Rabies: Knowledge and Practices Regarding Rabies in Rural Communities of the Brazilian Amazon Basin.

BACKGROUND:The occurrence of outbreaks of human rabies transmitted by Desmodus rotundus in Brazil in 2004 and 2005 reinforced the need for further research into this zoonosis. Studies of knowledge and practices related to the disease will help to define strategies for the avoidance of new cases, through the identification of gaps that may affect the preventive practices. METHODOLOGY/PRINCIPAL FINDINGS:A semi-structured questionnaire was applied to 681 residents of twelve communities of northeastern Pará state involved in the 2004 and 2005 outbreaks mentioned above. The objective was to evaluate the local knowledge and practices related to the disease. We found a highly significant difference (p<0.0001) in the knowledge of rabies among education levels, indicating that education is a primary determinant of knowledge on this disease. More than half of the respondents (63%) recognized the seriousness of the zoonosis, and 50% were aware of the importance of bats for its transmission, although few individuals (11%) were familiar with the symptoms, and only 40% knew methods of prevention. Even so, 70% of pet owners maintained their animals vaccinated, and 52% of the respondents bitten by bats had received post-exposure vaccination. Most of the respondents (57%) reported being familiarized with rabies through informal discussions, and only a few (23%) mentioned public health agents as the source of their information. CONCLUSION/SIGNIFICANCE:We identified many gaps in the knowledge and practices of the respondents regarding rabies. This may be the result of the reduced participation of public health agents in the transfer of details about the disease. The lack of knowledge may be a direct determinant in the occurrence of new outbreaks. Given these findings, there is a clear need for specific educational initiatives involving the local population and the public health entities, with the primary aim of contributing to the prevention of rabies

Knowledge of the transmission routes and prevention measures for rabies presented by the respondents residents of the RR communities (communities where cases of human rabies transmitted by <i>D</i>. <i>rotundus</i> were recorded, n = 445) and NR communities (No human rabies recorded, n = 236) on the Brazilian Amazon coast.

<p>Knowledge of the transmission routes and prevention measures for rabies presented by the respondents residents of the RR communities (communities where cases of human rabies transmitted by <i>D</i>. <i>rotundus</i> were recorded, n = 445) and NR communities (No human rabies recorded, n = 236) on the Brazilian Amazon coast.</p

Knowledge of the symptoms of rabies in humans and non-humans in the respondents residents of the RR communities (communities where cases of human rabies transmitted by <i>D</i>. <i>rotundus</i> were recorded) on the Brazilian Amazon coast (n = 445).

<p>Knowledge of the symptoms of rabies in humans and non-humans in the respondents residents of the RR communities (communities where cases of human rabies transmitted by <i>D</i>. <i>rotundus</i> were recorded) on the Brazilian Amazon coast (n = 445).</p

Map of Brazil (A), showing the three states that make up the Brazilian Amazon coast (B), the three municipalities included in the study area (C), and better visualization of communities 10, 9, 8, 7 (D).

<p>Communities in which no cases of human rabies had been recorded (white dots): 1- Treme, 2- Benjamin Constant, 3- Bacanga, 4-Vila Soares, 5- Açaiteua, 6- Serra do Piriá. Communities in which cases of rabies had been recorded (black dots): 7- Araí, 8- Cachoeira, 9- Porto do Campo, 10- Piçarrera, 11- Firmiana, 12- Curupaiti.</p

Results of the logistic regression (Logit) for the residents of RR communities (communities where cases of human rabies transmitted by <i>D</i>. <i>rotundus</i> were recorded) and NR communities (No human rabies recorded) on the Brazilian Amazon coast in relation to measures of prevention of rabies transmitted by <i>Desmodus rotundus</i>.

<p>Results of the logistic regression (Logit) for the residents of RR communities (communities where cases of human rabies transmitted by <i>D</i>. <i>rotundus</i> were recorded) and NR communities (No human rabies recorded) on the Brazilian Amazon coast in relation to measures of prevention of rabies transmitted by <i>Desmodus rotundus</i>.</p

Sources of information on <i>D</i>. <i>rotundus-</i>transmitted human rabies reported by respondents residents of RR communities (communities where cases of human rabies transmitted by <i>D</i>. <i>rotundus</i> were recorded; n = 445) and NR communities (No human rabies recorded; n = 236) communities on the Brazilian Amazon coast.

<p>Sources of information on <i>D</i>. <i>rotundus-</i>transmitted human rabies reported by respondents residents of RR communities (communities where cases of human rabies transmitted by <i>D</i>. <i>rotundus</i> were recorded; n = 445) and NR communities (No human rabies recorded; n = 236) communities on the Brazilian Amazon coast.</p

Living conditions in the rural areas of the Brazilian Amazon coast.

<p>A—wattle and daub house; B–timber house; C—brick house; D—arrangement of houses in a village; E—proximity of the houses to the edge of the forest; F—proximity of the corral (right) to the landowner’s house (left).</p

Perception of rabies in respondents from communities on the Brazilian Amazon coast where cases of human rabies transmitted by <i>D</i>. <i>rotundus</i> have been recorded (RR) and where no cases have been recorded (NR), classified by sex.

<p>Perception of rabies in respondents from communities on the Brazilian Amazon coast where cases of human rabies transmitted by <i>D</i>. <i>rotundus</i> have been recorded (RR) and where no cases have been recorded (NR), classified by sex.</p