Knowledge and practices on dog bite management for rabies prevention in eThekwini, South Africa

Dogs are responsible for rabies virus transmission to humans in up to 99% of cases. Human rabies cases in the eThekwini district have led to human fatalities.

The aim of this study is to evaluate the knowledge, attitudes and practices (KAP) of household heads (HHs) regarding the management of dog bites in the context of rabies prevention, along with the factors associated with these practices.

The study was conducted in facility catchment areas that reported > 10 dog bite cases in 2023 in the South region of the eThekwini district, KwaZulu-Natal province.

This was a cross-sectional survey, including HHs (≥ 18 years). An interviewer-administered questionnaire was used to collect data. Multivariable logistic regression was used to identify associated factors.

A total of 437 HHs were interviewed, including 258 (59%) females. The mean age was 40.6 (standard deviation [s.d.]: 15.7) years. Overall, 411 (94%) (95% confidence interval [CI]: 91.4% - 95.9%] of HHs had poor knowledge, 434 (99%) (95% CI: 98% - 99.8%) showed positive attitudes towards dog bite management and 102 (61%) (95% CI: 55.8% - 64.5%) had poor practices. In multivariable analysis, being aged 31-50 years (adjusted odds ratio [aOR] = 4.1; 95% CI: 0.86-19.3; p = 0.035) and having secondary education (aOR = 0.39; 95% CI: 0.17-0.92; p = 0.031) were associated with good knowledge. Owning a dog (aOR = 17.51; 95% CI: 10.3-29.6, p < 0.001) was associated with good practices towards dog bite management.

It is recommended that the District Ministry of Health enhance public awareness on proper dog bite management and emphasise the importance of dog vaccination.

The study highlights inadequate knowledge and poor practices related to dog bite management in rabies prevention. Identifying these gaps is essential for developing targeted health education initiatives, which can support the global objective of eliminating human rabies deaths by 2030.