AWARENESS, KNOWLEDGE, AND ATTITUDES ON RABIES AND PRIOR RABIES PREVENTIONS AMONG ADULTS LIVING ALONG THE BHUTAN–INDIA BORDER

Abstract

Background: Rabies is an almost universally fatal but entirely vaccine-preventable zoonotic disease, most commonly transmitted through dog bites. In Bhutan, rabies remains endemic in the southern districts along the porous Bhutan-India border due to free roaming dog populations and high human mobility. Objective: To assess the awareness, knowledge, and attitude on rabies and prior rabies preventions among adults aged 18 years or older living along the Bhutan-Indian border. Methods: A community-based, cross-sectional study was performed in seven high-risk rabies border districts. Participants were selected exploiting a multistage sampling method. Data were gathered through interviews managing a structured questionnaire. Factor analysis and descriptive statistical analyses were performed. Results: Among 728 participants, 69% had high level of overall awareness of which nearly all reported having heard of rabies (95%), followed by transmitted from animals to humans (92%), and rabies can be prevented (89%). High knowledge level in rabies prevention (68.0%) was higher than in cause of rabies (63.9%) and sign & symptom (57.3%), respectively. Standardized scores of awareness and attitude were higher than knowledge scores. Of 164 having history of dog bites in previous 12 months (22.5%), they reported that bite from unvaccinated animals (54.9%), washed bite wounds (76.8%), received PEP 69.6% with completed treatment (67.1%), and use traditional treatments (2.4%). Conclusion: Although awareness, attitudes, and access to care were generally good, rabies knowledge remained inadequate, with predominantly poor prevention practices among individuals with prior animal bites, underscoring the need for targeted education and prevention policies.