Assessing the impact of public education on a preventable zoonotic disease: rabies

Responsible ownership and health education can reduce the time of sporotrichosis treatment in domestic cats

Sporotrichosis is a widespread fungal infection that affects skin and subcutaneous tissues in humans and animals. In cats, it is displayed as nodules, ulcers and lesions on the nasal and respiratory mucosa. Antifungal treatment of cats is crucial but many cases are difficult, thus resulting in discontinue of the treatment, with disastrous consequences for the animal, encouraging contamination of the environment, other animals and people. The effects of responsible ownership education and health education for owners of cats with feline sporotrichosis as well as the interval between veterinary consultations on treatment outcomes for three groups of owners and their pet cats were evaluated in this study. The responsible ownership education and health education strategies consisted in videos in easy and accessible language for people with any level of education and were presented during consultations for two of the three groups included. The time between appointments was two weeks for two of the groups, and four weeks for one of the groups. The median of treatment time for the group without educational activities was 138 days, while for the other two groups it was 77.5 days and 86 days. It was found a significative reduction in the treatment time in the groups exposed to Responsible ownership education videos. There was no contamination of those responsible for home treatment, and the interval between monthly appointments did not impact on cure or death rates compared to the interval between fortnightly appointments. All these results can be applied to feline sporotrichoses treatment protocols increasing the owners treatment adherence and reducing either, the treatment discontinuation and the treatment costs and helps to control zoonotic sporotrichosis. The importance of attractive and comprehensible educational strategies as part of the feline sporotrichosis treatment protocol for the promotion of one health was highlighted.

Risk mapping and risk factors analysis of rabies in livestock in Bangladesh using national-level passive surveillance data

Rabies is a major zoonotic disease around the world, causing significant mortality to both humans and animals, especially in low- and middle-income countries. In Bangladesh, rabies is transmitted mostly by the bite of infected dogs and jackals to humans and domestic livestock, causing severe economic losses and public health hazards. Our study analyzed national passive surveillance data of veterinary hospital-reported rabies cases in cattle, buffalo, sheep, and goats from 2015 to 2017 in all 64 districts of Bangladesh. We used a zero-inflated negative binomial regression model to identify the main environmental and socio-economic risk factors associated with rabies occurrence in livestock, and we used model results to generate risk maps. Our study revealed that monsoon precipitation (RR=1.28, p-value=0.043) was positively associated with rabies cases in livestock, and the percentage of adults who have completed university education was also a significant predictor (RR=0.58, p-value<0.001) likely suggesting that districts with higher education levels tended to have a lower reporting of rabies cases in livestock. The standardized incidence ratio maps and predicted relative risk maps revealed a high risk of rabies cases in southeast areas in Bangladesh. We recommend implementing risk-based vaccination strategies in dogs and jackals in those high-risk areas before monsoon to reduce the burden of rabies cases in domestic ruminants and humans in Bangladesh.

Health Status of the Eastern Grey Squirrel (Sciurus carolinensis) Population in Umbria: Results of the LIFE Project 'U-SAVEREDS'

Simple Summary

Invasive alien species are non-native species introduced deliberately or unintentionally beyond their past or present natural distribution, and their introduction and spread threatens local biological diversity. The Eastern grey squirrel is native to North America and was introduced to the British Islands, Italy, and South Africa. Around the year 2000, a new population of grey squirrels was recorded in Perugia, central Italy, where the species populated an area of approximately 50 km², both in woodland and urban areas. The Eastern grey squirrel represents a huge threat to the conservation of the native Eurasian red squirrel when the two species coexist. Moreover, given their confident behaviour with humans, the non-native squirrels can negatively impact public health. The U-SAVEREDS Project was set up for Eurasian red squirrel conservation in Umbria through the eradication of the alien species and it also provided information on the health status of the Eastern grey squirrel to identify any infectious agents. The recovery of zoonotic pathogens allowed to assess the Eastern grey squirrel’s impact on human and domestic and wild animals’ health, provide helpful feedback for the management and eradication procedures, and raise public awareness through environmental education.

Abstract

The introduction of the Eastern grey squirrel (Sciurus carolinensis) in Europe is one of the best-known cases of invasive alien species (IAS) colonisation, that poses a severe risk to the conservation of biodiversity. In 2003, it was released in a private wildlife park near the city of Perugia (Italy), where it is replacing the native Eurasian red squirrel (Sciurus vulgaris). The LIFE13 BIO/IT/000204 Project (U-SAVEREDS) was set up for the Sciurus vulgaris conservation in Umbria through an eradication campaign of grey squirrels. One hundred and fifty-four animals were analysed for bacteriological, mycological, virological, and serological investigations (C4 action). Sanitary screening showed that Sciurus carolinensis is a dermatophyte carrier, and therefore, it could cause public health issues for humans, considering its confident behaviour. Moreover, it has been marginally responsible for the spreading of Candida albicans, Coxiella burnetii, and Borrelia lusitaniae. Health status evaluation conducted on the Sciurus carolinensis population indicated that it is necessary to raise awareness of its impacts on biodiversity and human health. Moreover, the health status and behaviours of the IAS must be considered when control or eradication campaigns are planned.

COVID-19 Disease and Vaccination: Knowledge, Fears, Perceptions and Feelings of Regret for Not Having Been Vaccinated among Hospitalized Greek Patients Suffering SARS-CoV-2 Infection

Background: The development of vaccines against COVID-19 has greatly altered the natural course of this infection, reducing the disease’s severity and patients’ hospitalization. However, hesitancy against vaccination remains an obstacle in the attempt to achieve appropriate herd immunity that could reduce the spread of SARS-CoV-2. The aim of this study was to investigate the perceptions and attitudes of COVID-19 patients hospitalized during the fourth pandemic wave in two Greek hospitals and assess whether their experience had changed their intentions regarding vaccination against COVID-19. Methods: This is a cross-sectional, questionnaire-based survey, conducted from 31 August 2021 to 18 February 2022 in the COVID-19 departments of two tertiary care hospitals. The questionnaire included questions regarding the patients’ educational level, knowledge and beliefs regarding SARS-CoV-2, personal protection measures, beliefs regarding vaccination, vaccination status, reasons for not been vaccinated against SARS-CoV-2, feelings of regret for not been vaccinated, and willingness to be vaccinated in the future. All adult patients with COVID-19 were eligible, regardless of their vaccination status against SARS-CoV-2. Results: In total, 162 patients agreed and participated in the study, with 97% of them suffering severe COVID-19. Their median age was 56 years, and 59.9% (97 patients) were male. Among them, 43.8% had been vaccinated against COVID-19. When unvaccinated patients were asked the reasons for not being vaccinated, the most frequent responses were that they were waiting for more scientific data, due to uncertainty about long-term consequences of the vaccine, and their fear of thrombosis. When at discharge, unvaccinated hospitalized COVID-19 patients were asked whether they would get vaccinated if they could turn time back, and 64.7% of them replied positively. Conclusions: The study reveals several patients’ fears and misconceptions and suggests that there is room for implementing measures that could reduce knowledge gaps allowing for improvement of vaccination rates against COVID-19.

Designing a rabies control mobile application for a community-based rabies surveillance system during the COVID-19 pandemic in Bali, Indonesia

Background and Aim: Rabies remains a public health concern in Indonesia, and the coronavirus disease (COVID-19) pandemic has stymied rabies prevention and control efforts. There is a need to transform the rabies program to be adaptable to pandemic situations to improve program coverage on dog vaccination and rabies surveillance. This study aimed to create a rabies control (RaCon) mobile application for a community-based rabies surveillance system during COVID-19 in Bali, Indonesia. Materials and Methods: We employ the Design Science Research methodology. Surveillance officers, veterinarians, community leaders, outreach workers, and dog owners participated in a series of offline in-depth interviews and focus group discussions. The RaCon prototype was evaluated using the Post-Study System Usability Questionnaire (PSSUQ) framework, which included the system's usefulness, information quality, and interface quality. In this study, we used both a qualitative (n=50) and quantitative (n=342) approach. Results: According to the findings of this study, integrating public health and animal health into the rabies surveillance system are critical to supporting the One Health approach and encouraging community engagement in rabies programs. The RaCon prototype is expected to include features such as pet ownership, case report, news and announcements, nearest vet, health information, outbreak radar, emergency call, and app feedback. The RaCon prototype passed both qualitative and quantitative evaluations, indicating that it could be used to support the rabies surveillance system, particularly in the COVID-19 situation. Conclusion: The RaCon prototype was accepted by the users and got positive feedback in terms of the system's usefulness, information quality, and interface quality dimension. As a result, this prototype has the potential to be integrated into the rabies surveillance system in Bali, particularly to strengthen the community-based rabies surveillance system. Even though this prototype received positive feedback, this study focuses solely on the design development and evaluation of its user interface. As a result, further development is required before incorporating RaCon into the rabies prevention and control program.

Knowledge, attitudes, practices (KAP) and control of rabies among community households and health practitioners at the human-wildlife interface in Limpopo National Park, Massingir District, Mozambique

Background

Rabies is a viral zoonotic disease that kills more than 26,000 people each year in Africa. In Mozambique, poverty and inadequate surveillance result in gross underreporting and ineffective control of the disease in animals and people. Little is known of the role of human attitudes and behaviour in prevention or control of rabies, thus this study was undertaken to assess the knowledge, attitudes and practices amongst selected households and health practitioners in one affected area, the Limpopo National Park (LNP), Massingir district.

Methodology

A cross-sectional study was conducted among 233 households in eight villages in LNP and among 42 health practitioners from eight health facilities in Massingir district between 2016 and 2018. Consenting household representatives aged 18 years or over were purposively selected. A KAP survey was administered to obtain information on dog ownership and knowledge of rabies, host species affected, modes of transmission, symptoms, recommended treatment and preventive methods.

Similar to household study participants, health practitioners were purposively selected and completed the questionnaire during the investigators’ visit. The questionnaire sought information on knowledge of rabies, management of bite wounds, vaccination sites and schedules of pre- and post-exposure prophylaxis. Descriptive and inferential data analyses were performed using SPSS software version 18.0.

Results

Approximately twenty per cent (18.9%; 95% CI: 14.3–24.3) and 13.3% (95% CI: 9.4–18.1) of households had good knowledge and practices of rabies, respectively. For health practitioners, only 16.7% (95% CI: 7.5–31.9) had good knowledge, whilst 33.3% (95% CI: 20.0–49.7) adopted adequate attitudes/practices towards the disease.

Conclusions/Significance

In conclusion, both households and health practitioners displayed poor levels of knowledge and adopted bad attitudes and practices towards rabies. The former, had more gaps in their attitudes and practices towards the disease. Village location and education level (P < .05) and similarly, sex and occupation, were found to be statistically associated with good knowledge of rabies among households as compared to HPs. Overall, a lack of community-based education and professional retraining courses contribute significantly to poor awareness of rabies in the LNP of Mozambique. Enhancing public health knowledge should consequently reduce dog-mediated human rabies deaths in this country.

In Mozambique, rabies is maintained primarily by the domestic dog, the principal vector and host species responsible for the majority of human cases dating back to the early 1900s. Control of animal rabies has historically been undertaken by government veterinary authorities, with limited involvement of the health and environment sectors. In the Massingir District in general, and in Limpopo National Park (LNP) in particular, parenteral dog rabies mass-vaccination campaigns and the provision of post-exposure prophylaxis are inconsistent. Limited resources for dog vaccination campaigns, insufficient veterinary field staff, inefficient disease notification procedures and inadequate training of health practitioners constraint effective rabies control across the country. Awareness of good practices regarding management of bite wounds among local community members and health practitioners is crucial to reducing rabies deaths. The results obtained in this study will inform government policy on practical interventions in the control of dog and human rabies.

Improving the knowledge of high school students about zoonotic diseases from pets in Medellín-Colombia

Background and Aim: The "One Health" concept is a global strategy that recognizes that public health is related to animal health and the environment; however, the role of domestic animals and their involvement in the transmission of zoonoses is often underestimated. The aim of the study was to evaluate and improve the knowledge about zoonotic diseases of domestic animals in high school students from Medellín, Colombia. Materials and Methods: A quasi-experimental intra-subject study was carried out. This study was conducted with 11th-grade students from four schools in Medellín, Colombia. A structured multiple-choice questionnaire was used from March 2021 to May 2021. The research had two phases, first, "naive" knowledge and learning. Then, descriptive, association, and comparative analysis were carried out using absolute and relative frequencies, Pearson's Chi-square test, and MacNemar's test with a value of p<0.05 considered statistically significant. Results: A research poll from 315 students of four private schools found that feeding their pets with raw food and leftovers cooked for human consumption were common practices; the results also show a lack of knowledge of their pets' immunization deworming status. It was understood that when the students were able to identify at least two symptoms of zoonoses, one route of its' transmission and two preventive measures, we found that only 12.49% of the polled students had proper knowledge of the disease in domestic animals. After conducting an educational strategy, the findings show a general increase in knowledge, leading us to accept that the academic approach was adequate to statistically increase the recognition of symptoms, routes of transmission and preventive measures (p=0.00). Conclusion: The use of the theoretical lecture is effective to improve the understanding of the concept of transmission of diseases from animals to humans; in addition, the results show an increase of knowledge in high school students of the related symptoms, transmission routes, and preventive measures of zoonoses diseases in the region.

Descriptive study of cattle and dog rabies cases in the Sheki-Zagatala region of Azerbaijan (2015-2016): Knowledge, attitudes, and practices of people towards rabies

Every year, rabies causes great damage to human health and the economy of countries around the world. This neurotropic and zoonotic viral disease is endemic to Azerbaijan. This study describes cattle and dog rabies cases identified between 2015 and 2016. In addition, a questionnaire was administered to 100 respondents comprised of case owners, and non-case animal owners, to assess knowledge, attitudes, and practices within this population. The study demonstrates a general lack of knowledge of rabies in the participating communities. The majority of respondents were familiar with rabies and understood that animal bites are a source of transmission. However, many respondents did not know that rabies is preventable and admitted not knowing additional routes of transmission. In addition, there was less perceived risk with contact with animal saliva. Despite free vaccinations in Azerbaijan, only 27 out of 45 dogs in this study were vaccinated. Although educational programming and preventive vaccination of dogs has been implemented, and significant progress has been made in the sphere of epidemiological surveillance and prevention, rabies cases remain problematic in the Sheki-Zagatala region. Regular educational programs for communities, strengthening of the existing vaccination programs, and a comprehensive epidemiological case-control study to identify the disease risk factors could help reduce the burden of rabies in Azerbaijan.

The effectiveness of community-led initiatives in livestock disease control: a case of African swine fever in rural areas of Uganda

Proper implementation of biosecurity is currently the only control measure of African swine fever (ASF) in the absence of an effective vaccine or drug against the disease. Despite the efforts that Uganda's local and central governments have invested to reduce livestock diseases, ASF outbreaks still persist in the country. In this study, we assessed the effectiveness of community-led initiatives in the control of ASF in Mukono District, central Uganda. In Mukono district, a community-led pilot program was initiated where stakeholders in the pig value chain organized themselves into an ASF control task force to enforce on-farm and pig value chain activities intended to limit the spread of ASF. Semi-structured interviews with pig famers (n = 211) were conducted in two areas with contrasting practices: one with active community-initiated and monitored ASF control initiatives since 2016 (Kasawo and Namuganga) and the other without such initiative as the control (Mpunge and Ntenjeru). A significant decline (Wilcoxon ranked sign test: Z =  - 5.412, p = 0.000) in the annual frequency of ASF outbreaks in both Kasawo and Namuganga sub-counties was observed after the implementation of community-led initiatives. The level of practice of most ASF control measures was significantly higher (p < 0.01) in sub-counties that instituted community-led ASF control initiatives than in the control sub-counties. The results of this study demonstrate the power of community-led initiatives in reducing ASF disease outbreaks in endemic areas.

The Impact of Socioeconomic Factors on Knowledge, Attitudes, and Practices of Dog Owners on Dog Rabies Control in Thailand

Rabies is a deadly zoonotic disease responsible for almost 60,000 deaths each year, especially in Africa and Asia including Thailand. Dogs are the major reservoirs for rabies virus in these settings. This study thus used the concept of knowledge, attitudes, and practices (KAP) to identify socioeconomic factors that contribute to the differences in the canine rabies occurrences in high and low-risk areas which were classified by a Generalized Additive Model (GAM). Multistage sampling was then applied to designate the study locations and a KAP-based questionnaire was used to retrieve data and relevant perspectives from the respondents. Based on the responses from 476 participants living across four regions of Thailand, we found that the knowledge of the participants was positively correlated with their behaviors but negatively associated with the attitudes. Participants who are male, younger, educated at the level of middle to high school, or raising more dogs are likely to have negative attitudes but good knowledge on rabies prevention and control whereas farmers with lower income had better attitudes regardless of their knowledge. We found that people in a lower socioeconomic status with a lack of knowledge are not willing to pay at a higher vaccine price. Public education is a key to change dog owners' behaviors. Related authorities should constantly educate people on how to prevent and control rabies in their communities. Our findings should be applicable to other countries with similar socioeconomic statuses.

Supporting control programs on African swine fever in Ukraine through a knowledge, attitudes, and practices survey targeting backyard farmers

A Knowledge, Attitudes, and Practices (KAP) questionnaire was designed to collect information on farmers' knowledge of ASF and their practices surrounding that could impact the spread of the disease. The questionnaire was distributed, and data collected, from 233 backyard farmers from five selected Oblasts (Rivne, Kharkiv, Odessa, Zakarpattia and Kiev). Kruskal-Wallis tests were conducted to identify factors that could influence knowledge, and Dunn tests were performed to determine differences between groups when the Kruskal-Wallis tests were significant. Spearman tests were carried out to explore the association between knowledge and risky practices. Results show that comprehensive knowledge on ASF is not common in backyard farmers and that risky practices that influence the spread of ASF are regularly performed. Of the respondents, 47% felt well-informed about how ASF can be transmitted and 31.8% felt confident about recognizing clinical signs of ASF. The independent variable "Oblast" was identified as a significant factor (p = 0.0015) associated with differences in knowledge on clinical signs. We demonstrated statistically significant differences of knowledge between backyard farmers from different Oblasts. Knowledge of preventive measures was positively correlated with risky handling practices related to edible pork products (p = 0.0053) and non-edible pork products (p = 0.0417). In conclusion, our results show that backyard farmers have knowledge gaps on ASF and practice various risky behaviours that might favour the spread of the disease in Ukraine. There are regional differences in ASF knowledge and risky practices that should be taken into consideration in future evidence-based ASF prevention and control programs, including public awareness activities.

Rift Valley fever knowledge, mitigation strategies and communication preferences among male and female livestock farmers in Eastern Province, Rwanda

The Government of Rwanda reported an outbreak of Rift Valley fever (RVF) in the Eastern Province in 2018. To respond to the outbreak, vaccination and education campaigns about the disease were carried out. Because RVF cases continue to be detected in Rwanda and the disease impacts livelihoods and health, accurate knowledge and communication are imperative. The objectives of this study were to evaluate knowledge and risk perceptions of RVF transmission among livestock farmers in Nyagatare District, Eastern Province, Rwanda, and to compare RVF knowledge, risk perceptions, and farming practices between male and female livestock farmers. This cross-sectional, quantitative study was conducted in selected sectors of Nyagatare District in the Eastern Province of Rwanda in June 2019. A 34-question survey was used to ask about demographics, livestock ownership, risk perceptions about zoonotic diseases and livestock management, RVF knowledge, preferred communication sources and information sharing strategies, and protective strategies for RVF mitigation while working with livestock. Livestock farmers were interviewed at three milk collection centers, two village meeting points, a farm cooperative meeting, and during door-to-door visits in villages. In total, 123 livestock farmers were interviewed. The survey found that most livestock farmers lacked knowledge about epizootic and zoonotic transmission of RVF, more male livestock farmers were familiar with RVF and risk mitigation strategies, and female livestock farmers are not viewed as reliable sources of information. Additionally, most livestock farmers had not vaccinated their animals against RVF despite past vaccination campaigns. Radio was the most popular communication channel. These findings show that RVF knowledge and information sharing are inadequate among livestock farmers in Eastern Province. Therefore, vaccination and education campaigns may need to be reevaluated within the context of these trends in order to prepare for future RVF outbreaks.

This study was conducted in order to evaluate RVF knowledge and awareness as well as communication and mitigation strategies among livestock farmers in Eastern Province, Rwanda. Rwanda declared an outbreak of RVF in 2018 and cases have continued to be detected. Thus, evaluating the status of knowledge, preventive strategies, and information sharing among livestock farmers is crucial in mitigating future outbreaks. Our team conducted a survey of knowledge, risk perceptions, mitigation strategies, and communication practices among livestock farmers from selected sectors within Nyagatare District and compared them between male and female livestock farmers in order to analyze gender-nuanced differences between these groups. Sectors were chosen for sampling based on their proximity to previous outbreak areas. Survey questionnaire results showed that knowledge and risk perceptions differed between male and female livestock farmers, and that they could be generally improved among all livestock farmers. Female livestock farmers and non-farming community members were viewed as unreliable sources of information which could impact information dissemination. Many farmers also reported that their livestock herds were not vaccinated for the disease despite previous vaccination campaigns. Communication strategies and information sources also differed between male and female livestock farmers, which highlights a need to consider gender in improving RVF vaccination and education campaign coverage. These findings pose implications for future community-based public health interventions as well as policy development for RVF control and mitigating future RVF outbreaks within Rwanda.

COVID-19, media coverage of bats and related Web searches: a turning point for bat conservation?

SARS‐CoV‐2, the virus that caused the COVID‐19 pandemic, is genomically similar to a SARS‐like beta‐coronavirus found in Asian rhinolophid bats. This evolutionary relationship impressed the global media, which then emphasised bats as key actors in the spillover that resulted in the pandemic. In this study, we highlight changes in the traditional and new media coverage of bats and in Internet search volumes that occurred since the beginning of the COVID‐19 pandemic in 2020.

We analysed Google and Wikipedia searches for bats and coronaviruses in 21 countries and eight languages, as well as television broadcasts in the USA, some of which have global coverage, between January 2016 and December 2020. In January 2020, the amount of television news about bats boomed, and news associated with the term ‘bat’ shifted to COVID‐19‐related topics. A nearly identical pattern was observed in Google searches during 2020 at the global scale. The daily time series of television coverage and Internet search volumes on bats and coronavirus in the USA covaried in the first quarter of 2020, in line with the existence of a media bubble. Time‐series analysis revealed that both the Google Trends index and visits to Wikipedia pages about bats boomed in early 2020, despite the fact that this time of year is usually characterised by low search volumes.

Media coverage emphasised, correctly or not, the role of bats in the COVID‐19 pandemic and amplified public interest in bats worldwide. The public image of these mammals, in many cases threatened and important ecosystem service providers, was seriously compromised. We therefore recommend that policymakers and journalists prioritise scientifically accurate communication campaigns about bats, which would help counteract the surge in bat persecution, and leverage interest towards positive human–bat interactions.

Knowledge, attitude, and practices to zoonotic disease risks from livestock birth products among smallholder communities in Ethiopia

Many causes of abortion in livestock are due to zoonotic pathogens that pose serious infection risks for humans. Carefully designed, empirical One Health research allows to untangle the complexity around these risks and guides the development of practical health education guidelines and best prevention practices for veterinary public health interventions. To support this, the study presented here aimed at understanding knowledge, attitudes, and practices (KAP) on zoonotic risks from livestock birth products among rural communities in Ethiopia. From July 2018 to February 2019, a cross-sectional study design was conducted with 327 randomly selected farmers and pastoralists in five districts in three regions in Ethiopia. The structured questionnaire consisted of 48 items to evaluate knowledge (24), attitude (9), and prevention practices (15) related to zoonotic diseases risks from livestock birth products. A unidimensional two-parameter logistic (2-PL) Item Response Theory (IRT) model was used for zoonotic disease risk KAP scale construction and evaluation. The 2-PL IRT model was fitted to determine the probability of a person to appropriately respond to an item with a provided zoonotic disease KAP level. We then examined differential item functioning (DIF) concerning to five important covariates. The attitude subscale had the highest total mean score (37.3, ± 28.92%) and the knowledge subscale had the lowest mean score (22.4, ± 33.6%) among the three subscales. The mixed model regression analysis indicated that region was the only apparent factor explaining differences in zoonotic diseases knowledge, attitude, and practice total mean scores. The knowledge and attitude subscales had good internal consistency with a Cronbach's α at 0.83 and 0.81, respectively, whereas the practice subscale had lower internal consistency with 0.51. There was a positive association between responding to knowledge questions correctly and a positive attitude (r2 = 0.44, p < 0.0001) and self-reported good practice (r2 = 0.307, p < 0.0001). The differential item functioning test showed that 19 of 37 (51.35%) and 12 of 37 (32.43%) items of the retained KAPs survey items had non-uniform and uniform DIF linked to at least one covariate respectively and all the covariates were related with DIF in at least one item. This study found substantial knowledge gaps, a low level of the desired attitude, and high-risk behavioural practices regarding zoonotic disease from livestock birth products. Consequently, livestock keepers are likely exposed to pathogens and thus these practices are an important contributing factor for zoonotic disease infection in people.

Mathematical modelling and phylodynamics for the study of dog rabies dynamics and control: A scoping review

BACKGROUND

Rabies is a fatal yet vaccine-preventable disease. In the last two decades, domestic dog populations have been shown to constitute the predominant reservoir of rabies in developing countries, causing 99% of human rabies cases. Despite substantial control efforts, dog rabies is still widely endemic and is spreading across previously rabies-free areas. Developing a detailed understanding of dog rabies dynamics and the impact of vaccination is essential to optimize existing control strategies and developing new ones. In this scoping review, we aimed at disentangling the respective contributions of mathematical models and phylodynamic approaches to advancing the understanding of rabies dynamics and control in domestic dog populations. We also addressed the methodological limitations of both approaches and the remaining issues related to studying rabies spread and how this could be applied to rabies control.

METHODOLOGY/PRINCIPAL FINDINGS

We reviewed how mathematical modelling of disease dynamics and phylodynamics have been developed and used to characterize dog rabies dynamics and control. Through a detailed search of the PubMed, Web of Science, and Scopus databases, we identified a total of n = 59 relevant studies using mathematical models (n = 30), phylodynamic inference (n = 22) and interdisciplinary approaches (n = 7). We found that despite often relying on scarce rabies epidemiological data, mathematical models investigated multiple aspects of rabies dynamics and control. These models confirmed the overwhelming efficacy of massive dog vaccination campaigns in all settings and unraveled the role of dog population structure and frequent introductions in dog rabies maintenance. Phylodynamic approaches successfully disentangled the evolutionary and environmental determinants of rabies dispersal and consistently reported support for the role of reintroduction events and human-mediated transportation over long distances in the maintenance of rabies in endemic areas. Potential biases in data collection still need to be properly accounted for in most of these analyses. Finally, interdisciplinary studies were determined to provide the most comprehensive assessments through hypothesis generation and testing. They also represent new avenues, especially concerning the reconstruction of local transmission chains or clusters through data integration.

CONCLUSIONS/SIGNIFICANCE

Despite advances in rabies knowledge, substantial uncertainty remains regarding the mechanisms of local spread, the role of wildlife in dog rabies maintenance, and the impact of community behavior on the efficacy of control strategies including vaccination of dogs. Future integrative approaches that use phylodynamic analyses and mechanistic models within a single framework could take full advantage of not only viral sequences but also additional epidemiological information as well as dog ecology data to refine our understanding of rabies spread and control. This would represent a significant improvement on past studies and a promising opportunity for canine rabies research in the frame of the One Health concept that aims to achieve better public health outcomes through cross-sector collaboration.

Wildlife-pet markets in a one-health context

Background and Aim: Wildlife markets are centers of trade involving live animals and their derivatives from wild-caught and captive-bred non-domesticated animals, including for the culinary, fashion, traditional medicine, curio, and pet sectors. These markets occur in Southeast Asia, India, North America, Latin America, Europe, Africa, and elsewhere. This study aims to address a diversity of related issues that have a one-health bearing while focusing on wildlife markets in relation to the pet trade. Across relevant regions and countries, all major animal classes are traded at wildlife-pet markets. Wildlife markets, in general, are considered distinct from so-called "wet markets" at which domesticated animals, fish, and other "seafood" are offered only for consumption. Several aspects of wildlife markets have attracted scientific and popular scrutiny, including animal welfare concerns, species conservation threats, legality, ecological alteration, introduction of invasive alien species, presence of undescribed species, and public and agricultural animal health issues. Materials and Methods: Onsite inspections were conducted for markets in the United States, Spain, Germany, The Netherlands, and the UK, as well as observational research of visual imagery of market conditions, and we compared these conditions with evidence-based standards for animal welfare and public health management. Results: Wildlife markets globally shared common similar structures and practices including the presence of sick, injured, or stressed animals; mixing of animals of uncertain origin and health state; and no specific or any hygiene protocols, with issues of animal welfare, public health and safety, agricultural animal health, and other one-health concerns being inherently involved. Conclusion: We conclude that wildlife markets are incompatible with responsible standards and practices, and we recommend that such events are banned globally to ameliorate inherent major problems.

Knowledge and Perception of Rabies among School Children in Rabies Endemic Areas of South Bhutan

Rabies is endemic in southern Bhutan and children are the frequent victims of dog bites. We surveyed the knowledge, attitude, and practices on rabies among school children in three schools located in southern Bhutan. A total of 701 students (57.9% female, 42.1% male) with an age range of 12–21 years (mean: 15 years) participated in the survey, of which 98.2% had heard about rabies. Most of the students demonstrated a good level of knowledge (59.7%) and a favorable perception towards rabies (57.7%). Multivariable logistic analysis revealed the relation between knowledge and the awareness campaign (OR:1.5, 95% CI: 1.1–2.1). Similarly, higher grades of students (OR:1.9, 95%CI: 1.3–2.9) and employed mothers of the students (OR: 1.6, 95% CI: 1.0–2.7) were associated with more favorable perceptions. However, some knowledge gaps were identified in this study, such as students not being able to clearly mention the susceptible hosts of rabies, transmission routes, clinical signs, and prevention and control options. Therefore, regular awareness programs on rabies are necessary among school children in Bhutan.

Human Behaviour Change Interventions in Animal Care and Interactive Settings: A Review and Framework for Design and Evaluation

Simple Summary

In many cases, to improve animal welfare, we must change the behaviour of the people who manage them, care for them, and interact with them. This can be achieved through behaviour change interventions. In this review, we aimed to explore the current state of the behaviour change literature in animal care and interactive settings. We identified significant deficiencies in the design, evaluation, and reporting of these interventions. It was often unclear what behaviours were targeted, how the intervention was designed to work, what was in it, and how it was delivered. Without this information, interventions cannot be rigorously evaluated, built upon by others, or implemented in other settings. Transparent reporting and a structured approach to the design and evaluation of interventions is now required to help the field move forward in a more consistent and robust way. We present such a framework, the “Ten-Task” guide, based on the intervention mapping framework, and demonstrate how its adoption would help progress this field substantially.

Abstract

Behaviour change interventions may be one of the most promising avenues to improve animal welfare. Yet there has been limited systematic research involving them in animal-related settings. We searched three major databases for studies involving an intervention to change interactive or care-related behaviours in any animal-related setting. Forty-seven papers were included in the review and each paper was coded for specific design and evaluation elements. We found a series of limitations in the quality and consistency of intervention design, evaluation, and reporting. Hence, we present a framework, the “Ten-Task” guide, based on the intervention mapping framework, to guide future work in this field. Adopting this structured approach will improve the quality and efficacy of behaviour change interventions for animal welfare and allow for the field to progress in a harmonious way.

One-health approach: A best possible way to control rabies

More than 75% of emerging infectious diseases and 60% of known human infectious diseases are transmitted from animals. Among these zoonoses, rabies is of utmost public health significance due to its lethality. The multi-faceted nature of zoonotic disease complicates control and prevention and thus, a multi-sectoral One Health Approach could be a better strategy to cope with rabies. Up until now, rabies prevention and control programs are conducted utilizing mass vaccination of domestic and community dogs and cats, and mass awareness programs. However, the burden of rabies has not been reduced as these approaches have failed to include all stakeholders (human, animal, and environmental health sectors) in disease management programs. The aim of this review is to highlight why and how One Health Approach would be the most effective way to control rabies in low- and middle-income countries (LMICs) like Nepal.

Public Interest in Preventive Measures of Coronavirus Disease 2019 Associated With Timely Issuance of Statewide Stay-at-Home Orders

Introduction:

One method of monitoring public preparedness is through measuring public interest in preventive measures. The objective of this study was to analyze public interest in the coronavirus disease 2019 (COVID-19) preventive measures and to identify variables associated with timely stay-at-home (SAH) orders issued by governors.

Methods:

State-level search volume was collected from Google Trends. Average preventive measure interest was calculated for the query terms “hand sanitizer,” “hand washing,” “social distancing,” and “COVID testing.” We then calculated the delay in statewide SAH orders from March 1, 2020, to the date of issuance and by-state presidential voting percentage. Bivariate correlations were computed to assess the relationship between interest in preventive measures and SAH order delay.

Results:

The correlation between average preventive measure interest and length of time before the SAH order was placed was −0.47. Average preventive measure interest was also inversely related to voting for a Republican presidential nominee in the 2016 election (R = −0.75), the latter of which was positively associated with longer delays in SAH orders (R = 0.48).

Conclusions:

States with greater public interest in COVID-19 preventive measures were inversely related to governor issuance of timely SAH orders. Increasing public interest in preventive measures may slow the spread of the virus that causes COVID-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), by improving preparedness.

Brucellosis in the Middle East: Current situation and a pathway forward

Brucellosis is a bacterial endemic zoonotic disease of global significance with detrimental impacts on public health and food animal production. It is caused by Brucella spp., an expanding group of pathogens able to infect various host species. Bovines and small ruminants, which excrete the bacteria in milk and in reproductive discharges, are major sources of infection for humans and other animals. Contact with contaminated animals and consumption of unpasteurized dairy products are the main routes for human infection. In spite of the considerable progress of knowledge gained and success achieved in brucellosis control in the developed world, this disease continues to be an important burden in the Middle East (ME). Common risk factors implicated in the difficulty and complexity of brucellosis control within the region include (1) social and political instabilities; (2) insufficient resources and infrastructure for appropriate diagnosis, reporting, and implementation of control measures; (3) variation of livestock husbandry systems and their commingling with other livestock and wildlife; and (4) traditional cultural practices, including consumption of unpasteurized dairy products. Development of core interdisciplinary competencies is required for a true One Health–based endeavor against the disease. National awareness and educational programs addressing all population sectors from consumers to decision-makers seem to be the next logical, sustainable, and economically viable approach toward improving disease status in this region. In the present review, we describe the current situation of brucellosis in the ME, focusing on the major limitations and shortcomings regarding disease control. We propose a regional approach toward public awareness of brucellosis as the first step in mitigating the disease and discuss the potential benefits, and components of such a strategy, which can further be used as a model for other endemic zoonotic diseases.

Implementation of a mass canine rabies vaccination campaign in both rural and urban regions in southern Malawi

Rabies is a devastating zoonotic disease causing nearly 60,000 deaths globally each year. The disease causes Malawi an economic loss of 13 million USD and kills almost 500 people annually. Domestic dogs are the main reservoir for rabies and vaccinating over 70% of the dog population is the most efficient method to reduce its incidence in both humans and canines. However, achieving such coverages is often difficult and depend on many geospatial factors. Rural and pastoral regions are considered difficult to vaccinate efficiently due to low dog densities, and reports of campaigns spanning large areas containing vastly different communities are lacking. This study describes a mass canine vaccination campaign covering rural and urban regions in southern Malawi. The campaign achieved an average vaccination coverage of 83.4% across 3 districts, and vaccinated over 89,000 dogs through a combined static point and door-to-door effort. A dog population of 107,574 dogs was estimated (dog:human ratio of 1:23). The canine population was found to be almost completely owned (99.2%) and mostly kept for security purposes (82.7%). The dogs were mainly adults, males, and not neutered. Regression analysis identified education level and proportion of young dogs as the only factors influencing (positively and negatively, respectively) whether vaccination coverage over 70% was achieved in a region, independently of variables such as population density or poverty. A second regression analysis was performed predicting absolute vaccination coverage. While education level and the proportion of confined dogs were associated with positive vaccination coverage, higher proportions of young animals and female dogs were associated with a decrease in coverage. This study confirms the feasibility of homogeneously vaccinating over 70% of the dogs in a large area including rural and urban communities. These findings can inform the logistics of future campaigns and might be used as a template to facilitate high-number, high-coverage vaccination campaigns to other regions in sub-Saharan Africa.

Impact of Integrating Rabies Education Into the Curriculum of Public Elementary Schools in Ilocos Norte, Philippines on Rabies Knowledge, and Animal Bite Incidence

As part of a province wide rabies elimination program, rabies specific information was integrated into the curriculum of all public elementary schools in Ilocos Norte, Philippines using a specifically developed teachers' manual. The rabies educational messages included rabies, animal bite prevention, bite management and responsible pet ownership and were integrated into lessons in several subjects. Four elementary schools were randomly selected and an assessment of the change in student's rabies knowledge and animal bite incidence were conducted. The study tested all students in grades 1-5 before the curriculum integration was implemented and retested these cohorts 1 year later, after implementation. Awareness of rabies was high before the implementation, likely due to the province-wide elimination campaign. However, awareness still increased significantly across all schools, and detailed knowledge of rabies increased significantly in all but one school and age cohort. Bite incidence in the 6 months prior to each survey was also recorded and the percentage of students suffering animal bites fell significantly between the two tests. The data suggested that knowledge increase correlated with decreased bite incidence in some groups but not all, suggesting a more complex relationship between knowledge acquisition and behavioral change which warrants further investigation.

Human rabies post exposure prophylaxis at the Pasteur Institute of Dakar, Senegal: trends and risk factors

BACKGROUND

Rabies remains a major public health problem in developing countries. Most fatal rabies cases, especially in children, result from dog bites and occur in low-income countries, such as those in Sub-Saharan Africa. Rabies can be controlled through mass dog vaccination and human deaths prevented through timely and appropriate post-exposure prophylaxis (PEP). As access to appropriate PEP remains a serious challenge for bite-victims, the aim of this study was to understand the use of PEP, to evaluate the knowledge, attitudes and practices with respect to rabies and to identify risk factors related to non-compliance with PEP to define recommendations for improving PEP in Senegal.

METHODS

This study included patients with suspicion of rabies exposure who sought PEP at the Pasteur Institute of Dakar from April 2013 to March 2014. Patients with rabies clinical symptoms, those who had already started PEP and those with exposure outside Senegal or for more than 3 months were excluded. Data on risk factors and propensity to seek and complete PEP were collected using questionnaires and phone interviews. The association between acceptability and compliance with PEP and other independent variables were evaluated using multivariate regression analysis.

RESULTS

Among the 905 patients enrolled into the study, 67% were male (sex ratio M/F, 2) and 46%, children under 15 years of age. Exposures by animal bites represented 87%, whereas the remainder were due to scratches or contact; 76% were classified as WHO category III and 88% were due to dogs. Among these patients, 7% refused to start PEP and 54.5% completed the full schedule. Main factors reported by non-compliant patients were vaccine costs and affordability, and knowledge on status of biting animal.

CONCLUSION

This study shows that despite the awareness about rabies dangers and prevention, only half of the patients completed the full PEP schedule. The following recommendations, such as free of charge prophylaxis or intradermal regimens as an alternative to intramuscular regimens, should be considered to increase the adherence to PEP at the Pasteur Institute of Dakar and in Senegal.