Awareness of rabies prevention and control measures among public health workers in Northern Vietnam.

ABSTRACT

OBJECTIVES: To assess and compare rabies related knowledge and awareness of public health workers at provincial and district levels in the seven provinces with the highest number of deaths from human rabies in northern Vietnam. STUDY DESIGN: A cross-sectional study. METHOD: A survey was administered to a convenience sample of public health workers attending four workshops on rabies disease, control and prevention between 16 October and 21 November, 2012. Total knowledge scores (maximum 38 points) were categorized into 'high' (>30 points) 'moderate' (21-30) and 'low' (<21). The Chi-square test was used to evaluate the statistical significance of the differences in responses between the respondents. RESULTS: Of the 105 public health workers attending the workshops 57% were male; 76% worked at the district level compared with 24% who worked at provincial level; and 45% had worked in rabies control for <1 year compared with 11% who had worked in rabies control for >5 years. Overall knowledge was patchy and ranked as 'moderate'. Important gaps in knowledge were identified particularly in relation to indications for rabies vaccine and rabies immunoglobulin, and routes of exposure to rabies virus. One in ten respondents did not know that rabies virus could be transmitted by the bite of an infected animal. When examining the overall mean knowledge scores, marginally significant differences were identified. The average scores for district level health workers (DLHW) and provincial level health workers (PLHW) were 28 ± 3 and 29 ± 3 points respectively (p = 0.098), which fell within the study definition of 'moderate' knowledge. In contrast, when 'high' knowledge scores were compared, a significantly greater proportion of PLHW achieved >30 points compared to DLHW (44.0% vs 22.5%, p = 0.044). CONCLUSIONS: Important gaps in knowledge and awareness of public health workers were identified particularly in relation to routes of exposure to rabies virus and indications for rabies vaccine and rabies immunoglobulin. Overall, comparison of knowledge scores revealed significant differences between district and provincial public health workers. The results obtained suggest that in order for rabies control programmes to succeed public health workers at all levels need to have accurate and evidence-based knowledge. This may be facilitated by improving the quantity and quality of their training and education.