EFFECTIVENESS OF A COMMUNITY-BASED EDUCATIONAL

INTERVENTION TO IMPROVE SCHOOL CHILDRENS KNOWLEDGE

OF RABIES AND DOG BITE PREVENTION

Aashima Auplish, Alison S. Clarke, Trent van Zanten Kate Abel, Charmaine Tham,

Thinlay N. Bhutia, Colin R. Wilks, Mark A. Stevenson, Simon M. Firestone

RATIONALE BEHIND COMMUNITY-BASED EDUCATIONAL INTERVENTION

Major factors contributing to endemicity: Knowledge gaps in rabies awareness Lack of nationally coordinated control and

prevention strategies

Changing the public perception of rabies prevention and control is a fundamental aspect of ongoing control efforts

RATIONALE BEHIND COMMUNITY-BASED EDUCATIONAL INTERVENTION

Target demographic:

Risk and burden falls on the most vulnerable sectors of society with 40% of human rabies deaths occurring in children

RATIONALE BEHIND COMMUNITY-BASED EDUCATIONAL INTERVENTION

Aim: To evaluate the implementation of a community-

based educational intervention, with target demographic of local school children in urban and rural Sikkim

WHERE DOES EDUCATION FALL INTO DOG POPULATION MANAGEMENT?

Impact 4: Reduce risks to Public Health Dog bite prevention Impact on rabies risk

Impact 5: Improve Public Perception Attitudes towards dogs Human-dog interactions

MAJOR GAPS IN KNOWLEDGE AND CONTROL STRATEGIES

Most patients are victims of rabies due to: Lack of knowledge Disregard of post-exposure prophylaxis An inadequate availability of primary health care

services

EDUCATIONAL SESSIONS Section I: Interpretation of dog behaviour Section II: Knowledge of rabies and its transmission Section III: Post-exposure precautionary steps

Sample size (n): 226 students Of 8,700 students participating in the education

program Comparison of pre- and post-test scores to evaluate

the effectiveness of educational intervention

SECTION 1: INTERPRETATION OF DOG BEHAVIOUR

Impact 4: Reduce risks to Public Health Dog bites & Impact on rabies

Impact 5: Improved Public Perception Attitudes towards dogs & Human-dog interaction

Most important reservoir of rabies are dogs 17 million dog bites occur annually in India Children more likely to suffer bites to the face and head

Key knowledge gap: Appropriate behaviour around scared dogs

SECTION 1: INTERPRETATION OF DOG BEHAVIOUR

Results: Increased awareness of the risk of approaching

scared dogs (30.4%) Improved ability to identify and approach a

happy dog (22%)

SECTION 1: INTERPRETATION OF DOG BEHAVIOUR

SECTION 2: KNOWLEDGE OF RABIES AND

TRANSMISSION Impact 4: Reduce risks to Public Health

Direct impact on reducing rabies risk

Only 15% of patients reported learning about rabies at school*

Key knowledge gap: Understanding animals other than dogs are a

potential source of rabies *As demonstrated in a multi-country, multicenter study conducted in

the SEAR

SECTION 2: KNOWLEDGE OF RABIES AND

TRANSMISSION

Results: Increased ability of identifying rabies as a virus

(19%)

Increased recognition of only mammals transmitting rabies (16%)

Increased ability to identify that cows transmit rabies (47.2%)

SECTION 2: KNOWLEDGE OF RABIES AND

TRANSMISSION

SECTION 3: ABILITY TO CORRECTLY ORDER POST-

EXPOSURE PRECAUTION STEPS

Impact 4: Reduce Risks to Public Health

Reduce dog bites and Impact on rabies risk

Estimated only 20% of 19 million humans bitten (in SEAR) receive one or more doses of PEP vaccine due to lack of awareness

Key knowledge gap: Correctly understanding post-exposure prophylaxis

SECTION 3: ABILITY TO CORRECTLY ORDER POST-

EXPOSURE PRECAUTION STEPS Results Increased ability to correctly order post-

exposure precautionary steps (40%) Absolute rise of 87.5%

SECTION 3: ABILITY TO CORRECTLY ORDER POST-

EXPOSURE PRECAUTION STEPS

LIMITATIONS & REVISIONS

Accessibility and time constraints Large classes of students Selection bias Reliance on students to self complete questions Poor English comprehension Unwillingness for students to answer questions

that they were unsure of the correct response

CONCLUSION

Gauged requirements for future programs Evidence for incorporation into school curriculum

INTERNING AT

October December 2014 within the Dept of Control of Neglected Tropical Diseases, under Dr Bernadette Abela Ridder

Organising the 4th International Meeting on the Control of Neglected Zoonotic Diseases

Creation of bite prevention and rabies oriented educational booklets with WHO, GARC for South Africa as part of the Kwa Zulu Natal Rabies Elimination Program

ACKNOWLEDGEMENTS

Vets Beyond Borders: Charmaine Tham Kate Abel Thinlay Bhutia Helen Byrnes

University of Melbourne Vet Faculty Simon Firestone Colin Wilks Mark Stevenson

External veterinarians Gabrielle Carter, Robert Holmes, Alan Sherlock

Effectiveness of a community-based educational intervention to improve school childrens knowledge of rabies and dog bite preventionRationale behind community-based educational interventionRationale behind community-based educational interventionRationale behind community-based educational interventionWhere does education fall into dog population management?Major gaps in knowledge and control strategiesEducational sessionsSection 1: interpretation of dog behaviourSection 1: interpretation of dog behaviourSlide Number 10Section 1: interpretation of dog behaviourSection 2: knowledge of rabies and transmissionSection 2: knowledge of rabies and transmissionSlide Number 14Slide Number 15Section 2: knowledge of rabies and transmissionSection 3: ability to correctly order post-exposure precaution stepsSection 3: ability to correctly order post-exposure precaution stepsSlide Number 19Section 3: ability to correctly order post-exposure precaution stepsLIMITATIONS & REVISIONSCONCLUSIONInterning atACKNOWLEDGEMENTS