Socio-demographic and economic factors
A total of 633 household heads were interviewed in this research, which yields a response rate of 100%. More than half 357 (56.6%) of the interviewed participants were females. Regarding age group, the age of the respondents range from 19 to 80 with a mean age of 42.3 ± 13.8 and the majority 271 (42.8%) of participants age were between 36-55 years old (Table 1).
Table 1: Socio-demographic and economic factors of respondents towards rabies among household heads in Mekelle city, Northern Ethiopia, 2016.
Variables
|
Frequency
|
%
|
Age
|
|
|
15-35
|
239
|
37.8
|
36-55
|
271
|
42.8
|
56-75
|
116
|
18.3
|
>75
|
7
|
1.1
|
Sex
|
|
|
Male
|
276
|
43.4
|
Female
|
357
|
56.6
|
Ethnicity
|
|
|
Tigre
|
576
|
91
|
Amahara
|
78
|
9
|
Marital status
|
|
|
Married
|
365
|
57.7
|
Unmarried
|
116
|
18.3
|
Divorced
|
92
|
14.5
|
Widowed
|
60
|
9.5
|
Educational status
|
|
|
Do not read and write
|
45
|
7.1
|
Read and write
|
89
|
14.1
|
Primary school complete
|
188
|
29.7
|
Secondary school complete
|
162
|
25.6
|
Higher education
|
149
|
23.5
|
Religion
|
|
|
Orthodox-Christian
|
540
|
85.3
|
Muslim
|
78
|
12.3
|
Catholic
|
15
|
2.4
|
Occupation
|
|
|
Government employee
|
140
|
22.1
|
Private employee
|
130
|
20.5
|
Merchant
|
133
|
21
|
House wife
|
88
|
13.9
|
Farmer
|
26
|
4.1
|
Student
|
39
|
6.2
|
Unemployed
|
77
|
12.2
|
Household size
|
|
|
1-3
|
327
|
51.7
|
4-6
|
264
|
41.7
|
>6
|
42
|
6.6
|
Average monthly income in birr
|
|
|
<1000
|
165
|
26
|
1000-2000
|
187
|
29.5
|
>2000
|
281
|
44.5
|
Access to health information and Environmental factors towards rabies
Among the study participants, about 267 (42.2%) of respondents heard information regarding rabies from informal sources, such as traditional healers, neighbors, friends, schools and relatives and 107 (17%) of study participants heard from formal (Radio/TV, newspaper and Books/magazines) (Table 2).
Table2: Access to health information and Environmental factors towards rabies among household heads in Mekelle city, Northern Ethiopia, 2016
Variables
|
Frequency
|
%
|
Dog ownership
|
|
|
Yes
|
256
|
40.4
|
No
|
377
|
59.6
|
Family exposure to dog bite
|
|
|
Yes
|
89
|
14.1
|
No
|
544
|
85.9
|
Has get training/awareness about rabies
|
|
|
Yes
|
208
|
32.9
|
No
|
425
|
67.1
|
Source of information about rabies
|
|
|
Formal (News paper, TV/radio)
|
107
|
17
|
Informal
|
267
|
42.2
|
Mixed Source
|
187
|
30
|
Governmental rabies vaccine campaigns
|
54
|
9
|
Main reservoir/source of rabies
|
|
|
Dog
|
624
|
98.6
|
Cat
|
147
|
23.2
|
Other domestic animals
|
160
|
24.5
|
|
|
|
Household heads knowledge, attitude and practice about rabies in Mekelle city
Twenty three questions (8 knowledge, 7 attitude and 8 practice) were asked for each respondent regarding cause, sources and mode of transmissions, attitude, practice and prevention and control measures about rabies. The questions were in a type of a response of either choosing the correct answer (had got one mark) or wrong answer (had got zero mark) for each question. The number of questions for which the respondent gave correct responses was counted and scored. This score was then pooled together and the mean score was computed to determine knowledge, attitude and practice of respondents. Respondents who score greater than or equal to the mean value (Mean=5.5, SD=1.96) grouped to good knowledge and less than the mean value poor knowledge level, respondents who score greater than or equal to the mean value (Mean=4.6, SD=1.36) grouped to positive attitude and less than the mean value negative attitude level, respondents who score greater than or equal to the mean value (Mean=1.9, SD=1.6) grouped to good practice and less than the mean value poor practice level.
Knowledge of participants towards rabies
This study revealed that 555(87.8%) of respondents had heard information about rabies (Table 3). About 470 (74.2%) of respondents said that rabies affect all warm blooded animals including human, 423 (66.8%) of participants said that dog rabies vaccine could be obtained from authorized governmental institutions (Table 3).
Table 3: Computed knowledge variables of participants to ward rabies among household heads in Mekelle city, Northern Ethiopia, 2016 (n=633)
Variables
|
Frequency
|
%
|
Heard about rabies disease
|
|
|
Yes
|
555
|
87.7
|
No
|
78
|
12.3
|
Rabies affect all warm blooded animals including human
|
|
|
Yes
|
470
|
74.2
|
No
|
163
|
25.8
|
Dog rabies vaccine could be obtained from governmental institutions
|
|
|
Yes
|
423
|
66.8
|
No
|
210
|
33.2
|
Rabies prevented by vaccination
|
|
|
Yes
|
442
|
69.8
|
No
|
178
|
28.1
|
I don't know
|
13
|
2.1
|
Rabies treated by Post Exposure Prophylaxis
|
|
|
Yes
|
428
|
67.6
|
No
|
184
|
29.1
|
I don't know
|
21
|
3.3
|
Almost 100% fatal nature of rabies
|
|
|
Yes
|
289
|
45.7
|
No
|
344
|
54.3
|
Wash dog bite wounds with soap and water
|
|
|
Yes
|
382
|
60.3
|
No
|
251
|
39.7
|
Your family are at risk of getting rabies if the dog is not vaccinated
|
|
|
Yes
|
507
|
80.1
|
No
|
126
|
19.9
|
Attitude towards rabies
This study revealed that 525 (82.9%) of respondents said that stray dogs are dangerous and 360 (56.9%) were willing to register their pets. About 536 (84.7%) of respondents were annoyed with stray dogs. Majority 557 (88%) were said rabies prevented by health education and 315 (49.8%) respondents believed holly water cure rabies (Table 4).
Table 4: Computed attitudes toward rabies among household heads in Mekelle city, Northern Ethiopia, 2016 (n=633)
Variables
|
Frequency
|
%
|
Stray dogs are dangerous
|
|
|
Yes
|
525
|
82.9
|
No
|
108
|
17.1
|
Rabies is a problem in your kebelle
|
|
|
Yes
|
244
|
38.5
|
No
|
389
|
61.5
|
Holly water can treat rabies disease
|
|
|
Yes
|
315
|
49.8
|
No
|
318
|
50.2
|
Rabies can be effectively prevented by killing stray dogs
|
|
|
Yes
|
394
|
62.2
|
No
|
239
|
37.8
|
Rabies prevented by educating people
|
|
|
Yes
|
557
|
88
|
No
|
76
|
12
|
Willing to register pets
|
|
|
Yes
|
360
|
56.9
|
No
|
273
|
43.1
|
Annoyed with stray dogs
|
|
|
Yes
|
536
|
84.7
|
No
|
97
|
15.3
|
Practice of participants towards rabies
This study showed that, 383 (60.5%) of participants have contact with dogs and cats and 351 (60.5%) participants have hand washing habit after touching dogs and cats(Table 5). Among 89 respondents who had ever been bitten by a dog or who had a family member ever bitten by a dogs, only 69 (77.5%) went to health institution after bite as followed by 11 (12.3%) went to holly water (Table 5).
Table 5: Computed practice variables toward rabies among household heads in Mekelle city, Ethiopia, 2016
Variables
|
Frequency
|
%
|
Your family members touch dogs and cats
|
|
|
Yes
|
383
|
60.5
|
No
|
250
|
39.5
|
Your family members wash their hands after touching the dog, cat
|
|
|
Yes
|
351
|
55.5
|
No
|
282
|
44.5
|
Would you inform authorities if you were bitten by dog
|
|
|
Yes
|
82
|
92.2
|
No
|
7
|
7.8
|
Vaccinated your dog
|
|
|
Yes
|
195
|
79.3
|
No
|
51
|
20.7
|
Do you have dog vaccination certificate of your dog
|
|
|
Yes
|
151
|
77.4
|
No
|
44
|
22.6
|
Ever been bitten by a dog
|
|
|
Yes
|
89
|
14.1
|
No
|
544
|
85.9
|
When you get bit where did you go first
|
|
|
Stay at home
|
0
|
0
|
To health institution
|
69
|
77.5
|
To holly water
|
11
|
12.4
|
To traditional Healers
|
9
|
10.1
|
Measure taken to control stray dogs
|
|
|
Aware the owner
|
45
|
18.3
|
Killing
|
81
|
32.9
|
Animal birth control
|
14
|
5.7
|
Incarceration
|
106
|
43.1
|
Care your dog on
|
|
|
Housed in cages
|
179
|
72.8
|
Tied outside the house
|
38
|
15.4
|
Free living inside the house
|
21
|
8.5
|
Free to roam around
|
8
|
3.3
|
Knowledge, Attitude and Practice related to rabies
According to the study 56.1% (95%CI=52.2, 59.9), 56.2% (95%CI=52.4, 60.1) and 61.3% (95%CI=57.5, 65.1) of participants had good knowledge, positive attitude and good practice towards rabies respectively, as shown in figure 2.
Figure 2: Knowledge, attitude and practice towards rabies among household heads in Mekelle city, Northern Ethiopia
Factors associated with knowledge
Variables including sex, occupation, dog ownership, training, monthly income, educational status and exposed family to dog bite with p-value less than 0.2 in bivariate analysis were entered in to multivariable binary logistic regression analysis model (Table 6).
The multivariable analysis result of this study declared that sex, occupation, dog ownership, training and monthly income had statistically significant association with knowledge about rabies at 5% level of significance.
Table 6: Factors associated with knowledge towards rabies among household heads in Mekelle city, Northern Ethiopia, 2016 (n=633)
Variables
|
Knowledge
|
COR 95% CI
|
AOR 95% CI
|
good n(%)
|
poor n(%)
|
Sex
|
Male
|
140(50.7%)
|
136(49.3%)
|
1
|
1
|
Female
|
215(60.2%)
|
142(39.8%)
|
1.47(1.07, 2.02)
|
1.50(1.05, 2.13)*
|
Educational status
|
Not read & write
|
22(48.9%)
|
23(51.1%)
|
1
|
1
|
Read & write
|
41(46.1%)
|
48(53.9%)
|
0.89(0.44, 1.83)
|
1.09(0.50, 2.41)
|
Primary
|
103(54.8%)
|
85(45.2%)
|
1.27(0.66, 2.43)
|
1.57(0.75, 3.27)
|
Secondary
|
99(61.1%)
|
63(38.9%)
|
1.64(0.85, 3.19)
|
1.98(0.93, 4.22)
|
Higher education
|
90(60.4%)
|
59(39.6%)
|
1.60(0.82, 3.12)
|
1.77(0.81, 3.86)
|
Occupation
|
Government employee
|
86(61.4%)
|
54(38.6%)
|
1.81(1.03, 3.18)
|
1.96(1.03, 3.73)*
|
Private employee
|
76(58.5%)
|
54(41.5%)
|
1.60(0.91, 2.83)
|
1.39(0.75, 2.60)
|
Merchant
|
73(54.9%)
|
60(45.1%)
|
1.39(0.79, 2.43)
|
1.38(0.74, 2.56)
|
House wife
|
50(56.8%)
|
38(43.2%)
|
1.50(0.81, 2.77)
|
1.37(0.71, 2.64)
|
Farmer
|
10(38.5%)
|
16(61.5%)
|
0.71(0.29, 1.76)
|
0.77(0.29, 2.00)
|
Student
|
24(61.5%)
|
15(38.5%)
|
1.82(0.83, 4.00)
|
1.36(0.58, 3.19)
|
Unemployed
|
36(46.8%)
|
41(53.2%)
|
1
|
1
|
Average monthly income birr
|
<1000
|
99(60%)
|
66(40%)
|
1
|
1
|
1001-2000
|
94(50.3%)
|
93(49.7%)
|
0.67(0.44, 1.03)
|
0.61(0.38, 0.96)*
|
>2000
|
162(57.7)
|
119(42.3%)
|
0.91(0.61, 1.34)
|
0.64(0.41, 1.02)
|
Dog ownership
|
Yes
|
164(64.1%)
|
92(35.9%)
|
1.74(1.25, 2.40)
|
1.68(1.17, 2.41)*
|
No
|
191(50.7%)
|
186(49.3)
|
1
|
1
|
Exposure fam. to dog bite
|
Yes
|
61(68.5%)
|
28(31.5%)
|
1.85(1.15, 2.99)
|
1.56(0.92, 2.65)
|
No
|
294(54%)
|
250(46%)
|
1
|
1
|
Training/awareness rabies
|
Yes
|
145(69.7%)
|
63(30.3%)
|
2.36(1.66, 3.35)
|
2.22(1.53, 3.21)*
|
No
|
210(49.4)
|
215(50.6%)
|
1
|
1
|
Note: Superscript indicates statistical significance *p-value < 0.05
Factors associated with attitude
Variables including marital status, educational status, household size, dog ownership, exposure family to dog bite, monthly income and knowledge with p-value less than 0.2 in bivariate analysis were entered in to multivariable binary logistic regression analysis model (Table 7).
The multivariable analysis result of this study declared that marital status(married) educational status, household size, dog ownership and family exposure to dog bite had statistically significant association with attitude about rabies at 5% level of significance (Table 7).
Table 7: Factors associated with attitude towards rabies among household heads in Mekelle city, Northern Ethiopia, 2016 (n=633)
Variables
|
Attitude
|
COR 95% CI
|
AOR 95% CI
|
positive
|
negative
|
Marital status
|
Married
|
215(58.9%)
|
150(41.1%)
|
1.43(0.83, 2.48)
|
2.19(1.16, 4.16)*
|
Unmarried
|
53(45.7%)
|
63(54.3%)
|
0.84(0.45, 1.57)
|
1.46(0.70, 3.02)
|
Divorced
|
58(63%)
|
34(37%)
|
1.71(0.88, 3.30)
|
2.70(1.27, 5.75)*
|
Windowed
|
30(50%)
|
30(50%)
|
1
|
1
|
Educational status
|
Not read & write
|
33(73.3%)
|
12(26.7%)
|
1
|
1
|
Read & write
|
57(64%)
|
32(36%)
|
0.65(0.29, 1.43)
|
0.90(0.37, 2.19)
|
Primary
|
123(65.4%)
|
65(34.5%)
|
0.69(0.33, 1.42)
|
0.83(0.36, 1.90)
|
Secondary
|
85(52.5%)
|
77(47.5%)
|
0.40(0.19, 0.83)
|
0.42(0.18, 0.97)*
|
Higher education
|
58(38.9%)
|
91(61.1%)
|
0.23(0.11, 0.49)
|
0.27(0.12, 0.65)*
|
Average monthly income birr
|
<_1000
|
100(60.6%)
|
65(39.4%)
|
1
|
1
|
1001-2000
|
114(61%)
|
73(39%)
|
1.02(0.66, 1.56)
|
1.19(0.73, 1.93)
|
>2000
|
142(50.5%)
|
139(49.5%)
|
0.66(0.45, 0.98)
|
0.82(0.52, 1.33)
|
House hold size
|
1-3
|
191(58.4%)
|
136(41.6%)
|
1.87(0.98, 3.59)
|
3.22(1.51, 6.90)*
|
4-6
|
147(55.7%)
|
117(44.3%)
|
1.68(0.87, 3.22)
|
2.70(1.26, 5.78)*
|
>6
|
18(42.9%)
|
24(57.1%)
|
1
|
1
|
Dog ownership
|
Yes
|
182(71.1%)
|
74(28.9%)
|
2.87(2.05, 4.02)
|
2.64(1.80, 3.86)*
|
No
|
174(46.2%)
|
203(53.8%)
|
1
|
1
|
Exposure fam. to dog bite
|
Yes
|
69(77.5%)
|
20(22.5%)
|
3.09(1.83, 5.23)
|
2.24(1.23, 4.10)*
|
No
|
287(52.8%)
|
257(47.2%)
|
1
|
1
|
Knowledge
|
Good
|
141(50.7%)
|
137(49.3%)
|
1.49(1.09, 2.05)
|
1.42(0.99, 2.03)
|
Poor
|
215(60.6%)
|
140(39.4%)
|
1
|
1
|
Note: Superscript indicates statistical significance *p-value < 0.05
Factors associated with practice
Variables including marital status, educational status, age, household size, knowledge, attitude, dog ownership and family exposure to dog bite with p-value less than 0.2 in bivariate analysis were entered in to multivariable binary logistic regression analysis model (Table 8).
The multivariable analysis result of this study declared that dog ownership and exposure family to dog bite had statistically significant association with practice about rabies at 5% level of significance (Table 8).
According to this study, educational status, age, household size, knowledge and attitude were not significantly associated with practice about rabies in the multivariable analysis (Table 8).
Table 8: Factors associated with practice towards rabies among household heads in Mekelle city, Northern Ethiopia, 2016 (n=633)
Variables
|
Practice
|
COR 95% CI
|
AOR 95% CI
|
good
|
poor
|
Educational status
|
Not read & write
|
33(73.3%)
|
12(26.7%)
|
1
|
1
|
Read & write
|
52(58.4%)
|
37(41.6%)
|
0.51(0.23, 1.12)
|
0.69(0.27, 1.76)
|
Primary
|
113(60.1%)
|
75(39.9%)
|
0.55(0.27, 1.13)
|
0.45(0.19, 1.15)
|
Secondary
|
107(66%)
|
55(34%)
|
0.71(0.34, 1.48)
|
0.70(0.28, 1.76)
|
Higher education
|
83(55.7%)
|
66(44.3%)
|
0.46(0.22, 0.95)
|
0.54(0.22, 1.38)
|
Age
|
18-35
|
149(62.3%)
|
90(37.7%)
|
0.28(0.03, 2.33)
|
0.61(0.05, 6.86)
|
36-55
|
169(62.4%)
|
102(37.6%)
|
0.28(0.30, 2.33)
|
0.45(0.04, 4.97)
|
56-75
|
64(55.2%)
|
52(44.8%)
|
0.21(0.02, 1.76)
|
0.29(0.26, 3.27)
|
>75
|
6(85.7%)
|
1(14.3%)
|
1
|
1
|
House hold size
|
1-3
|
193(59%)
|
134(41%)
|
0.45(0.21, 0.95)
|
0.55(0.22, 1.39)
|
4-6
|
163(61.7%)
|
101(38.3%)
|
0.50(0.24, 1.07)
|
0.60(0.24, 1.52)
|
>6
|
32(76.2%)
|
10(23.8%)
|
1
|
1
|
Dog ownership
|
Yes
|
233(91%)
|
23(9%)
|
14.5(9.02, 23.3)
|
11.8(7.16, 19.6)*
|
No
|
155(41.1%)
|
222(58.9%)
|
1
|
1
|
Exposure fam. to dog bite
|
Yes
|
83(93.3%)
|
6(6.7%)
|
10.8(4.65, 25.3)
|
5.25(2.09, 13.2)*
|
No
|
305(56.1%)
|
239(43.9%)
|
1
|
1
|
knowledge
|
Good
|
152(54.7%)
|
126(45.3%)
|
1.64(1.19, 2.27)
|
1.20(0.81, 1.79)
|
Poor
|
236(66.5%)
|
119(33.5%)
|
1
|
1
|
Attitude
|
Positive
|
142(51.3%)
|
135(48.7%)
|
2.13(1.54, 2.95)
|
1.35(0.91, 2.01)
|
Negative
|
246(69.1%)
|
110(30.9%)
|
1
|
1
|
Note: Superscript indicates statistical significance *p-value < 0.05