Evaluation Of A Community-based Rabies Health Communication Intervention Program In Guangxi,China

Rabies,preventable but incurable,is one of the most serious neglected tropical diseases and worldwide public health issue.59,000 people were estimated to die from rabies every year in the world,and China has a high incidence of human rabies.Enormous literature and researches have discussed and proved that improvement of KAP of the public in affected communities results in the better rabies prevention and elimination results.Thus,how to improve rabies KAP to boost the awareness and ability of rabies prevention and elimination,will be a key question of achieving the goal of "ZERO BY 2030" in China.This research adopted the Difference-in-Difference model and designed a quasi-experimental study,which conducted the health intervention and collected independent pooled cross-sectional data in two communities:Wuxuan(intervention group)and Xingbin(control group)in 2013 and 2017.SMS,pamphlet,and video were used to do the health education in Wuxuan.The data of questionnaires collected shows that the health intervention program improved the overall KAP mean score of local residents by 2.8%,and the AP(attitude and behavior)parts contributed the most.From 2013 to 2017,compared with rapidly rising rabies exposed population of Xingbin district,Wuxuan county had a gradual decrease tendency.It shows that health communication intervention and KAP have a negative correlation with rabies exposed population.According to the data collected in 2017,residents who "watched the video" have an 8.84 points((95%CI:7.51-10.18,P<0.01)improvement,compared with those who"haven't heard about it";The mean KAP score of people who "heard about it,but haven't watched" is 6.97 points(95%Cl:5.52-8.42,P<0.01)higher than the group that "haven't heard about it".However,the elderly aged above 60 years old and teenagers below 16 years old have a relatively lower score than other age groups,which indicates that they are more vulnerable and susceptible to rabies than others.What's more,the dog management and raising behaviors part has a lower mean score than knowledge and attitude parts.Therefore,the rabies community health intervention is effective,and larger scale implementation should be based on the local social background and adopt multiple methods to have the best effects.The young and elderly group deserve more attention,and more intervention content should be focused on dog management.