A Knowledge, Attitudes and Practices (KAP) survey on canine rabies prevention and control in four rural areas of Sri Lanka

Rabies is a fatal viral disease that affects all mammals. It causes an estimated 59,000 human deaths worldwide annually. Dogs are the main reservoir and transmitter of rabies to human in Sri Lanka. Prevention and control measures include the mass vaccination of dogs and human post-exposure treatment. While these measures appear to be homogeneous across the country, there is a need to identify community-level gaps due to the decentralization of regional health and veterinary services in conducting such activities. A community-based questionnaire survey was conducted to identify potential risk factors and gaps related to knowledge, attitudes and practices on rabies prevention and control in the rural regions of Sri Lanka. Lower knowledge scores were associated with respondents between 18 and 38 years old, had no experience of being bitten, and own semi-independent dogs. Despite associated fear of stray dogs with health issues, some communities provide shelter and/or food for the stray dogs. Uptake of population control and vaccination of dogs across the grama niladhari divisions (GNDs), which are the smallest administrative units, differed. More than 80% of dogs were not desexed and community knowledge on vaccination delivery, booster and vaccination schedules were also variable. Even though 69% of respondents identified stray/community dogs as potential carriers’ owners allow their dogs to roam the neighbourhood. Most of the respondents were able to identify the need for post-exposure treatment after a dog bite. However, post-exposure prophylaxis uptake by the local victims ranged between 83.00% and 87.50%. Low participation was reported in health education in the communities. Lack of knowledge on other potential carriers was similar to previous survey studies in the last decade. Collaborations between local communities, veterinary and medical services are necessary to scale up the control programme in order to achieve the global target of zero rabies deaths by 2030. Further community-level studies are recommended.