Awareness and practices survey of two ancient zoonotic diseases in Dhading District of Nepal

BACKGROUND: Tuberculosis and rabies are two ancient zoonotic diseases that were discovered millennia ago, yet still claim thousands of lives worldwide in the twenty-first century. In Nepal, these diseases are endemic and pose a significant public health challenge in rural areas, such as the Dhading District, which has a low literacy rate and limited data availability. This study aims to address the gaps by evaluating knowledge of zoonotic diseases and identifying associated practices that can prevent their transmission. METHODS: An in-person randomized cross-sectional survey was conducted in five Village Development Committees in the Dhading District using a standard, structured, and validated questionnaire. The participants were stratified into five groups based on their daily work and were expected to interview 50 people from each category per VDC. Questions related to these two diseases were used to determine knowledge scores and awareness. Descriptive statistics were calculated, and regression and mediation analysis were used to determine the factors that influence disease awareness and prevention practices. RESULTS: This study interviewed 749 participants from five VDCs and achieved acceptable internal consistency and reliability (α = 0.74). Awareness of rabies was higher than that of TB (excellent: 2% vs 1%, and sufficient: 60% vs 11%) among these participants. Youth and women participants had significantly lower awareness of rabies and TB (p < 0.05). Mediation and path analysis indicated that TB knowledge is shaped more by structural and demographic variables rather than practice alone. In contrast, the rabies model highlights that while occupation strongly influences practices, its contribution to knowledge is complex and mediated by factors such as age, gender, and locality. CONCLUSIONS: Our findings emphasize that knowledge pathways differ across diseases even within the same population, necessitating tailored interventions. For TB, integrating education into occupational and practice-based platforms is critical, while for rabies, interventions should focus on overcoming gender and community-level disparities. Developing educational initiatives on zoonotic diseases and awareness among the public, specifically targeting women and youth, would benefit in reducing the burden of rabies and tuberculosis diseases in Nepal.