Dog Ecology and Rabies Knowledge, Attitude and Practice (KAP) in the Northern Communal Areas of Namibia

Abstract

In 2021, a comprehensive dog demographic questionnaire combined with a KAP survey were conducted in the northern communal areas (NCAs) of Namibia with the aim of gaining a better understanding of dog populations, owner behaviour, and knowledge, attitudes and practices (KAP) relating to rabies. The survey of 3,726 households across the eight regions of the NCAs provided insights that will inform interventions on order to improve human rabies prevention and Namibias dog rabies control strategy. The results showed a relatively low average human/dog ratio (HDR) of 5.4:1 indicating a surprisingly high dog population of at least 272,000 dogs in the NCAs, 93% of which appear to be owned but are free-roaming. Data analysis revealed opportunities but also highlighted needs for improvements in rabies surveillance and mass dog vaccinations. Although knowledge, attitude, and practice scores towards epidemiologic and clinical aspects, human rabies prevention, and canine rabies vaccination were deemed to be acceptable, the survey nevertheless revealed deficiencies in some of the population. Interestingly, data seemed to indicate a certain number of unreported human rabies cases. Other findings included the very high number of dogs. However, only 50% of dog-owning households reported having vaccinated their dogs. In order to address these issues, the planning, announcement, and implementation of mass dog vaccination campaigns need to be adapted to achieve adequate vaccination coverage. Another focus needs to be on rabies awareness and education if Namibia is to be significantly contributing to the global goal of "Zero by 30". Author SummaryAs a neglected disease, rabies remains a major One Health problem in Africa and Asia. Here we report the results of an extensive community survey on dog ownership and knowledge, attitudes and practices (KAP) related to rabies control and prevention, covering the Northern Communal Areas of Namibia. Our results showed that the dog population is large with a human/dog ratio (HDR) of 5.4:1, of which the vast majority is free-roaming thus supporting disease transmission but complicating control efforts. The majority of people across this part of Namibia were aware of rabies and had acceptable levels of attitudes and practices. While dog bite incidences per 100,000 people were high, ranging between 262 and 1,369, more than 90% of bite victims reported having visited a hospital after a bite incident. Still, gaps in dog rabies surveillance exist and incomplete or missing post exposure prophylaxes caused human casualties and call for ongoing interventions aimed at increasing knowledge and awareness.