To the best of our knowledge, this was the first study to assess the factors influencing rabies protective practices among dog owners in the endemic region of Sarawak. The findings could help policymakers develop more effective community-based education programmes to reduce the incidence of rabies in both dogs and humans.
This study found that most dog owners in the southern zone of Sarawak had a generally good knowledge of rabies disease (54.2%). Rabies may be more common in the areas where the respondents live, which might explain why they have a high degree of awareness of the disease. This aligns with prior studies from Addis Ababa, Ethiopia (1), and India (12) that discovered lower percentages of respondents with good knowledge, at 83% and 68.7%, respectively. However, higher percentages from the other research found excellent understanding in 100% and 98% of respondents in Zuria, Ethiopia (15), and Gujarat, India (22). Possible disparities in the research domains are to blame for the disparity. Dog owners from both urban and rural areas participated in this research. This population is more likely to be well-informed about animal health issues in their neighbourhood because of better communication and information dissemination channels, such as word-of-mouth, social media, the widespread dog vaccination campaign, and any information gathered during visits to the vet for services like vaccination and treatments.
It was known by most respondents that rabies might be spread by many animals, including dogs. Additionally, most respondents were aware that rabies can be transmitted by dog bites. Consistent with other research in Haiti (9) and India (23), about 57.6% of respondents knew that dog bites may transmit rabies to humans. Even though only 39% of the respondents thought that rabies signs were easy to see in dogs, 90% knew that the disease is almost invariably fatal in humans, and 64% understood the same for dogs. Results from studies conducted in Sri Lanka (17) and Tanzania (20) showed that most people were aware that clinical human rabies may be lethal (63–78.8%). Given that rabies cannot be effectively treated once it has reached a clinical stage (19), it is evident that most of our respondents were well-informed about the severity of rabies. There must be a greater effort to raise awareness about rabies via community engagements, radio and television broadcasts, and other means to increase understanding of the disease and its symptoms in the community.
In addition, more than half of the total respondents, 150 (50.8%), displayed a positive attitude towards rabies. This finding is slightly lower than that of earlier research, which found that 56.2% of people had a positive attitude towards rabies (10). The community seems to have a higher chance of putting control measures into action if the relevant authorities make every effort to do so. Since the efficacy of most traditional treatments is unknown, 36.6% of the respondents strongly doubted that they work. Generally, people in the community are aware of the severity of the disease and the availability of modern medical treatments. Despite this good information, some respondents were still seeking traditional treatments; therefore, raising public awareness is essential to seek more up-to-date medical treatment (2). Most of the respondents (36%) would kill a dog if they thought it had rabies. This confirms what has been reported in the past from Ethiopia (47.7%) (27) and India (42%) (10). Hence, to rule out rabies, such a dog should be isolated and watched for 10 days (28). Over 80% of respondents would seek medical treatment if they were bitten by a dog, and over 25% of respondents thought that post-exposure prophylaxis would be efficient in preventing rabies. This aligns with research conducted in Gelephu, central-southern Bhutan (22).
Notably, the study showed that sociodemographic characteristics such as gender, education level, and residence place significantly impact knowledge and attitude towards rabies (p < 0.05). Interestingly, male dog owners are more likely to possess sufficient knowledge than female dog owners, according to a statistically significant disparity in knowledge ratings between the sexes. Previous reports have been confirmed by this outcome (10). Besides that, those who have completed some levels of formal education are more informed about rabies than those who have not. Consistent with other findings, this one found that people with greater levels of education were more likely to possess sufficient knowledge (4). Those with more education may be better able to access health education resources and comprehend the effects of the condition. The study results also indicate that people living in urban regions are more likely to exhibit good knowledge about rabies than those living in rural areas. A related study found that people living in cities were more knowledgeable about rabies than those living in rural areas and that this knowledge translated into distinct attitudes and protective practices that might help reduce the transmission of the disease (17). Perhaps this is because urban districts tend to have better health education services and a generally greater level of education among their residents. Thus, this research indicates that dog owners should be better educated on rabies to change their mindset and practices in the fight against the disease.
Furthermore, more than half of the dog owners (57.6%) who participated in the study demonstrated good rabies protective practices. This is slightly lower compared to earlier estimates in Mekelle town, Ethiopia, where 61.3% of dog owners demonstrated good rabies protective practices (10) and in other African countries like Nigeria (74%) (8). Respondents in the study were chosen from both urban and rural areas, which may explain why their rabies protective practices score was lower than in prior studies. For example, in Mekelle, Ethiopia, the study participants were all from urban areas. According to a previous study, pet care practices are better in urban settings than rural ones. Considering that rabies is a disease that may be avoided with vaccination, most of the respondents strongly agreed to have their dogs vaccinated this year and in the next 12 months. Moreover, most of the respondents strongly agreed to have their dog vaccinated, even if it required them to pay some payment fees, even though the vaccination centre was far from their house. This aligns with the beliefs and stance of the World Health Organisation and the Organisation for Animals (OIE), which assert that rabies vaccination is the best and most economical way to protect humans and eradicate the disease from canines. The use of PEP in treating dog bites is minimised, and the number of fatalities caused by rabies is decreased by the vaccination of dogs (28). In the event of a bite, almost 60% of the respondents knew what to do regarding first aid. The results were the same in Tanzania (20) and India (21), with percentages of 5% and 43.17%, respectively. A few respondents showed little understanding of how to treat dog bite wounds by covering them with bandages or salt. Applying irritants such as chilli powder, plant juices, acids, or alkalis to a bite wound is prohibited (25). Prevention of human rabies fatality may be achieved with the following measures: cleaning the bite wound with soap and water, administering a post-exposure rabies vaccination, and infiltrating the bite wound with rabies immunoglobulin (26).
Therefore, the study's results highlight the significance of rabies protective practices among dog owners in the southern zone of Sarawak in the fight against rabies. Rabies protective practices among dog owners were significantly correlated with the level of knowledge (p < 0.001) and attitude level (p < 0.002). Specifically, most dog owners with good knowledge and a positive attitude towards rabies disease exhibited higher scores for rabies protective practices. Hence, this research emphasised that protective practices regarding rabies management were impacted by their level of knowledge and attitude towards the disease. This agrees with what Mascie-Taylor and others have found (16).
This study has several limitations. As the study only covered one part of Sarawak, the southern zone, which is endemic to rabies, its results may not apply to the rest of the state or even Malaysia. Nonetheless, it did provide statistics for that part of Sarawak, which is densely populated. Besides that, in the study, we refrained from checking dog owners' vaccination certificates, and thus, we suggest that future studies consider checking for dog owners' vaccination certificates since doing so would have provided additional evidence to support the owners' self-reports about their dogs' immunisation status, as this would have improved the research overall. In addition, the lack of serology findings limits the study's applicability, and hence, we suggest that future studies consider having serology data with the stated vaccination status of local canines, as this will greatly improve the study's overall quality, eliminate bias, and fill in the information gap.
Launching rabies vaccination and education programmes in other parts of the country is essential to properly managing and controlling the disease nationwide. Rabies education initiatives should also prioritise reaching illiterate populations, especially in rural areas. Enhancing rabies surveillance systems is equally critical to helping achieve the worldwide goal of zero human fatalities from dog-mediated rabies by 2030.