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SCHOOL OF PUBLIC HEALTH

DEPARTMENT OF ENVIRONMENTAL

HEALTH

VACCINATION STATUS OF DOGS IN STABICHA

VILLAGE WEBUYE LOCATION

Submitted in partial fulfillment for the requirement of Bsc.

Environmental Health of Moi University

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April 2010

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DECLARATION

I hereby declare that the contents of this report as my original work compiled

in fulfillment of Field Attachment II objectives during the six week placement

at Webuye District Hospital, Bungoma East District.

Author: Ochieng Donald Otieno

Admission no: EVH/1010/06

Signature: ___________________

Supervisors: Mr. R. Kei Signature:

_________________Date...

Department of Environmental Health

Dr. Rutto Signature:

_________________Date

Department of Health Management

Dr. George Sowayi Signature:

__________________Date

S.O.M

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DEDICATION

The findings of this report are dedicated to The Public health department Webuye

district hospital and The District Vetinary Officer Webuye.

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LIST OF ABBREVIATIONS

COBES Community Based Education and Service

DHMT District Health Management Team

PHT Public Health Technicians

PHO Public Health Officer

DMOH District Medical Officer of Health

NGO Non Governmental Organization

DPHO District Public Health Officer

DPHN District Public Health Nurse

DVO District Vetinary Officer

DHEO District Health Education Officer

DDC District Development Committee

GOK Government of Kenya

Km sq. Kilometers squared

LIST OF TABLES

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Table 1: Population of dogs in Stabicha

Village.Page 7

LIST OF FIGURES

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Figure 1: Distribution of dogs in Stabicha village.

Page 7

Figure 2:Frequency of vaccination in Webuye location

Page 8

Figure 3:Vaccination status of dogs in Stabicha Village

Page 8

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ACKNOWLEDGEMENT

My Sincere gratitude to Mr. Robert Kei (Head of Department Environmental

Health) for his role as a fatherly figure during my fourth year of study, and

the entire field attachment II committee for facilitating the programmme.

My sincere gratitude to my supervisors Dr. G Sowayi and Dr. Rutto during

both study in the field and preparation of this Report.Their informative

discussions and willingness to work with me is greatly appreciated.

Id also like to acknowledge MR. Cheruyiot (District Public Health Officer) and

his very competent team whose support was invaluable during the

attachment period.

My Dear Parents and fellow colleagues whose moral support made this study

a success.

Our Almighty Father for seeing me through this research period.

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ABSTRACT

Title: Vaccination status of dogs in Stabicha village Webuye location, of

Western Province, Kenya

Researcher: Ochieng Donald, EVH/1010/06, Bsc. Environmental Health

Student, Moi University

Introduction: Rabies is best described as a neglected zoonotic disease. It is

vaccine preventable. Almost 99% of all human deaths from rabies occur in Africa

and Asia((WHO2009).Human rabies is transmitted via Domestic dogs with more

than 95% of human cases caused by bites from rabid dogs (Maherisoa et al).cost

of post exposure treatment Kenya cost is 1500 per shot this very

high.Government employs pre-exposure vaccination of dogs and post exposure

treatment of humans to prevent onset of disease.Stabicha village has thehighest cases of dog bites going up to 179 reported cases (2009)of which only

12 were vaccinated. This poses a serious health risk should an outbreak of

rabies occur

Research Question: What is the vaccination status of dogs in Stabicha village

Webuye location?

Broad objective: To determine the vaccination status of dogs in Webuye

location.

Specific objectives:

1. To Determine the number of dogs in the village

2. To Assess the frequency of vaccination of dogs in the location

3. To determine the currency of the vaccination cards for dogs in the Village

Methods and Materials:

The Study was carried out in Stabicha village of Webuye location. crossectional

study design was used. The study population was all domestic dogs in Stabicha

village and applied systematic sampling. The sample size was all dogs in the

homesteads visited and data collection involved administering Interviews of key

informants and document analysis of DVO records. Questionnaires were

administered. Qualitative data was analyzed using Microsoft excel. Descriptive

statistics used proportions and percentages presented through Tables, charts,

graphs, continuous prose.

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Findings and Discussion: Dog population is quite high compared to similar

studies hence an intimate relationship between dog and man. Vaccination is

done annually through mass campaigns and record highest vaccination records.

Vaccination status is very low compared to the expected 70 %( WHO)

Conclusions and Recommendations: Dog population is quite high henceadequate surveillance of population should be introduced. Vaccination through

mass campaigns record highest vaccination records. Hence more campaigns

should be organized. Dog vaccination is very low hence more effective

vaccination schedules be introduced.

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TABLE OF CONTENTS

CHAPTER 1

1.0 INTRODUCTION

1.1GENERAL INTRODUCTION

1.1.1 Rationale for the Attachment

During the fourth year of study of the Bsc. Environmental Health programme in

the school of Public Health students are introduced into the field to participate in

Environmental Health Administration and Urban Health (Field Attachment II)

During the course of the this activity students are attached to various District

Public Health Officers (DPHOs) in districts with functional public health

departments of the municipality. This avails students with the opportunity to

have a practical hands on experience in the field of environmental healthIt

offers students the opportunity to put theory into practice by being apprentices

in managerial and administrative activities as well as liaising with the DPHO to

carry out other activities like premises inspection, meat inspection, health

education and promotion, town planning and public health law enforcement. The

course is a sequel to other COBES courses done in the 2nd and 3rd year of study.

1.1.2 Health Management Services

The District Health Management Team (DHMT) consists of 14 members and is in

charge of health services in the district. It is chaired by the District Medical

Officer of Health (DMOH) and it performs the role of supervising all health

activities in the district. The District Health Administrative Officer (DHAO), the

District Public Health Nurse (DPHN), the District Clinical Officer (DCO) AND the

District Public Health Officer among other members assist the DMOH in the

running of administrative functions.

The executive expenditure committee of the DHMT consists of four core

members with the DMOH as the chairman, the DHAO as the secretary and two

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members who are the DPHN and DPHO whose role is to plan and supervise

expenditure in the district. They are also responsible for the handling of

recurrent, cost sharing and donor funds. The DHMT also ensures total dev

elopement of health service delivery through the DDC by liaising with Non-

governmental Organizations (NGOs).

1.1.3 INTRODUCTION TO RABIES

Rabies is best described as a neglected zoonotic disease. It is a classified as

a notifiable and is vaccine preventable. However, it continues to pose a

serious public health Problem in many countries of Asia and Africa even

though safe effective vaccines for both human and veterinary use exist.

Rabies is responsible for 24 000 deaths in Africa alone and 31000 in Asia

hence a record 55000 deaths annually in Asia and Africa alone at the same

time more than 99% of all human deaths from rabies occur in Africa and

Asia((WHO, Human and animal rabies, 2009).

Human rabies is mostly transmitted via Domestic dogs with more than 95%

of human cases caused by bites from rabid dogs (Maherisoa Ratsitorahina et

al). Given the intimate contact of dogs with other animals and man, dogs

have the potential to play a significant role as reservoirs and vectors of

disease, transferring disease to human and livestock.Hence dogs pose a

serious public health risk.

People most at risk of rabies live in rural areas of Africa and Asia. Dog rabies

is responsible for more than 14 million courses of post-exposure treatment to

prevent the onset of disease. The economic burden of rabies in the

developing world also takes a large toll. The average cost of rabies

immunizations after a suspicious animal bite is US$ 40 in Africa, and US$ 49

in Asia. This post-exposure treatment is a major financial burden for most

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households in these countries, where the average wage is about US$ 1 to

US$ 2 per day, per person (WHO).

Dogs continue to be the main carrier of rabies in Africa and Asia and are

responsible for most of the human rabies deaths worldwide. This means that

high rates of dog bites in a community pose a serious risk of outbreak of

human rabies. In the event this was to occur, the impact especially in the

rural communities would be disastrous given challenges such as Poverty,

harsh environment, lack of infrastructure, lack of education and

absence/inefficiency of systems of medical care challenges that plague such

communities.

The scenario is made worse in a case where most of the dogs havent been

vaccinated. Both human animal rabies will be on the high making control of

the epidemic difficult.

1.5 Justification of the study topic

Given the high public health risk and concern of rabies, the

government has employed pre-exposure vaccination of dogs and cats

as a first line of defence to control and prevent animal rabies and inturn human rabies. The government also employs post exposure

treatment of humans to prevent onset of disease as a second line of

defence in the control and prevention of human rabies. This is

achieved through collaboration between the Ministry of livestock and

Development that are responsible for pre-exposure vaccination of

dogs, the Ministry of Public Health and Sanitation who co-ordinate and

monitor distribution and administration of post exposure treatment,

and finally the Ministry of Medical services who are responsible for

administration of post exposure treatment.

Pre exposure vaccination of dogs is conducted through the office of the

district vetinary officer. Dogs are vaccinated annually using Rabisin

vaccine administered to dogs from three months and older.

Vaccination is done annually and in Webuye location it conducted in

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the months of October and November. Each vaccine costs ksh 70 and

is issued with an original vaccination receipt acting as proof of

vaccination.

The cost of post exposure treatment is high going for 1500 per shot.

Many rural families cannot afford this cost hence either fail to completethe treatment or fail to come for treatment. This hence places pre-

exposure vaccination as the most effective in control of rabies

therefore emphasising its crucial link and significance to public

health.Dog vaccination constitutes the main solution that can be

applied against dog rabies (LOMBARD et al., 1988)

Much as the government may put in place mechanisms and structures

to prevent the outbreak of rabies there have been high numbers of dog

bites in Webuye location in the last one year there have been 548

cases of dog bites in Webuye location.Stabicha village has the highest

cases of dog bites going upto 179 cases in the last one year of which

only 12 were reported to have been vaccinated. This raises the

question as to whether these dogs are vaccinated to avert the

imminent risk of outbreak of rabies given the high activity of its

primary reservoir. However no study has been carried out in the past in

the location concerning this state, the purpose of this study, therefore,was to asses the vaccination status of dogs in the village.

2.0 RESEARCH QUESTION AND OBJECTIVES

2.1 Research Question

What is the vaccination status of dogs in Webuye location?

2.2 Broad Objective

To determine the vaccination status of dogs in the location.

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2.3 Specific Objectives

1. To establish the number of dogs

2. To establish the frequency of vaccination of dogs in the location

3. To determine the validity of vaccination cards of dogs in the location

CHAPTER 3METHODS AND MATERIALS

1.0 Study Area

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The study was carried out in Stabicha Village of Webuye location. The village has a

total of 57 homesteads.

1.1 Study Design

The study design applied was a cross-sectional study.

1.2 POPULATION AND SAMPLING

1.2.1 Population

Study population: All the dogs in Stabicha villages.

Population characteristics: The village has 57

homesteads

1.2.2 Sampling

Sampling units used were homesteads

Sample size: was all the dogs in the homesteads visited

Sampling methods: Purposive sampling was used to identify the

village. Stabicha village was identified since it had the leading number

of reported cases of dog bites in the location. Systematic sampling

was used to identify the homesteads in the village where the

questionnaire was administered. The index homestead was selected

at random then an interval of 1 was used to skip and select

subsequent homestead.

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1.3 Data Collection

Primary data - Interviews of key informants;

Residents of Stabicha Village

Secondary data

Records from the Public Health department, Webuye District

Hospital

Vaccination records at the Webuye District Vetinary Office

1.4 Data analysis and presentation

Quantitative data were coded, summarized and analyzed using Microsoft Excel.

Descriptive statistics included use of proportions and percentages. Qualitative datawas sorted, processed and grouped according to themes, analyzed qualitatively

and then presented in the form of tables, charts and graphs.

1.5 Ethical Considerations

1. Consent was obtained from the DPHO to carry out the study.

2. Consent was obtained from the DVO.

3. Confidentiality of information was ensured.

1.6 Study Limitations

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1. Access to the households was difficult due to the poor infrastructure.

CHAPTER 4

STUDY FINDINGS

Introduction

This chapter shows the findings of the study. The objectives of the study were to:

1. To establish the number of domestic dogs

2. To establish the frequency of vaccination of domestic dogs in the location

3. To determine the number of domestic dogs with validity of vaccination cards

of dogs in the location

Table 1: NUMBER OF DOGS AGED 3 MONTHS AND ABOVE IN STAVICHA

VILLAGE

AGE 3 MONTHS AND OVERNUMBER 52

The population of dogs was 52 in the 29 homesteads visited.

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Figure1. Distribution of dogs in Stabicha village

Most of the house holds own dogs 8% (n=24) the remaining 14% (n= 4)

homesteads dont posses any dogs

Figure 2:Frequency of vaccination in Webuye location.

Most of the vaccinations are given in November during annual mass

vaccination campaigns 30 %( n=112).The rest were administered at owners

request.

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Figure 3:Vaccination status of dogs in Stabicha Village.

Only 27% (n=14) were vaccinated the remaining 73% (n=38) were not

vaccinated

CHAPTER 5

DISCUSSION

Introduction

This chapter focuses on the discussion of the findings of the study. This study

aimed at

1. establish the number of domestic dogs

2. To establish the frequency of vaccination of domestic dogs in the

location

3. To determine the number of domestic dogs with validity of vaccination

cards of dogs in the location

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It has been long accepted that understanding dog population ecology is

required for successful rabies control (Maherisoa Ratsitorahina et

al).However no such data is available regarding the dog population. The

study established that the village had a population of 52 domestic dogs in 29

homesteads visited out of the total 57 homesteads present in the village. Of

the 29 homes visited only 4(14%) homesteads did not have dogs this shows

that most 25(86%) of the homesteads have dogs. This finding may be

slightly higher compared to a similar study done in a Machakos by Philip

Kitala et al where the dog ownership is within a range of 5381% however

the values may have been different if the study area was lager as the Kitala

et al study. This study shows that dog population is quite high and

emphasizes the intimate relationship between man and dogs in that Stabicha

village, and the health risk non-vaccination of the dogs could pose to the

people.

The Findings indicate that Dog vaccination In Webuye location is done

through mass vaccination campaign annually in the month of November; it is

also done at owners request any time of the year hence a more or less

continuous process. In the past year 2009 a total of 398 dogs were

vaccinated valid up to November 2010.Much as one may view this figure as

low given the fact that one village {Stabicha} has not less than 52 domestic

dogs, determining vaccination coverage that would give an accurate value of

whether vaccination coverage is high or low is quite not possible since there

are no records of dog population in the location. The data analysis shows

that indeed in the month of November records high rates of vaccination that

is 30 %( n=112).Hence most of the dog owners vaccinate the dogs duringthis period. This may be attributed to the affordability of the vaccine which is

charged at ksh70 as opposed to ksh150 if vaccination is done at owners

request. This may also be as a result of pre-sensitization of the community

just before the onset of the Programme.

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The data analysis of the interviews and questionnaires on the validity of

vaccination cards of domestic dogs in Webuye location administered in

Stabicha village reveal that only 27% (n=14)of the domestic dogs arevaccinated and have valid vaccination cards. This represents only a quarter

of the total sampled domestic dog population which is 52.This is indicative of

very low vaccination coverage given that to eliminate rabies in dog

populations a 70% minimum coverage is recommended.(WHO)

Furthermore of the reported cases of dog bites in the location, only 16

involved vaccinated dogs. The remaining 100 cases between the months of

December 2009 and February 2010 involved non vaccinated dogs (Public

health dept). This further shows the low levels of vaccination of dogs. This

may be as result of lack of awareness of the community on the significance

of vaccination of dogs.

The low vaccination status may also be as a result of the cost involved in

vaccination of the dogs.

Chapter summaryThe findings of the study show that Dog population is quite high compared to

similar studies hence an intimate relationship between dog and man.

Vaccination is done annually through mass campaigns and record highest

vaccination records it is also done at owners request however the results of

this method are quite low. Vaccination status is very low compared to the

expected 70 %( WHO)

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CHAPTER 6

CONCLUSIONS AND RECOMMENDATIONS

6.0 CONCLUSION

This study investigated the vaccination status of dogs in Webuye location. It

sought to establish the validity of vaccination of dogs in Webuye location

given the high levels of reported dog bites that totaling up to 548 putting

into consideration that some may not have been reported in the past one

year. The study specifically sought to establish the population of domestic

dogs, establish the frequency of vaccination and finally to determine the

validity of vaccination cards of dogs there by confirming how many have

actually been vaccinated.

The study established that in the sampled village of Stabicha the population

of domestic dogs is 52 which is quite high given 86% is the dog ownership.

The vaccination is done annually through an outreach activity in the month

of November; however it is an ongoing process done upon request of the

owner. The vaccination status of dogs is low at 23 %( n=12) as compared tothe expected 70% by WHO.

In the view of these findings the study concludes the population of domestic

dogs is high bringing an intimate relationship between dogs and man. It also

concludes that the vaccination status of these dogs is very low given their

high population.

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7.0 RECOMMENDATIONS

Human rabies is mostly transmitted via Domestic dogs with more than 95%

of human cases caused by bites from rabid dogs. This fact coupled with the

findings of this study that is high population of dogs and high rates of bites

from non vaccinated dogs only serves to emphasize the high risk of an

outbreak of both human and dog rabiesthat will be difficult to controlgiven

challenges such as Poverty, harsh environment, lack of infrastructure, lack of

education and absence/inefficiency of systems of medical care challenges

that plague such communities.

Hence there is need of improving the vaccination coverage to avert the risk

of outbreak of rabies. This can be achieved by the following

recommendations

To The District Vetinary Office and the Public health department.

1. Establish community based surveillance system to ensure dog

populations are monitored closely. This is key in the control of rabiesand establishing dog populations.

2. Introduce a multisectoral or an integrated approach during

organization and execution of vaccination campaigns. Such a synergy

of action between the Public health department and the District

Vetinary Office will help to improve awareness and service delivery

during Vaccination campaigns.

3. Developing community based vaccination programmes that will

depend on dog density and socio-economic conditions. This will

improve the vaccination coverage in the district as a whole

4. Properly informing the community about the positive effects of

systematic and regular dog vaccination.

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REFERENCES

Philip M. Kitala (1999) Population dynamics of dogs in Machakos District,

Kenya: Implications for Vaccination strategy. (Pubmed)

Maherisoa Ratsitorahina,et al (2007)Dog ecology and demography inAntananarivo. Institut Pasteur de Madagascar, BP 1274, Antananarivo 10

Kitala P et al (2001) Dog ecology and demography information to support the

planning of rabies control in Machakos District, Kenya,(pubmed).

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APPENDIX

INTERVIEW SCHEDULE

RESEARCH TOPIC: VACCINATION STATUS OF DOGS IN STABICHA

VILLAGE WEBUYE LOCATION

CONSENT

I am a fourth year Bsc. Environmental health student from the school of publichealth Moi University. I am undertaking a research on the above topic this will entail

interviewing residents in this area of study. The information collected will be treated

with absolute confidentiality. I appreciate your voluntary participation in this study.

IDENTIFICATION

Serial number:

Date:

QUESTIONS

1).Do you have a dog?

YES NO

A).If yes how many?

2).Have they been vaccinated?

YES NO

A).If yes how many?

B). If yes when were they vaccinated

Within the past 12months

More than 12 months ago

CHECKLIST

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VACCINATION CARD PRESENT NOT PRESENT

DATE OF ISSUE

COBES V FINALL!2

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