Keys to good knowledge, attitude and practice on rabies prevention in disease-free communities

Many developing countries have recently faced public health challenges due to outbreaks of human rabies, while some areas have remained free from outbreaks of the disease. The aim of this study was to identify keys to good knowledge, attitude and practice (KAP) in rabies-free areas of Thailand to provide a functional model for rabies prevention in endemic zones. A cross-sectional study was conducted using a questionnaire in conjunction with interviews that were designed to elicit relevant information. Multivariate logistic regression analysis and content analysis were used to interpret the data obtained from the questionnaire and interviews, respectively. The results gathered from 1,392 respondents and 36 interviewees indicated that age, education and the residential area of the subjects were associated with knowledge and practice, but not with attitude. Late midlife subjects reported good knowledge and practice scores due to some form of personal encounter with rabies and attendance at rabies meetings and campaigns, while secondary education levels or above were associated with higher knowledge and practice scores due to the inclusion of a rabies course in the secondary school curriculum. Moreover, the findings showed that a community using a form of public communication known as wired broadcasting had greater knowledge, and a community organizing comprehensive participatory activities had better practice. Ultimately, it was not only age, education and residential area, but also the integration of appropriate interventions and control measures by the authorities that proved beneficial in making good knowledge and practice more uniform throughout the communities included in the study.