Prevalence, knowledge, attitudes and practices regarding rabies among bite victims: a cross-sectional study at a national hospital, Sri Lanka

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It is considered as one of the dreaded infectious diseases among warm-blooded animals, which progressed into invariably fatal encephalomyelitis. Method : Data was retrieved from the available records from January 2021 to December 2023 at the rabies diagnostic unit for the assessment of rabies prevalence. A descriptive cross-sectional study was carried out using 113 bite victims attending the rabies diagnostic unit at National Hospital Galle, Sri Lanka from January 2023 to December 2023 using a modified pre-tested interviewer administered questionnaire for the assessment of knowledge, attitudes and practices towards rabies. Results : From the total samples received, 48%, 38% and 41% were confirmed positive for rabies by Sellers’ staining and/or direct fluorescent antibody test in year 2021, 2022 and 2023, respectively. The reduction in rabies prevalence from 2021 to 2023 was statistically significant (p<0.05). Majority of the positive cases were of canine in origin and were domesticated animals. More than 90% of the positive cases were from the animals which were non-vaccinated or without a vaccination history. Around 2% of the positive cases were reported from the vaccinated animals. Of the total respondents, 40% were aware that rabies is an infectious disease and 61% knew that it is preventable. All the respondents knew that dogs and cats transmit the disease via bites, scratches and aerosols, however 69% believed the possibility of transmitting the disease by rats. Almost all the participants believed vaccination of dogs/cats as a preventive measure to control rabies and 70% knew that vaccination need to be done annually. The scores of knowledge level, attitudes and practices of respondents were in satisfactory levels and none of the socio-demographic characteristics of respondents’ contributed for the scores significantly. Conclusion : This study highlights the prevalence of rabies in non-vaccinated domestic animals with a significant percentage in dogs, although it shows a reduction in total number of positive cases with time. Further, the results revealed satisfactory level of knowledge, attitudes and practices on rabies among the bite victims to the rabies unit. Prevalence Attitudes Knowledge Practices Rabies Southern Province Introduction Rabies is a neglected tropical disease of poor and at-risk groups with an annual global mortality rate of 1% ( 1 ). Endemic canine rabies related human deaths in Asia and Africa annually exceeds 30,000 and 23,000, respectively, causing huge economic loss due to expenses on post-exposure prophylaxis ( 2 ). The World Health Organization, the World Organization for Animal Health, Food and Agriculture Organization and the Global Alliance for Rabies Control, have set guidelines targeting zero dog-mediated human rabies deaths by 2025 ( 1 ). In line with the global healthcare requirements, the Sri Lankan government had implemented measures such as dog vaccination, female dog sterilization, vaccination of at-risk groups, upgrading laboratory diagnostic facilities and educational outreach programmes to enhance community knowledge, with the aim of zero rabies in the country by 2020. Despite the strategies implemented for controlling and prevention of the disease, a considerable decline of human rabies deaths has been observed in the country during the last few years, while extending the national target of ’zero by 2020’ up to 2025 ( 3 ). Majority of recently reported cases were due to the lack of post-exposure prophylaxis and the ignorance of the local community once they exposed ( 4 ). Rabies is still prevalent and underestimated particularly in undeveloped or developing countries, because human healthcare is not sufficient and domestic dogs have not been widely vaccinated. Though rabies transmission is well-known from pet animals, it can also be transmitted from wild animals (e.g., bats, raccoons, skunks, and foxes), and larger carnivores. Pets and dogs are the main vectors to transmit rabies to humans if they are not vaccinated. Avoiding contact with pets, dogs, and other domestic animals, and the unrealistic nature to exclude the possibility that these animals may contact with rabid vectors, the vaccination of these animals for pre-exposure prophylaxis is the best strategy to prevent animal rabies ( 5 ). Hence, strengthening surveillance would play a key role in effective controlling and prevention of the disease towards the national goal of zero deaths by 2025. In this scoping, the present study was undertaken to retrieve laboratory diagnostic and surveillance data from the bite victims attending the rabies unit, National Hospital Galle (NHG), which is the only tertiary care hospital in the Southern Sri Lanka, to assess the prevalence, knowledge, attitudes and practices towards rabies, as a preliminary step to support the national target of zero human deaths from dog rabies by 2025. Negri bodies are intracytoplasmic inclusion bodies that constitute the hallmark of rabies infection. To identify Negri bodies the smears can be stained using various techniques as Van Gieson, Mann, Williams, Stimson, Mallory, Harris, Reichel and Engle, Luzzoni and Lentz. For this experiment sellers’ staining was used obtaining the samples from hippocampus, cerebellum and brain stem. With that the Negri bodies could be observed in bright cherry red colour with internal basophilic granules ( 6 ). Staining reaction of Negri bodies can vary due to different factors; the thickness of smear, staining time, and degree of moisture. Still the technique is useful and still practicing due to the advantages; the less time requirement, easily prepared stain, no need of preliminary fixation of the smear and this method can be used in staining bacteria, exudates, blood or thin smears of fresh tissue from any source. As the limitations of this procedure, the method will not be staining of Negri bodies in smears which are previously fixed in alcohol, formol, Zenkers, orany other fixative and while the stain is easily prepared and operated, there are certain very important precautions to be observed can be taken ( 6 , 7 ). Numerous other methods, such as direct fluorescent antibody, inoculation of mice, infection of tissue cultures, and polymerase chain reaction, can also be used to identify animal rabies. All of these techniques have the approval of world health organization. The rabies antigen can be identified by agglutination on a glass plate with latex particles loaded in gamma globulin. The fluorescent antibody test (FAT) on brain sections is considered a “gold standard” method for identification of rabies. Further, the mice inoculation testing, which has been employed as a method of improving quality procedures for the FAT in the past, has critical defects. The FAT performed by trained personnel has high sensitivity; 99.78%. However, the FAT is costly as the requirement of pricy chemicals and equipment, skilled workers, and necropsy supplies. On the other hand, once the decomposition of brain specimens begins, the test’s sensitivity will significantly decrease ( 8 ). Materials and methods Study setting A descriptive cross-sectional study was carried out in the rabies diagnostic unit at NHG, which is the sole rabies diagnostic unit in Southern province of Sri Lanka. Laboratory diagnosis of rabies is carried out by initial sellers’ staining to identify the presence of Negri bodies followed by direct fluorescent antibody test (DFAT) for the confirmation, in the samples from hippocampus, cerebellum and brain stem received to the rabies diagnostic unit at NHG. Further, NHG is the key facility in the Southern region to provide post-exposure treatment for bite victims. Sampling and data collection Convenient sampling technique was used to recruit participants. The prevalence data and laboratory test results were retrieved from the archived reports from January 2021 to December 2023, at the rabies unit in NHG. The data on type of animal, area of the sample received, results obtained from Negri body test using Sellers’ staining and results obtained from DFAT with reference to the animal samples received to the rabies diagnostic unit were retrieved from laboratory records. A total of 113 bite victims were interviewed for the collection of data on knowledge, attitudes and practices. A modified pre-tested interviewer administered questionnaire was used to collect data following obtaining the consent from study participants who visited the rabies diagnostic unit at NHG from January 2023 to December 2023. The questionnaire consisted of two parts. The first part was to collect socio-demographic information of the responders including age, gender, ethnicity and profession. The second part included 18 questions, which included nine questions to investigate knowledge, six questions for attitudes and three questions to assess practices. Among the knowledge parameters, six questions had a single correct answer, and three questions had more than one correct answer. The respondent received one point for each correct response and the scores of overall knowledge, attitudes and practices ranged from; 0 to 15, 0 to 6 and 0 to 10, respectively. The ethical approval for the study was received from the Ethics review committee, Faculty of Allied Health Sciences, University of Ruhuna (Ref. No. 202.01.2023). The extracted data was subjected to statistical analysis with descriptive statistics. Data analysis Data was analyzed using SPSS version 25 for windows. Continuous variables were presented as mean ± standard deviation (SD). Categorical data was presented using frequencies and percentages. Each correct answer was scored one mark when assessing the knowledge, attitude and practices. The cumulative scores for knowledge, attitude and practices were assessed separately. Paired t -test was used to compare the group data to determine the significance where applicable and p < 0.05 was considered statistically significant. Results Prevalence of rabies Data on a total of 641 brain stem specimens from dogs ( Canis familiaris ; 54.6%), cats ( Felis catus ; 41.5%), rabbits ( Lepus nigricollis ; 0.6%), guinea pigs ( Cavia porcellus ; 0.2%), cattle (Boss spp.; 0.3%), squirrels ( Ratufa macroura ; 1.9%) and mongoose ( Herpestes smithii ; 0.8%), were retrieved from the laboratory records from January 2021 to December 2023. Among them, 48%, 38% and 41% were confirmed positive cases for rabies by Sellers’ staining and/or DFAT in year 2021, 2022 and 2023, respectively. Most of them were received from Baddegama (13%), Elpitiya (7%) and Galle (6%) Medical Officer of Health areas in Galle district. The reduction in rabies prevalence from 2021 to 2023 was statistically significant (p < 0.05). Majority of the positive cases (84.3%) were of canine in origin and were domesticated animals (50.6%). More than 90% of the positive cases were from the animals which were non-vaccinated or without a vaccination history. However, 1.7% of the positive cases were reported from the vaccinated animals. Sociodemographic characteristics of the bite victims A total of 113 participants were consented and enrolled to gather information on knowledge, attitudes, practices towards rabies. The majority of the participants were males (66%) and the mean age was 44.2 (± 12.8) years. Of the total, majority belonged to the age group 31–50 years (58.4%). There were only 3.5% Muslims and others were Sinhalese. Their occupations were belonged to the categories of professionalized (38%), skilled (40%), and unemployed (22%). Table 1 presents the sociodemographic characteristics of animal bite victims. Table 1 Sociodemographic characteristics of the 113 bite victims Characteristic N % Gender Female 38 33.6 Male 75 66.4 Age 50 years 32 28.3 Ethnicity Sinhala 109 96.5 Muslim 4 3.5 Occupation Professionals 13 11.5 Associate profesionals 5 4.4 Clerks 17 15.0 Service workers 8 7.1 Skilled agriculture, fisheries 7 6.2 Craft related workers 18 15.9 Plant & machine operators 1 0.9 Elementary workers 19 16.8 No occupation 25 22.1 Knowledge, attitudes and practices regarding rabies Of the total study population, 99% had heard about rabies, and the neighbours and the friends were the main source of information. Approximately 39% of the participants were aware of the fact that rabies is an infectious disease while 47.8% did not know it has an infectious nature. Further, 60.2% of participants were aware that rabies is a preventable disease and the majority believed vaccination of dogs and cats (99.1%) as a preventive measure of rabies. Table 2 shows the knowledge regarding rabies among bite victims. Table 2 Knowledge regarding rabies among participants Knowledge parameter N (%) Have you ever heard of Rabies? Yes 112 99.1 No 1 0.9 What is your source of Rabies information? Neighbors/friends 109 96.5 Media 88 77.9 Veterinary surgeon/ regional veterinary office 34 30.1 School 97 85.8 Physician/ hospital 77 68.1 Experience 72 63.7 Is Rabies an infectious disease? Yes 44 38.9 No 54 47.8 Do not know 15 13.3 Is Rabies preventable? Yes 69 61.1 No 28 24.8 Do not know 16 14.2 Is Rabies curable? Yes 38 33.6 No 59 52.2 Do not know 16 14.2 Which animal/s transmit Rabies? Dog 113 100.0 Cat 113 100.0 Cow 30 26.5 Bat 74 65.5 Rat 78 69.0 Which of the following are routes of transmission? Animal bites 113 100 Animal scratches 113 100 Inhalation of infected aerosols 24 21.2 Other 2 1.8 Do you know dogs should be vaccinated against Rabies? Yes 113 100 No 0 0 Do not know 0 0 Do you know cats should be vaccinated against Rabies? Yes 112 99.1 No 1 .9 Do not know 113 100.0 How often animals should be vaccinated against with Rabies? Six monthly 12 10.6 Annually 79 69.9 Once in five years 8 7.1 Other 14 12.4 The attitudes of bite victims regarding post-exposure measures were assessed and the results are shown in Table 3 . Majority of the participants believed that seeking medical advice, having first-aid, checking animal vaccination history, observing animal behaviour, having complete course of post-exposure vaccination are important as post exposure prophylaxis measures. Table 3 Attitudes regarding post-exposure measures among participants Attitude parameter N (%) Agree Neutral Disagree I should seek for medical advice following exposure to a rabies suspected animal. 112 0 1 I should take first-aid before meeting the doctor. 96 8 9 The vaccination history of the animal should be checked. 93 17 2 The behavior of the animal should be observed for a period of at least one month. 83 20 6 I should have complete course of post exposure vaccination. 81 28 1 I have no issue/ phobia in getting vaccinated. 96 13 4 From the study population 83.2% had exposed to dog bites, and the post exposure prophylaxis was practiced. Out of the individuals who were exposed to a dog bite, 75% has gone to hospitals immediately, and the majority of them have observed animal behaviour, checked the vaccination history and brought the head of animal to rabies diagnostic unit. The results are shown in Table 04 . Table 4 Practices towards rabies among respondents Practice parameter N Yes No Measures underwent by the respondent; Went to the hospital immediately 93 6 Washed wound with running tap water and soap 98 1 Used traditional medicine only 8 91 Went to the hospital after traditional medicine 17 82 Did nothing 7 92 Went to the hospital after first aid 70 29 Measures taken regarding the animal; Observed its behavior 98 1 Brought its head to Rabies diagnosis 98 1 Checked its records of vaccination 81 19 Did not care 1 98 Univariate analyses The mean scores observed for knowledge, attitudes and practices were 10.45 ± 1.49, 4.98 ± 1.23, 7.88 ± 3.18, respectively. The scores for knowledge, attitudes, and practices of the bite victims based on the sociodemographic characteristics are shown in Table 5 . Any of the sociodemographic characteristics of the respondents was not significantly contributed for the scores. Table 5 Knowledge, attitudes, and practices scores of respondents Characteristic (n) Knowledge score Attitude score Practice score Mean (SD) P-value Mean (SD) P-value Mean (SD) P-value Gender 0.279 0.136 0.929 Male (75) 10.24 (1.497) 4.79 (1.436) 7.76 (3.175) Female (38) 10.56 (1.491) 5.08 (1.112) 7.93 (3.223) Age 0.167 0.151 0.129 50 years (32) 10.03 (1.576) 4.91 (1.146) 8.59 (2.448) Ethnicity 0.785 Sinhala (109) 10.46 (1.512) Muslim ( 4 ) 10.25 (0.957) Occupation 0.212 0.139 0.899 Professionals & service providers (43) 10.77 (1.306) 5.05 (1.112) 8.05 (3.352) Skilled persons/Labourers (45) 10.27 (1.601) 5.16 (1.086) 7.73 (3.236) Unoccupied (25) 10.24 (1.562) 4.56 (1.583) 7.84 (2.939) SD; standard deviation. Discussion Rabies is a major public health concern, mainly in Asia and Africa. ‘United against rabies’ collaboration through the ‘One Health’ approach is the current motto of the global rabies elimination strategy. Several studies related to the prevalence and associated demographic factors of rabies in Sri Lanka have demonstrated the prevailing burden. Mass dog vaccination, animal birth control and awareness raising activities have implemented in Sri Lanka to reduce human deaths due to rabies. However, human rabies cases are still getting reported due to limited dog vaccination coverage and insufficient dog population management in the district level ( 3 ). The effective planning of mass dog vaccination campaigns, it is crucial to understand the factors associated with variation in canine vaccination rates. A study conducted in 2022 using the dogs of streets and dog-owning house-holds from three states of Nigeria a probabilistic model has been developed to understand factors associated with dog vaccination and non-vaccination ( 9 ). The present study was to assess the perveance of animal rabies in southern Sri Lanka and to identify the awareness of bite victims by assessing their knowledge, attitudes and the practices towards rabies. The most commonly received samples in the study were from dogs and cats and it is corroborated by the fact that dogs and cats are the common domesticated animals among Sri Lankan population, and therefore has a higher possibility of rabies transmission through them. These findings are in line with the results of a study in Philippine by Mananggit, et al., 2021, which also showed higher percentage of samples (> 90%) from dogs and cats ( 10 ). Furthermore, majority of the positive cases reported were from dogs in the present study, and these findings make the national target of zero dog-mediated human rabies deaths by 2025 quite unrealistic. Previous study in Central province of Sri Lanka has also revealed that > 75% of the rabies positive cases are from dogs, either vaccinated or not ( 11 ). Though the possibility of exposure to cattle and squirrels also high, the low rate of samples received from those can be affected by the unawareness of possible rabies transmission by them. Furthermore, rabbits, guinea pigs, and mongoose samples were received during the study period showing their exposure even with a low number. The samples received were investigated for rabies using Sellers’ stain and DFAT. The results revealed a decreasing prevalence of rabies among the samples received from year 2021 to 2023. More than seventy percent of positive samples had been received from Baddegama, Elpitiya and Galle MOH areas in Galle district. Increased population, unsuccessful animal vaccination programs could be the reasons for reporting more cases from these areas compared to other areas. Interestingly, majority of the positive cases were of dog samples (80%) while more than 50% of those are domesticated. Hence, proper vaccination of domestic pets is a matter of concern. Even though vaccination of domestic animals and pet animals is a common practice for prevention of zoonotic disease in Sri Lanka, particularly due to possibility of rabies transmission, which is a fatal infection, around 2% of vaccinated animals showed rabies positivity in the present study. It is an alarming sign of vaccination failure which needs attention of relevant authorities ( 12 ). Moreover, the positive samples over 90% were from unvaccinated or improperly vaccinated animals. Not having proper knowledge and guidance to the owners can lead to improper vaccinations or missing the vaccinations of animals on a regular basis and these findings further signifies the failure of national rabies prevention program. Therefore, establishing programs to evaluate the efficacy of vaccination and quality of vaccination is essential for safeguarding both animals and humans from rabies. Further, awareness programs on rabies prevention would improve knowledge of animal owners and the public and help to increase sample submission and proper identification of disease prevalence. This fact is further substantiated by the results of Indian study on rabies vaccination programs which revealed effective rabies control of both domestic and wild life over years with proper vaccination coupled with surveillance ( 13 ). Requirement of awareness programs and the level of awareness of animal owners and bite victims were evaluated by the second phase of this study by assessing their knowledge, attitudes and practices through a pretested questionnaire. Herein, we aimed to identify gaps and refine preventive strategies that may subsequently help to reduce and eliminate human rabies. The professional category of animal owners is a valid indicator of their knowledge. Majority of the respondents had heard about rabies indicating that it is well concerned by the society. The most common sources of information were either friends or neighbors or veterinary offices, while media, schools, hospitals and experiences were also have identified as useful information source. However, contradictory findings were reported in a Thailand study which indicated media as the first and favorite source of information and most followed was YouTube, followed by TikTok, showing the possibility of using them as information sources ( 14 ). The findings highlight the potential use of the media to improve rabies awareness in Sri Lanka as well. Around 60% of participants were aware that rabies is a preventable disease and that knowledge is important for making arrangements for rabies prevention. Around 50% of the participants mentioned that the infectious nature of rabies is not known showing the requirement for filling the gap in knowledge. Further, of the total 432 participants in a Indonesian study, 56.9% were aware of the clinical signs of rabies ( 15 ). Dogs, cats, cows and bats were identified as rabies transmitting animals by 100%, 100%, 26.5%, and 66.5%, respectively and routes of transmission were identified as animal bites, animal scratches, and inhalation of aerosols by 100%, 100% and 21.2%, respectively of the respondents. Significant population of the sample considered annual vaccination of dogs and cats as a preventive method. Posterior distributions in Mshelbwala, (2024) revealed that the probability of dog vaccination was positively associated with the owner’s latent knowledge of rabies, civil servant service employment ( 9 ). Interestingly, majority of the participants believed that seeking medical advice, having first-aid, checking animal vaccination history, observing animal behavior, having complete course of post-exposure vaccination are important as post exposure prophylaxis measures. Around 83.2% of the respondents has exposed to dog bites and post exposure prophylaxis. Yet, approximately 7.1% of the respondents have not received any prophylactic treatment, and this is a matter of concern which need the attention of the relevant authorities in order to meet the national target of zero dog-mediated human rabies deaths by 2025. The present findings on knowledge, attitudes and practices on rabies among bite victims were satisfactory and showed better results compared to the Chinese study by Li, et al., 2021 which revealed the level of rabies knowledge, attitudes and practice among bite victims in China was suboptimal ( 16 ). However, continuation of animal vaccination and rabies awareness programs are recommended. Further, the prevalence data highlights rabies in non-vaccinated domestic animals with a substantial percentage in dogs, although it shows a reduction in total number of positive cases with time. Limitations and future research This study is not without limitations. The data reported by interviewer administered questionnaire may have biasness due to self-reporting. Further, as the data collection period included lock-down periods with movement restrictions for individuals due to Corona virus disease outbreak, there is a possibility to not to receive all the suspected animal samples and bite victims. Future research can be directed see the status of rabies infection in whole country by having representative from all the diagnostic laboratories of Sri Lanka. Conclusions The study revealed the prevalence of rabies in non-vaccinated domestic animals with a significant percentage in dogs, although it shows a reduction in total number of positive cases with time. Further, the knowledge, attitudes and practices towards rabies of bite victims were in a satisfactory level. However, the gaps identified in this study will be beneficial in developing targeted educational interventions to uplift the capacity of knowledge, attitudes and practices of the general public, particularly the animal owners to facilitate prevention of rabies that will foster collaboration and guidance with the ultimate goal of improving human and animal health outcomes related to zoonotic diseases. Abbreviations NHG National Hospital Galle FAT Fluorescent antibody test DFAT Direct fluorescent antibody test Declarations Author contributions: Conceptualization: RMTM Ramanayake Methodology: HH Peiris, AMSS Amarasiri, RMTM Ramanayake Formal analysis and investigation: HH Peiris, AMSS Amarasiri Writing - original draft preparation: RMTM Ramanayake Writing - review and editing: RMTM Ramanayake, HH Peiris, AMSS Amarasiri Acknowledgements I would like to acknowledge laboratory staff of rabies diagnostic unit, National Hospital, Galle, Sri Lanka and all the bite victims who participated in this study. Ethics approval and consent to participate The study adhered to the ethical principles outlined in the Declaration of Helsinki of Research Involving Human Subjects and the ethical approval for the study was received from Ethical review committee, faculty of Allied health sciences, university of Ruhuna, Sri Lanka (ref. No 202.01.2023). Participation in the study was entirely voluntary. Informed consent was obtained from all participants before completing the questionnaire, which included a clear description of the study’s objectives and assurances of anonymity and confidentiality. Availability of data and materials The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request. Competing interests The authors declare no competing interests Funding This study was not supported by any funds. Consent for publication Not applicable References Mshelbwala PP, Weese JS, Sanni-Adeniyi OA, et al. Rabies epidemiology, prevention and control in Nigeria: Scoping progress towards elimination. PLoS neglected tropical diseases. 2021;15(8). e0009617. doi: 10.1371/journal.pntd.0009617. Mani RS, Madhusudana SN. Laboratory diagnosis of human rabies: recent advances. Scientific World Journal. 2013;. doi: 10.1155/2013/569712. Kanda K, Jayasinghe A, Jayasinghe C, et al. 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Viruses. 2022;14;14(1):155. doi: 10.3390/v14010155. PMID: 35062358; PMCID: PMC8777998. Laorujisawat M, Wattanaburanon A, Abdullakasim P, et al, Rabies-Related Knowledge, Attitudes, and Practices Among Primary School Students in Chonburi Province, Thailand. Inquiry. 2022;Jan-Dec;59:469580221087881. doi: 10.1177/00469580221087881. Rehman S, Rantam FA, Rehman A, Effendi MH, Shehzad A. Knowledge, attitudes, and practices toward rabies in three provinces of Indonesia. Vet World. 2021 Sep;14(9):2518-2526. doi: 10.14202/vetworld.2021.2518-2526. Epub 2021 Sep 25. PMID: 34840473; PMCID: PMC8613781. Li D, Liu Q, Chen F, Jiang Q, et al, Knowledge, attitudes and practices regarding to rabies and its prevention and control among bite victims by suspected rabid animals in China. One Health. 2021;8;13:100264. doi: 10.1016/j.onehlt.2021.100264. PMID: 34036144; PMCID: PMC8135036. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8401902","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":580994127,"identity":"8d914580-35fb-4ab7-8be8-92bb3fdf0d34","order_by":0,"name":"Tharanga Madhushani Ramanayake Mudiyanselage","email":"data:image/png;base64,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","orcid":"","institution":"University of Ruhuna","correspondingAuthor":true,"prefix":"","firstName":"Tharanga","middleName":"Madhushani Ramanayake","lastName":"Mudiyanselage","suffix":""},{"id":580994128,"identity":"9d4379eb-03b5-42a2-b557-74e1e15539e4","order_by":1,"name":"Sachinthi Amarasiri","email":"","orcid":"","institution":"University of Ruhuna","correspondingAuthor":false,"prefix":"","firstName":"Sachinthi","middleName":"","lastName":"Amarasiri","suffix":""},{"id":580994129,"identity":"ad5fcff7-1925-40e4-be87-6a1d32560f21","order_by":2,"name":"Harshini Peiris","email":"","orcid":"","institution":"University of Ruhuna","correspondingAuthor":false,"prefix":"","firstName":"Harshini","middleName":"","lastName":"Peiris","suffix":""},{"id":580994130,"identity":"eadf7103-496a-467c-bad3-deca2cb589c9","order_by":3,"name":"Buddhini Samaraweera","email":"","orcid":"","institution":"Medical Research Institute","correspondingAuthor":false,"prefix":"","firstName":"Buddhini","middleName":"","lastName":"Samaraweera","suffix":""}],"badges":[],"createdAt":"2025-12-19 07:38:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8401902/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8401902/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":103493808,"identity":"13f43923-8f6b-4c56-b0de-fdd4db4777fc","added_by":"auto","created_at":"2026-02-26 10:27:06","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":895058,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8401902/v1/1056409e-9da8-4ab9-a5a4-39a5d1a2830c.pdf"},{"id":101396330,"identity":"82592a56-0723-448e-840d-d16b614ed17c","added_by":"auto","created_at":"2026-01-29 09:17:32","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":17525,"visible":true,"origin":"","legend":"","description":"","filename":"02012026Questionaire.docx","url":"https://assets-eu.researchsquare.com/files/rs-8401902/v1/85583953d883d30ebe1fa385.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prevalence, knowledge, attitudes and practices regarding rabies among bite victims: a cross-sectional study at a national hospital, Sri Lanka","fulltext":[{"header":"Introduction","content":"\u003cp\u003eRabies is a neglected tropical disease of poor and at-risk groups with an annual global mortality rate of 1% (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Endemic canine rabies related human deaths in Asia and Africa annually exceeds 30,000 and 23,000, respectively, causing huge economic loss due to expenses on post-exposure prophylaxis (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe World Health Organization, the World Organization for Animal Health, Food and Agriculture Organization and the Global Alliance for Rabies Control, have set guidelines targeting zero dog-mediated human rabies deaths by 2025 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). In line with the global healthcare requirements, the Sri Lankan government had implemented measures such as dog vaccination, female dog sterilization, vaccination of at-risk groups, upgrading laboratory diagnostic facilities and educational outreach programmes to enhance community knowledge, with the aim of zero rabies in the country by 2020. Despite the strategies implemented for controlling and prevention of the disease, a considerable decline of human rabies deaths has been observed in the country during the last few years, while extending the national target of \u0026rsquo;zero by 2020\u0026rsquo; up to 2025 (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eMajority of recently reported cases were due to the lack of post-exposure prophylaxis and the ignorance of the local community once they exposed (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Rabies is still prevalent and underestimated particularly in undeveloped or developing countries, because human healthcare is not sufficient and domestic dogs have not been widely vaccinated. Though rabies transmission is well-known from pet animals, it can also be transmitted from wild animals (e.g., bats, raccoons, skunks, and foxes), and larger carnivores. Pets and dogs are the main vectors to transmit rabies to humans if they are not vaccinated. Avoiding contact with pets, dogs, and other domestic animals, and the unrealistic nature to exclude the possibility that these animals may contact with rabid vectors, the vaccination of these animals for pre-exposure prophylaxis is the best strategy to prevent animal rabies (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Hence, strengthening surveillance would play a key role in effective controlling and prevention of the disease towards the national goal of zero deaths by 2025. In this scoping, the present study was undertaken to retrieve laboratory diagnostic and surveillance data from the bite victims attending the rabies unit, National Hospital Galle (NHG), which is the only tertiary care hospital in the Southern Sri Lanka, to assess the prevalence, knowledge, attitudes and practices towards rabies, as a preliminary step to support the national target of zero human deaths from dog rabies by 2025.\u003c/p\u003e \u003cp\u003eNegri bodies are intracytoplasmic inclusion bodies that constitute the hallmark of rabies infection. To identify Negri bodies the smears can be stained using various techniques as Van Gieson, Mann, Williams, Stimson, Mallory, Harris, Reichel and Engle, Luzzoni and Lentz. For this experiment sellers\u0026rsquo; staining was used obtaining the samples from hippocampus, cerebellum and brain stem. With that the Negri bodies could be observed in bright cherry red colour with internal basophilic granules (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eStaining reaction of Negri bodies can vary due to different factors; the thickness of smear, staining time, and degree of moisture. Still the technique is useful and still practicing due to the advantages; the less time requirement, easily prepared stain, no need of preliminary fixation of the smear and this method can be used in staining bacteria, exudates, blood or thin smears of fresh tissue from any source. As the limitations of this procedure, the method will not be staining of Negri bodies in smears which are previously fixed in alcohol, formol, Zenkers, orany other fixative and while the stain is easily prepared and operated, there are certain very important precautions to be observed can be taken (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eNumerous other methods, such as direct fluorescent antibody, inoculation of mice, infection of tissue cultures, and polymerase chain reaction, can also be used to identify animal rabies. All of these techniques have the approval of world health organization. The rabies antigen can be identified by agglutination on a glass plate with latex particles loaded in gamma globulin. The fluorescent antibody test (FAT) on brain sections is considered a \u0026ldquo;gold standard\u0026rdquo; method for identification of rabies. Further, the mice inoculation testing, which has been employed as a method of improving quality procedures for the FAT in the past, has critical defects. The FAT performed by trained personnel has high sensitivity; 99.78%. However, the FAT is costly as the requirement of pricy chemicals and equipment, skilled workers, and necropsy supplies. On the other hand, once the decomposition of brain specimens begins, the test\u0026rsquo;s sensitivity will significantly decrease (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy setting\u003c/h2\u003e \u003cp\u003eA descriptive cross-sectional study was carried out in the rabies diagnostic unit at NHG, which is the sole rabies diagnostic unit in Southern province of Sri Lanka. Laboratory diagnosis of rabies is carried out by initial sellers\u0026rsquo; staining to identify the presence of Negri bodies followed by direct fluorescent antibody test (DFAT) for the confirmation, in the samples from hippocampus, cerebellum and brain stem received to the rabies diagnostic unit at NHG. Further, NHG is the key facility in the Southern region to provide post-exposure treatment for bite victims.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eSampling and data collection\u003c/h3\u003e\n\u003cp\u003eConvenient sampling technique was used to recruit participants. The prevalence data and laboratory test results were retrieved from the archived reports from January 2021 to December 2023, at the rabies unit in NHG. The data on type of animal, area of the sample received, results obtained from Negri body test using Sellers\u0026rsquo; staining and results obtained from DFAT with reference to the animal samples received to the rabies diagnostic unit were retrieved from laboratory records.\u003c/p\u003e \u003cp\u003eA total of 113 bite victims were interviewed for the collection of data on knowledge, attitudes and practices. A modified pre-tested interviewer administered questionnaire was used to collect data following obtaining the consent from study participants who visited the rabies diagnostic unit at NHG from January 2023 to December 2023.\u003c/p\u003e \u003cp\u003eThe questionnaire consisted of two parts. The first part was to collect socio-demographic information of the responders including age, gender, ethnicity and profession.\u003c/p\u003e \u003cp\u003eThe second part included 18 questions, which included nine questions to investigate knowledge, six questions for attitudes and three questions to assess practices. Among the knowledge parameters, six questions had a single correct answer, and three questions had more than one correct answer. The respondent received one point for each correct response and the scores of overall knowledge, attitudes and practices ranged from; 0 to 15, 0 to 6 and 0 to 10, respectively.\u003c/p\u003e \u003cp\u003e The ethical approval for the study was received from the Ethics review committee, Faculty of Allied Health Sciences, University of Ruhuna (Ref. No. 202.01.2023). The extracted data was subjected to statistical analysis with descriptive statistics.\u003c/p\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eData analysis\u003c/h2\u003e \u003cp\u003eData was analyzed using SPSS version 25 for windows. Continuous variables were presented as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (SD). Categorical data was presented using frequencies and percentages. Each correct answer was scored one mark when assessing the knowledge, attitude and practices. The cumulative scores for knowledge, attitude and practices were assessed separately. Paired \u003cem\u003et -test\u003c/em\u003e was used to compare the group data to determine the significance where applicable and p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003ePrevalence of rabies\u003c/h2\u003e \u003cp\u003eData on a total of 641 brain stem specimens from dogs (\u003cem\u003eCanis familiaris\u003c/em\u003e; 54.6%), cats (\u003cem\u003eFelis catus\u003c/em\u003e; 41.5%), rabbits (\u003cem\u003eLepus nigricollis\u003c/em\u003e; 0.6%), guinea pigs (\u003cem\u003eCavia porcellus\u003c/em\u003e; 0.2%), cattle (Boss spp.; 0.3%), squirrels (\u003cem\u003eRatufa macroura\u003c/em\u003e; 1.9%) and mongoose (\u003cem\u003eHerpestes smithii\u003c/em\u003e; 0.8%), were retrieved from the laboratory records from January 2021 to December 2023. Among them, 48%, 38% and 41% were confirmed positive cases for rabies by Sellers\u0026rsquo; staining and/or DFAT in year 2021, 2022 and 2023, respectively. Most of them were received from Baddegama (13%), Elpitiya (7%) and Galle (6%) Medical Officer of Health areas in Galle district.\u003c/p\u003e \u003cp\u003eThe reduction in rabies prevalence from 2021 to 2023 was statistically significant (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Majority of the positive cases (84.3%) were of canine in origin and were domesticated animals (50.6%). More than 90% of the positive cases were from the animals which were non-vaccinated or without a vaccination history. However, 1.7% of the positive cases were reported from the vaccinated animals.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eSociodemographic characteristics of the bite victims\u003c/h2\u003e \u003cp\u003eA total of 113 participants were consented and enrolled to gather information on knowledge, attitudes, practices towards rabies. The majority of the participants were males (66%) and the mean age was 44.2 (\u0026plusmn;\u0026thinsp;12.8) years. Of the total, majority belonged to the age group 31\u0026ndash;50 years (58.4%). There were only 3.5% Muslims and others were Sinhalese. Their occupations were belonged to the categories of professionalized (38%), skilled (40%), and unemployed (22%). Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e presents the sociodemographic characteristics of animal bite victims.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSociodemographic characteristics of the 113 bite victims\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristic\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e33.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e66.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;30 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e31\u0026ndash;50 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e58.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;50 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEthnicity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSinhala\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e109\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e96.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMuslim\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOccupation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProfessionals\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAssociate profesionals\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClerks\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eService workers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSkilled agriculture, fisheries\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCraft related workers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlant \u0026amp; machine operators\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eElementary workers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo occupation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eKnowledge, attitudes and practices regarding rabies\u003c/h3\u003e\n\u003cp\u003eOf the total study population, 99% had heard about rabies, and the neighbours and the friends were the main source of information. Approximately 39% of the participants were aware of the fact that rabies is an infectious disease while 47.8% did not know it has an infectious nature. Further, 60.2% of participants were aware that rabies is a preventable disease and the majority believed vaccination of dogs and cats (99.1%) as a preventive measure of rabies. Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the knowledge regarding rabies among bite victims.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eKnowledge regarding rabies among participants\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eKnowledge parameter\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHave you ever heard of Rabies?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e99.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhat is your source of Rabies information?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeighbors/friends\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e109\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e96.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e77.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVeterinary surgeon/ regional veterinary office\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSchool\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e85.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhysician/ hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e68.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExperience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e63.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIs Rabies an infectious disease?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDo not know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIs Rabies preventable?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e61.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDo not know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIs Rabies curable?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDo not know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhich animal/s transmit Rabies?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDog\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCat\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBat\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e65.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRat\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhich of the following are routes of transmission?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnimal bites\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnimal scratches\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInhalation of infected aerosols\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDo you know dogs should be vaccinated against Rabies?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDo not know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDo you know cats should be vaccinated against Rabies?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e99.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDo not know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHow often animals should be vaccinated against with Rabies?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSix monthly\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnnually\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOnce in five years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe attitudes of bite victims regarding post-exposure measures were assessed and the results are shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e. Majority of the participants believed that seeking medical advice, having first-aid, checking animal vaccination history, observing animal behaviour, having complete course of post-exposure vaccination are important as post exposure prophylaxis measures.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAttitudes regarding post-exposure measures among participants\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eAttitude parameter\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNeutral\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI should seek for medical advice following exposure to a rabies suspected animal.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI should take first-aid before meeting the doctor.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe vaccination history of the animal should be checked.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe behavior of the animal should be observed for a period of at least one month.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI should have complete course of post exposure vaccination.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI have no issue/ phobia in getting vaccinated.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eFrom the study population 83.2% had exposed to dog bites, and the post exposure prophylaxis was practiced. Out of the individuals who were exposed to a dog bite, 75% has gone to hospitals immediately, and the majority of them have observed animal behaviour, checked the vaccination history and brought the head of animal to rabies diagnostic unit. The results are shown in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e04\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePractices towards rabies among respondents\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePractice parameter\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMeasures underwent by the respondent;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWent to the hospital immediately\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWashed wound with running tap water and soap\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUsed traditional medicine only\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e91\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWent to the hospital after traditional medicine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e82\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDid nothing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e92\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWent to the hospital after first aid\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMeasures taken regarding the animal;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eObserved its behavior\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBrought its head to Rabies diagnosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChecked its records of vaccination\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDid not care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e98\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003eUnivariate analyses\u003c/h3\u003e\n\u003cp\u003eThe mean scores observed for knowledge, attitudes and practices were 10.45\u0026thinsp;\u0026plusmn;\u0026thinsp;1.49, 4.98\u0026thinsp;\u0026plusmn;\u0026thinsp;1.23, 7.88\u0026thinsp;\u0026plusmn;\u0026thinsp;3.18, respectively. The scores for knowledge, attitudes, and practices of the bite victims based on the sociodemographic characteristics are shown in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e. Any of the sociodemographic characteristics of the respondents was not significantly contributed for the scores.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eKnowledge, attitudes, and practices scores of respondents\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristic (n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eKnowledge score\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eAttitude score\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003ePractice score\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eMean (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003eMean (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.279\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.136\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.929\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale (75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.24 (1.497)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e4.79 (1.436)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e7.76 (3.175)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale (38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.56 (1.491)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e5.08 (1.112)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e7.93 (3.223)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.167\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.151\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.129\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;30 years (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.53 (1.457)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e4.47 (1.767)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e8.60 (2.197)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e31\u0026ndash;50 years (66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.64 (1.443)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e5.14 (1.108)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e7.36 (3.610)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;50 years (32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.03 (1.576)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e4.91 (1.146)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e8.59 (2.448)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEthnicity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.785\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSinhala (109)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.46 (1.512)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMuslim (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.25 (0.957)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOccupation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.212\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.139\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.899\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProfessionals \u0026amp; service providers (43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.77 (1.306)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e5.05 (1.112)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e8.05 (3.352)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSkilled persons/Labourers (45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.27 (1.601)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e5.16 (1.086)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e7.73 (3.236)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnoccupied (25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.24 (1.562)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e4.56 (1.583)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e7.84 (2.939)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c10\" namest=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eSD; standard deviation.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eRabies is a major public health concern, mainly in Asia and Africa. \u0026lsquo;United against rabies\u0026rsquo; collaboration through the \u0026lsquo;One Health\u0026rsquo; approach is the current motto of the global rabies elimination strategy. Several studies related to the prevalence and associated demographic factors of rabies in Sri Lanka have demonstrated the prevailing burden. Mass dog vaccination, animal birth control and awareness raising activities have implemented in Sri Lanka to reduce human deaths due to rabies. However, human rabies cases are still getting reported due to limited dog vaccination coverage and insufficient dog population management in the district level (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). The effective planning of mass dog vaccination campaigns, it is crucial to understand the factors associated with variation in canine vaccination rates. A study conducted in 2022 using the dogs of streets and dog-owning house-holds from three states of Nigeria a probabilistic model has been developed to understand factors associated with dog vaccination and non-vaccination (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe present study was to assess the perveance of animal rabies in southern Sri Lanka and to identify the awareness of bite victims by assessing their knowledge, attitudes and the practices towards rabies. The most commonly received samples in the study were from dogs and cats and it is corroborated by the fact that dogs and cats are the common domesticated animals among Sri Lankan population, and therefore has a higher possibility of rabies transmission through them. These findings are in line with the results of a study in Philippine by Mananggit, et al., 2021, which also showed higher percentage of samples (\u0026gt;\u0026thinsp;90%) from dogs and cats (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Furthermore, majority of the positive cases reported were from dogs in the present study, and these findings make the national target of zero dog-mediated human rabies deaths by 2025 quite unrealistic. Previous study in Central province of Sri Lanka has also revealed that \u0026gt;\u0026thinsp;75% of the rabies positive cases are from dogs, either vaccinated or not (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Though the possibility of exposure to cattle and squirrels also high, the low rate of samples received from those can be affected by the unawareness of possible rabies transmission by them. Furthermore, rabbits, guinea pigs, and mongoose samples were received during the study period showing their exposure even with a low number.\u003c/p\u003e \u003cp\u003eThe samples received were investigated for rabies using Sellers\u0026rsquo; stain and DFAT. The results revealed a decreasing prevalence of rabies among the samples received from year 2021 to 2023. More than seventy percent of positive samples had been received from Baddegama, Elpitiya and Galle MOH areas in Galle district. Increased population, unsuccessful animal vaccination programs could be the reasons for reporting more cases from these areas compared to other areas. Interestingly, majority of the positive cases were of dog samples (80%) while more than 50% of those are domesticated. Hence, proper vaccination of domestic pets is a matter of concern. Even though vaccination of domestic animals and pet animals is a common practice for prevention of zoonotic disease in Sri Lanka, particularly due to possibility of rabies transmission, which is a fatal infection, around 2% of vaccinated animals showed rabies positivity in the present study. It is an alarming sign of vaccination failure which needs attention of relevant authorities (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Moreover, the positive samples over 90% were from unvaccinated or improperly vaccinated animals. Not having proper knowledge and guidance to the owners can lead to improper vaccinations or missing the vaccinations of animals on a regular basis and these findings further signifies the failure of national rabies prevention program. Therefore, establishing programs to evaluate the efficacy of vaccination and quality of vaccination is essential for safeguarding both animals and humans from rabies. Further, awareness programs on rabies prevention would improve knowledge of animal owners and the public and help to increase sample submission and proper identification of disease prevalence. This fact is further substantiated by the results of Indian study on rabies vaccination programs which revealed effective rabies control of both domestic and wild life over years with proper vaccination coupled with surveillance (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eRequirement of awareness programs and the level of awareness of animal owners and bite victims were evaluated by the second phase of this study by assessing their knowledge, attitudes and practices through a pretested questionnaire. Herein, we aimed to identify gaps and refine preventive strategies that may subsequently help to reduce and eliminate human rabies.\u003c/p\u003e \u003cp\u003eThe professional category of animal owners is a valid indicator of their knowledge. Majority of the respondents had heard about rabies indicating that it is well concerned by the society. The most common sources of information were either friends or neighbors or veterinary offices, while media, schools, hospitals and experiences were also have identified as useful information source. However, contradictory findings were reported in a Thailand study which indicated media as the first and favorite source of information and most followed was YouTube, followed by TikTok, showing the possibility of using them as information sources (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). The findings highlight the potential use of the media to improve rabies awareness in Sri Lanka as well. Around 60% of participants were aware that rabies is a preventable disease and that knowledge is important for making arrangements for rabies prevention. Around 50% of the participants mentioned that the infectious nature of rabies is not known showing the requirement for filling the gap in knowledge. Further, of the total 432 participants in a Indonesian study, 56.9% were aware of the clinical signs of rabies (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Dogs, cats, cows and bats were identified as rabies transmitting animals by 100%, 100%, 26.5%, and 66.5%, respectively and routes of transmission were identified as animal bites, animal scratches, and inhalation of aerosols by 100%, 100% and 21.2%, respectively of the respondents. Significant population of the sample considered annual vaccination of dogs and cats as a preventive method. Posterior distributions in Mshelbwala, (2024) revealed that the probability of dog vaccination was positively associated with the owner\u0026rsquo;s latent knowledge of rabies, civil servant service employment (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eInterestingly, majority of the participants believed that seeking medical advice, having first-aid, checking animal vaccination history, observing animal behavior, having complete course of post-exposure vaccination are important as post exposure prophylaxis measures.\u003c/p\u003e \u003cp\u003eAround 83.2% of the respondents has exposed to dog bites and post exposure prophylaxis. Yet, approximately 7.1% of the respondents have not received any prophylactic treatment, and this is a matter of concern which need the attention of the relevant authorities in order to meet the national target of zero dog-mediated human rabies deaths by 2025.\u003c/p\u003e \u003cp\u003eThe present findings on knowledge, attitudes and practices on rabies among bite victims were satisfactory and showed better results compared to the Chinese study by Li, et al., 2021 which revealed the level of rabies knowledge, attitudes and practice among bite victims in China was suboptimal (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). However, continuation of animal vaccination and rabies awareness programs are recommended. Further, the prevalence data highlights rabies in non-vaccinated domestic animals with a substantial percentage in dogs, although it shows a reduction in total number of positive cases with time.\u003c/p\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eLimitations and future research\u003c/h2\u003e \u003cp\u003eThis study is not without limitations. The data reported by interviewer administered questionnaire may have biasness due to self-reporting. Further, as the data collection period included lock-down periods with movement restrictions for individuals due to Corona virus disease outbreak, there is a possibility to not to receive all the suspected animal samples and bite victims. Future research can be directed see the status of rabies infection in whole country by having representative from all the diagnostic laboratories of Sri Lanka.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe study revealed the prevalence of rabies in non-vaccinated domestic animals with a significant percentage in dogs, although it shows a reduction in total number of positive cases with time. Further, the knowledge, attitudes and practices towards rabies of bite victims were in a satisfactory level. However, the gaps identified in this study will be beneficial in developing targeted educational interventions to uplift the capacity of knowledge, attitudes and practices of the general public, particularly the animal owners to facilitate prevention of rabies that will foster collaboration and guidance with the ultimate goal of improving human and animal health outcomes related to zoonotic diseases.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eNHG\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eNational Hospital Galle\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eFAT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eFluorescent antibody test\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eDFAT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eDirect fluorescent antibody test\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthor contributions:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConceptualization: RMTM Ramanayake\u003c/p\u003e\n\u003cp\u003eMethodology: HH Peiris, AMSS Amarasiri, RMTM Ramanayake\u003c/p\u003e\n\u003cp\u003eFormal analysis and investigation: HH Peiris, AMSS Amarasiri\u003c/p\u003e\n\u003cp\u003eWriting - original draft preparation: RMTM Ramanayake\u003c/p\u003e\n\u003cp\u003eWriting - review and editing: RMTM Ramanayake, HH Peiris, AMSS Amarasiri\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eI would like to acknowledge laboratory staff of rabies diagnostic unit, National Hospital, Galle, Sri Lanka and all the bite victims who participated in this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study adhered to the ethical principles outlined in the Declaration of Helsinki of Research Involving Human Subjects and the ethical approval for the study was received from Ethical review committee, faculty of Allied health sciences, university of Ruhuna, Sri Lanka (ref. No 202.01.2023). Participation in the study was entirely voluntary. Informed consent was obtained from all participants before completing the questionnaire, which included a clear description of the study\u0026rsquo;s objectives and assurances of anonymity and confidentiality.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was not supported by any funds.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Not applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eMshelbwala PP, Weese JS, Sanni-Adeniyi OA, et al. Rabies epidemiology, prevention and control in Nigeria: Scoping progress towards elimination. PLoS neglected tropical diseases. 2021;15(8). e0009617. doi: 10.1371/journal.pntd.0009617.\u003c/li\u003e\n \u003cli\u003eMani RS, Madhusudana SN. Laboratory diagnosis of human rabies: recent advances. Scientific World Journal. 2013;. doi: 10.1155/2013/569712.\u003c/li\u003e\n \u003cli\u003eKanda K, Jayasinghe A, Jayasinghe C, et al. Public health implication towards rabies elimination in Sri Lanka: A systematic review. Acta Tropica. 2021; 223, p.106080.\u003c/li\u003e\n \u003cli\u003eWorld Organization for Animal Health, 2009, Rabies. Available at https://www.woah.org/fileadmin/Home/eng/Publications_\u0026amp;_Documentation/docs/ pdf/rabies.pdf.\u003c/li\u003e\n \u003cli\u003eChen SJ, Rai CI, Wang SC, et al. Infection and Prevention of Rabies Viruses. Microorganisms.2025;9:13(2):380. doi: 10.3390/microorganisms13020380.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eYoung CC, Sellers TF, Laboratory: a New Method for staining Negri Bodies of rabies. Am J Public Health (N Y). 1927;17(10):1080-1. doi: 10.2105/ajph.17.10.1080.\u003c/li\u003e\n \u003cli\u003eSingh R, Singh KP, Cherian S, et al, Rabies - epidemiology, pathogenesis, public health concerns and advances in diagnosis and control: a comprehensive review. Vet Q. 2017;37(1):212 251. doi: 10.1080/01652176.2017.1343516. PMID: 28643547.\u003c/li\u003e\n \u003cli\u003eBourhy H, Cowley JA, Larrous, F., et al, P.J. Phylogenetic relationships among rhabdoviruses inferred using the L polymerase gene. J. Gen. Virol. 2005;86(10), 2849\u0026ndash;2858. doi: 10.1099/vir.0.81128-0.\u003c/li\u003e\n \u003cli\u003eMshelbwala PP, Rupprecht CE, Osinubi MO, et al, Factors influencing canine rabies vaccination among dog-owning households in Nigeria. One Health. 2024;10;18:100751.doi: 10.1016/j.onehlt.2024.100751. PMID: 38827784; PMCID: PMC11141449.\u003c/li\u003e\n \u003cli\u003eMananggit MR, Kimitsuki K, Saito N, et al, Background and descriptive features of rabies-suspected animals in Central Luzon, Philippines. Trop Med Health. 2021;49(1):59. doi: 10.1186/s41182-021-00351-x.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eKularatne SA, Ralapanawa DM, Weerakoon K, et al, Pattern of animal bites and post exposure prophylaxis in rabies: A five year study in a tertiary care unit in Sri Lanka. \u0026nbsp;BMC Infect Dis. 2016;16:62. doi: 10.1186/s12879-016-1394-5.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eLiu C, Cahill JD. Epidemiology of Rabies and Current US Vaccine Guidelines. R I Med J. \u0026nbsp;2020 ;103(6):51-53. PMID: 32752569.\u003c/li\u003e\n \u003cli\u003eYale G, Lopes M, Isloor S, et al, Review of Oral Rabies Vaccination of Dogs and Its Application in India. Viruses. 2022;14;14(1):155. doi: 10.3390/v14010155. PMID: 35062358; PMCID: PMC8777998.\u003c/li\u003e\n \u003cli\u003eLaorujisawat M, Wattanaburanon A, Abdullakasim P, et al, Rabies-Related Knowledge, Attitudes, and Practices Among Primary School Students in Chonburi Province, Thailand. Inquiry. 2022;Jan-Dec;59:469580221087881. doi: 10.1177/00469580221087881.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eRehman S, Rantam FA, Rehman A, Effendi MH, Shehzad A. Knowledge, attitudes, and practices toward rabies in three provinces of Indonesia. Vet World. 2021 Sep;14(9):2518-2526. doi: 10.14202/vetworld.2021.2518-2526. Epub 2021 Sep 25. PMID: 34840473; PMCID: PMC8613781.\u003c/li\u003e\n \u003cli\u003eLi D, Liu Q, Chen F, Jiang Q, et al, Knowledge, attitudes and practices regarding to rabies and its prevention and control among bite victims by suspected rabid animals in China. One Health. 2021;8;13:100264. doi: 10.1016/j.onehlt.2021.100264. PMID: 34036144; PMCID: PMC8135036.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Prevalence, Attitudes, Knowledge, Practices, Rabies, Southern Province","lastPublishedDoi":"10.21203/rs.3.rs-8401902/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8401902/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction: \u003c/strong\u003eRabies is a zoonotic disease of the central nervous system, caused by the neurotropic virus of the genus Lyssavirus of the family Rhabdoviridae. It is considered as one of the dreaded infectious diseases among warm-blooded animals, which progressed into invariably fatal encephalomyelitis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod\u003c/strong\u003e: Data was retrieved from the available records from January 2021 to December 2023 at the rabies diagnostic unit for the assessment of rabies prevalence. A descriptive cross-sectional study was carried out using 113 bite victims attending the rabies diagnostic unit at National Hospital Galle, Sri Lanka from January 2023 to December 2023 using a modified pre-tested interviewer administered questionnaire for the assessment of knowledge, attitudes and practices towards rabies.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: From the total samples received, 48%, 38% and 41% were confirmed positive for rabies by Sellers’ staining and/or direct fluorescent antibody test in year 2021, 2022 and 2023, respectively. The reduction in rabies prevalence from 2021 to 2023 was statistically significant (p\u0026lt;0.05). Majority of the positive cases were of canine in origin and were domesticated animals. More than 90% of the positive cases were from the animals which were non-vaccinated or without a vaccination history. Around 2% of the positive cases were reported from the vaccinated animals. Of the total respondents, 40% were aware that rabies is an infectious disease and 61% knew that it is preventable. All the respondents knew that dogs and cats transmit the disease via bites, scratches and aerosols, however 69% believed the possibility of transmitting the disease by rats. Almost all the participants believed vaccination of dogs/cats as a preventive measure to control rabies and 70% knew that vaccination need to be done annually. The scores of knowledge level, attitudes and practices of respondents were in satisfactory levels and none of the socio-demographic characteristics of respondents’ contributed for the scores significantly.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: This study highlights the prevalence of rabies in non-vaccinated domestic animals with a significant percentage in dogs, although it shows a reduction in total number of positive cases with time. Further, the results revealed satisfactory level of knowledge, attitudes and practices on rabies among the bite victims to the rabies unit.\u003c/p\u003e","manuscriptTitle":"Prevalence, knowledge, attitudes and practices regarding rabies among bite victims: a cross-sectional study at a national hospital, Sri Lanka","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-29 09:17:27","doi":"10.21203/rs.3.rs-8401902/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"cc78e115-2be5-4020-984f-93eb3fececbd","owner":[],"postedDate":"January 29th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-02-26T10:26:29+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-29 09:17:27","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8401902","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8401902","identity":"rs-8401902","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}