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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