Basin

We examined the natural abundance of ¹⁵N in soil profiles along two chronosequences in the western Brazilian Amazon Basin state of Rondônia, to investigate possible mechanisms for changes to soil nitrogen sources and transformations that occur as a result of land use. One chronosequence consisted of forest and 3-, 5- and 20-year-old pasture, the other of forest and 8- and 20-year-old pasture. The ¹⁵N values of surface soil and soil to 1 m depth in the native forest ranged from 9.8 to 13.6 and were higher than reported for temperate forest soils. Fractionation associated with nitrification and denitrification and selective losses of ¹⁵N-depleted nitrate, could potentially result in a strong enrichment of nitrogen in soil organic matter over the time scale of soil development in highly weathered tropical soils. Pasture surface soils were 1–3, depleted in ¹⁵N compared with forest soils. Lower ¹⁵N values in 20-year-old pastures is consistent with greater cumulative inputs of ¹⁵N-depleted atmospheric-derived nitrogen, fixed by free-living bacteria associated with planted pasture grasses in older pastures, or differential plant utilization of soil inorganic N pools with different ¹⁵N values. The pattern of ¹⁵N values following conversion of forest to agricultural use differs from the pattern in the temperate zone, where pasture or cultivated soils are typically more enriched in ¹⁵N than the forest soils from which they were derived.     

DNA Barcodes of Rosy Tetras and Allied Species (Characiformes: Characidae: Hyphessobrycon) from the Brazilian Amazon Basin

DNA barcoding can be an effective tool for fast and accurate species-level identification based on sequencing of the mitochondrial cytochrome c oxidase subunit (COI) gene. The diversity of this fragment can be used to estimate the richness of the respective species. In this study, we explored the use of DNA barcoding in a group of ornamental freshwater fish of the genus Hyphessobrycon. We sequenced the COI from 10 species of Hyphessobrycon belonging to the “Rosy Tetra Clade” collected from the Amazon and Negro River basins and combined our results with published data. The average conspecific and congeneric Kimura 2-parameter distances were 2.3% and 19.3%, respectively. Six of the 10 species were easily distinguishable by DNA barcoding (H. bentosi, H. copelandi, H. eques, H. epicharis, H. pulchrippinis, and H. sweglesi), whereas the remaining species (H. erythrostigma, H. pyrrhonotus, H. rosaceus and H. socolofi) lacked reciprocal monophyly. Although the COI gene was not fully diagnostic, the discovery of distinct evolutionary units in certain Hyphessobrycon species under the same specific epithet as well as haplotype sharing between different species suggest that DNA barcoding is useful for species identification in this speciose genus.     

Knowledge,Attitudes and Practices (KAP) about Rabies Prevention and Control: A Community Survey in Tanzania

Background

Despite being entirely preventable, canine rabies still kills 55,000 people/year in developing countries. Information about local beliefs and practices can identify knowledge gaps that may affect prevention practices and lead to unnecessary deaths.

Methodology/Principal Findings

We investigated knowledge, attitudes and practices related to rabies and its prevention and control amongst a cross-section of households (n = 5,141) in urban and rural areas of central, southern and northern Tanzania. Over 17% of respondents owned domestic dogs (average of 2.3 dogs/household),>95% had heard about rabies, and>80% knew that rabies is transmitted through dog bites. People who (1) had greater education, (2) originated from areas with a history of rabies interventions, (3) had experienced exposure by a suspect rabid animal, (4) were male and (5) owned dogs were more likely to have greater knowledge about the disease. Around 80% of respondents would seek hospital treatment after a suspect bite, but only 5% were aware of the need for prompt wound cleansing after a bite. Although>65% of respondents knew of dog vaccination as a means to control rabies, only 51% vaccinated their dogs. Determinants of dog vaccination included (1) being a male-headed household, (2) presence of children, (3) low economic status, (4) residing in urban areas, (5) owning livestock, (6) originating from areas with rabies interventions and (7) having purchased a dog. The majority of dog-owning respondents were willing to contribute no more than US$0.31 towards veterinary services.

Conclusions/Significance

We identified important knowledge gaps related to, and factors influencing the prevention and control of rabies in Tanzania. Increasing knowledge regarding wound washing, seeking post-exposure prophylaxis and the need to vaccinate dogs are likely to result in more effective prevention of rabies; however, greater engagement of the veterinary and medical sectors is also needed to ensure the availability of preventative services.     

Seroprevalence of viral hepatitis in riverine communities from the Western Region of the Brazilian Amazon Basin.

The western region of the Brazilian Amazon Basin has long been shown to be a highly endemic area for hepatitis B and hepatitis D viruses. Data concerning the prevalence of hepatitis C and E viruses in this region are still scarce. In this study we investigated the presence of hepatitis A, B, C, D and E viruses infection in communities that live along the Purus and Acre rivers in the states of Acre and Amazonas within the Amazon Basin. A total of 349 blood samples were collected and tested for hepatitis A-E serological markers (antibodies and/or antigens) using commercial enzyme linked immunosorbent assays. Anti-HCV positive sera were further assayed by an immunoblot. HBsAg positive sera were subtyped by immunodifusion. The overall prevalence for hepatitis A, B, C, and E were 93.7%, 66.1%, 1.7%, and 4%, respectively. A very high prevalence of delta hepatitis (66.6%) was found among HBsAg positive subjects. Hepatitis A, B and D viruses were shown to be largely disseminated in this population, while hepatitis C and E viruses infection presented low prevalence rates in this region. The analysis of risk factors for HBV infection demonstrated that transmission was closely associated with sexual activity.     

Seasonal and Habitat Influences on Fish Communities within the Lower Yasuni River Basin of the Ecuadorian Amazon

We sampled lagoon, river and forest stream habitats during the rising water, wet, falling water, and dry seasons in the lowland region of the Yasuni National Reserve in the Ecuadorian Amazon. We collected 195 species, increasing the current number of species for the Napo River basin to approximately 562. The steady rate of species accumulation per sample suggests that the fish fauna is still undersampled. Lagoon, river and forest stream fish communities are highly diverse and variable, composed of common species found within several habitats, of characteristic species found throughout the year, and of seasonally migrating species. Characteristic lagoon species were mainly the curimatids Curimata vittata, Psectrogaster amazonica, Potamorhina altamazonica, P. latior and Cyphocharax plumbeus. The characins Hyphessobrycon copelandi and Hemigrammus cf. lunatus and the catfishes Nemadoras humeralis, Pimelodella sp. C and Sorubim sp. A were characteristic river species. Characteristic forest stream species included Hoplias malabaricus, Hyphessobrycon copelandi, Pimelodella sp. B and Sternopyugus macrurus. During the dry season, lagoon and river habitats had the highest number of individuals and species, as fishes were concentrated in decreasing habitat area. In contrast, stream habitats had the highest species richness and abundance during the rising water and falling water seasons. Species collected included vital food fishes and seasonal migrants. The migratory catfishes Brachyplatystoma vaillantii, Hemisorubim platyrhynchos, Platynematichthys notatus, Platystomatichthys sturio and Sorubim lima were collected during the falling water season, which suggests that these species may begin migrating earlier than expected. These findings highlight the importance of seasonality for both adequately assessing aquatic biodiversity and for developing research and conservation programs encompassing whole river ecosystems.     

Dog Demography,Animal Bite Management and Rabies Knowledge-Attitude and Practices in the Awash Basin,Eastern Ethiopia

Background

Rabies is a viral zoonosis that has been described in limited numbers of studies in Ethiopia at large and among pastoralists in particular. This study assessed dog demography, bite wound prevalence and management, potential risk factors of disease transmission and knowledge attitude practice towards rabies among urban dwellers, pastoralists and health workers in Awash, Eastern Ethiopia.

Methodology

Information was collected by means of structured questionnaires and interviews and through medical and official records from the Agricultural and Health bureaus.

Principal Findings

Respondents totaled 539 (471 urban, 49 pastoralists, 19 medical). Dog(s) were owned in 33% urban and 75.5% pastoralist households respectively. Mean dog number per dog owning household was 1.50 (95%CI: 1.40–1.60) in urban and 2.05 (95%CI: 1.51–2.60) in pastoralists sites. Human Dog Ratio in Metahara was 4.7:1. No bite wounds records were kept in medical facilities, where staff recalled around 100 bites per year, 2/3 being in adults. Over 90% of the respondents claimed knowing rabies but up to 79.2% pastoralist did not know how dogs acquire the disease; 37.3% urban and 23% pastoralist did not know the symptoms of rabies in dogs; 36% urban and 44% pastoralists did not know rabies symptoms in people. Eighty percent of pastoralists did not know that the disease was fatal in people if untreated. Over half (58.7%) of pastoralist respondents go to traditional healers if bitten, despite a health extension worker program in place in the study area. Knowledge gaps were also shown amidst medical staff.

Conclusions

The study highlighted overall poor disease knowledge, severe under-reporting of human rabies cases, lack of record keeping and poor collaboration between the public and animal health sectors and communities in rabies control.