Household survey on owned dog population and rabies knowledge in selected municipalities in Bulacan, Philippines: A cross-sectional study

Background Despite the effort to eradicate rabies in the Philippines, human rabies cases have not decreased in the past decade. Rabid dogs pose the most significant hazard in the countries with the highest burden of rabies, and 70% rabies vaccine coverage is recommended for dogs in high-risk areas. Ascertaining the owned dog population and community knowledge on rabies can help improve vaccine coverage and information campaigns. Methodology/Principal findings We conducted a cross-sectional survey in six randomly selected communities (five urban, one rural) in Central Luzon, Philippines. We first conducted the complete mapping of 9,173 households and then randomly selected 727 households. More than half (54.1%) of the households owned dogs (1.21 dogs/household). In the 727 households, we identified 878 owned dogs and 3256 humans. According to these results, the dog-to-human ratio was approximately 1:3.7. Only 8.8% of households reported a history of dog bite in 2019. Among dog-owning households, 31% reported that they allow their dogs to roam freely. Of the recorded dogs, 35.9% have never been vaccinated, and only 3.5% were spayed or castrated. Factors associated with lower rabies knowledge include (1) no education aOR: 0.30 (0.16-0.59), and (2) only primary school education aOR: 0.33 (0.22-0.49). In contrast, factors associated with higher knowledge include (1) owning a dog and not allowing them to roam freely aOR: 2.01 (1.41-2.87) and (2) owning a dog and allowing them to roam freely aOR: 1.84 (1.17-2.92), when compared to those with no dogs. Conclusions/Significance We identified a larger dog population in the community than the usual estimates (1:10), suggesting that annual vaccine needs in the Philippines must be reassessed. Our survey shows a relatively good understanding of rabies; however, awareness of the concept of rabies as a disease, and how animals and humans can acquire it, is lacking. Author summary Rabies is a fatal disease primarily transmitted by rabid dogs. It is estimated that 59 000 human deaths occur worldwide annually because of rabies. Prevention is possible using pre-exposure prophylaxis or post-exposure prophylaxis (PEP). Despite this, rabies remains a neglected disease and a burden, particularly in developing countries. In this study, we found that the current estimated dog to human ratio of 1:10 may be incorrect. Our data show that the ratio of 1:3.7 may more closely reflect real-world figures. This finding is supported by previous studies on dog populations. We provide compelling evidence that there is a need to revise the current guidelines for estimating the dog population to provide adequate vaccine coverage. Our findings on community knowledge about rabies show that there is relatively good understanding regarding rabies; however, awareness of the concept of rabies as a disease and how animals and humans can acquire it is lacking. This should be a point of focus for future education campaigns.

Automated summary

In the Philippines, human rabies cases have not decreased, posing the highest risk for rabies in the country. Conducting a survey on the owned dog population and community knowledge about rabies can improve vaccine coverage and awareness campaigns.