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\title{Assessment of Knowledge and Associated Risk Factors Regarding Zoonotic Disease among Community Members of Siddharthanagar Municipality, Bhairahawa, Rupandehi}
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             \author[1]{Dr. Arjun  Chapagain}

             \author[2]{Subash  Rimal}

             \author[3]{Asmita  Shrestha}

             \author[4]{Rabina  Ghimire}

             \affil[1]{  Tribhuwan University}

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\date{\small \em Received: 11 December 2018 Accepted: 4 January 2019 Published: 15 January 2019}

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\begin{abstract}
        


Zoonoses are the common cause of disease occurrence in animals and humans in Bhairahawa. Many zoonotic disease such as Tuberculosis, Rabies, Heartworm, Brucella, Leptospira has been encountered in Veterinary Teaching Hospital, Institute of Agriculture and Animal Science (IAAS), Tribhuvan University from Bhairahawa periphery. We conducted a cross-sectional purposive random survey of total 303 villagers of Siddharthanagar Municipality, Bhairahawa, Rupandehi to study awareness status about zoonosis. Out of total individuals interviewed, 176 (58%) heard about the zoonotic disease and radio/television (37.5%) were the source of information. 66.7% female and 56.9% male knew about zoonosis. 72.9% of youths (30-50 years),  36.6% farmers, 33.33% Dalit and 40.2% Madheshi, 58.6% Hindu, 66.7% Buddhist, 66.7% of Christian knew about zoonosis. 86% of aware people knew about direct transmission rout of zoonotic disease, and 100%, 77.84%, 100%, 100% and 47.72% respondents knew about the contaminated food, milk, meat, bite, and secretion transmission route respectively. Age, education, ethnicity, occupation play highly significant (P<0.05) effect on zoonosis, where religion had significant (P<0.05) effect but sex had no significant relationship. Hence our study suggests that zoonotic disease pose a threat to people but the risk grossly underestimated.

\end{abstract}


\keywords{survey, zoonoses, siddharthanagar, veterinary teaching hospital, bhairahawa.}

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\let\tabcellsep& 	 	 		 
\section[{Introduction a) Background}]{Introduction a) Background}\par
oonoses caused by infection that spread between animal and people. Of the known pathogen species implicated in human disease, 61\% are zoonotic. Comparatively neglected among this vast group of pathogens are endemic zoonoses. Many endemic zoonoses not only cause considerable human disability but also impair livestock productivity, imposing multiple burdens on poor communities. Developing and under developed countries are being comparatively more affected by these zoonotic diseases due to lack of proper education on zoonoses, awareness, and improper management of farms \hyperref[b0]{(Chowdhury et. al., 2018)}. And this situation is alarming.\par
In context of Nepal, people are mainly dependent on the animal and the animal husbandry practice as their source of an income, and there is a very close association of animals with humans. Many people interact with the animals in their daily lives, both at home and away from home. Pets offer companionship and entertainment, with millions of households having one or more pets. We might come into close contact with the animals at a county fair or petting zoo, or encounter wildlife while enjoying outdoor activities. Also, livestock animals are an important food source for human and provide meat, dairy and eggs. Because of the close connection between people and animals, numbers of diseases transfer from animal to human and vice-versa. But in Nepal due to risk factors such as lack of awareness, education, poverty, large populations are unknown about zoonotic disease. 
\section[{b) Statement of problem}]{b) Statement of problem}\par
Zoonoses are the common cause of disease occurrence in animals and humans in Bhairahawa. There are large numbers of dog bites cases admitted to veterinary hospitals as well as a human hospital of Bhairahawa. Rabies, Tuberculosis, Brucellosis, Echinococcusis, Heartworm, Leptospirosis are most zoonoses encountered on Veterinary Teaching Hospital, IAAS Paklihawa. These all disease has zoonotic importance, but many people are unknown about these diseases which have a high risk of transmission. The exact status of zoonotic disease and its consequences have not been access in Nepal. Since humans share their environment with animals, it was decided to study the level of awareness among humans regarding some of the zoonotic diseases spread by animals. 
\section[{c) Rationale of study}]{c) Rationale of study}\par
The major rationale of this study is to assess the level of awareness among the farmers, risk factors associated with the zoonosesand concerned personnel. This study also aims to assess the zoonotic risks associated with infected animals and help to make policy about awareness of zoonoses because this study provides status and conditions of awareness about zoonoses around the Bhairahawa periphery.  
\section[{b) Study design}]{b) Study design}\par
A cross-sectional purposive sampling was conducted with irrespective of; age, sex, cast, were done by stratified random sampling method. 
\section[{c) Sample size}]{c) Sample size}\par
The Sample size were estimated by using ausvetEpitools epidemiological calculators assuming: Estimated Proportion=0.3, Desired precision of estimate= 0.05, Confidence level= 0.95 and Population size of Siddharthanagara municipality was 163483 in 2011. By this way, the sample size was 323, but only 303 villagers were selected in the study. 
\section[{d) Methods}]{d) Methods}\par
A total of 303 villagers were selected randomly from Siddharthanagar Municipality, Bhairahawa, Nepal and interviewed with a questionnaire containing both open-and close-ended questions on various aspects of zoonotic diseases and test their knowledge and awareness about zoonotic diseases. The questionnaire contains general zoonoses knowledge; reported a recent experience of zoonoses cases; knowledge of signs and symptoms of selected zoonoses in humans and animals; knowledge of zoonoses transmission; and testing, prevention, and treatment practices, etc. The section assessing knowledge of disease symptoms and signs consisted of a series of closed (yes/no response) questions asking whether a particular symptom or sign was commonly associated with each disease. Listed symptoms and signs included those commonly associated with each named disease as well as others not typically associated with any of these diseases. 
\section[{III.}]{III.} 
\section[{Statistical Analysis}]{Statistical Analysis}\par
The data were collected, coded and tested by using SPSS-tools and were analyzed by chi-square test and descriptive analysis was done by using MS-excel. 
\section[{IV.}]{IV.} 
\section[{Result}]{Result}\par
Total 303 individuals of Siddharthanagar Municipality, Rupandehi were interviewed for assessing the knowledge and associated risk factors regarding zoonotic disease among community members of Siddharthanagar Municipality, Bhairahawa, Rupandehi. 
\section[{a) Descriptive Analysis i. Heard about zoonosis and their source of knowledge}]{a) Descriptive Analysis i. Heard about zoonosis and their source of knowledge}\par
Out of total individuals interviewed 176 (58\%) have heard about zoonotic disease whereas 127 (42\%) have not.  iii. Gender 267 male and 36 female were interviewed. Among total males, 152 (56.9\%) have heard about zoonosis, and among total females, 24 (66.7\%) have heard about it.                
\section[{c. Milk Transmission}]{c. Milk Transmission}\par
Out of 176 individuals, 137 (77.84\%) thinks that zoonotic disease could be transmitted through the consumption of milk from the infected animals.  
\section[{e. Bite Transmission}]{e. Bite Transmission}\par
Out of 176 individuals, 100\% assumes that zoonosis transmits through the bite of an infected rheanimal. 
\section[{f. Secretion Transmission}]{f. Secretion Transmission}\par
Out of 176 individuals, 84 thinks zoonosis can transmit through secretion of an infected animal.   V. 
\section[{Discussion}]{Discussion}\par
In our study, out of total individuals interviewed 58\% have heard about zoonotic disease whereas 42\% haven't heard about the zoonotic disease. This result is lower than \hyperref[b4]{Singh et al., 2019;}\hyperref[b6]{Wario et al., 2018;}\hyperref[b3]{Ozioko et al., 2018}. The lower level of knowledge regarding zoonoses is likely to cause exposure at increased risks to these diseases.\par
Television and radio are the source of information to most respondents who know about zoonosis accounting to 37.5\%. This might be due to the easy access to radio and television.\par
Age of respondent significantly influenced the knowledge about zoonosis (p=0.000). The people of higher age group ie, above 50 years had less about zoonosis compared to the lower age group. This might be because younger people are more educated than, the older age group.\par
267 male and 36 female household were interviewed, but only 56.9\% male have heard about zoonosis, and 66.7\% female have about it but the results were statistically non-significant. Males are at a higher risk of zoonotic disease transmission due to their occupational exposure.\par
Respondents were mostly educated up to primary level. Illiterate people have the least knowledge about zoonosis ie, only 38.7\% whereas all respondents 100\% from Bachelor's, and above have heard about zoonosis. The educational status of respondents showed a highly significant difference (p=0.000) responding to the knowledge about zoonosis. The lower level of knowledge about zoonosis is due to a low level of education level in people.\par
People with a different occupation were interviewed, among which people involved in agriculture were mostly interviewed. However, only 36.5\% of the agricultural respondents knew about zoonotic diseases. Knowledge about zoonosis was significantly affected by the occupation of respondents (p=0.000). Livestock and animal holders are more at risk of zoonosis due to their close contact with animals, but due to lack of awareness among them, they may contract these diseases. All students interviewed knew about zoonotic diseases.\par
Most of our respondents consist of Madhesi ethnicity, and there is a low level of zoonotic knowledge among them. Also, the dalit community had a lower level of regarding zoonosis. Other ethnic groups like Brahmin, Chhetri, Janjati were comparatively more aware of the diseases. The result was statistically significant (p=0.000). Sidhharthanagar municipality consists of more Madhesi community. The lower level of awareness among these communities may be due to the lower level of literacy and marginalized living standard. They are at more risk of contracting zoonotic diseases.\par
In this study, 86\%, 100\%, 77.84\%, 100\%, 100\% and 47.72\% respondents who know about zoonotic diseases think that zoonotic disease can be transmitted directly from animal to man, through contaminated food, milk, meat, bite, and secretion respectively. Most respondents knowing about zoonotic diseases are aware that the transmission takes place in different ways. This awareness is likely to decrease the risk of contracting zoonotic diseases, and they can take proper precautions.\par
Many respondents knew that zoonotic disease were transmitted from dogs, and cats and less of them knew about transmission through other animals. Majority of the respondents knew that rabies is transmitted by the bite of the dog. People are aware about vaccination against rabies after any dog bite. Out of the respondents interviewed, four people's family have been previously affected with the zoonotic disease.\par
VI. 
\section[{Conclusion}]{Conclusion}\par
This study suggests that the zoonotic disease pose a threat to people, but the risks were grossly underestimated. Despite the risks possessed by the zoonotic diseases, only a few people are aware and know zoonosis in Siddharthanagar municipality, Rupandehi. Age, gender, occupation, ethnicity, educational status of the respondents showed a significant difference concerning about zoonosis, which may have been because of the higher level of literacy among the specific risk factors. Thus, awareness is to be raised in the people regarding the threats and risks of zoonotic diseases to humans by the collaborative efforts of veterinarians, human health professionals as well as the government by conducting awareness campaigns, dramas or advertisements in the radio or television or by a distribution of pamphlets and printed materials among people.\begin{figure}[htbp]
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\noindent\textbf{11}\includegraphics[]{image-11.png}
\caption{\label{fig_10}Fig. 11 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{1213}\includegraphics[]{image-12.png}
\caption{\label{fig_11}Fig. 12 :Fig. 13 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{1}\includegraphics[]{image-13.png}
\caption{\label{fig_12}1 F}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{} \par 
\begin{longtable}{P{0.06663135593220339\textwidth}P{0.6924258474576271\textwidth}P{0.0729343220338983\textwidth}P{0.008103813559322035\textwidth}P{0.009904661016949153\textwidth}}
\tabcellsep \multicolumn{2}{l}{d) Objectives}\\
\tabcellsep \multicolumn{2}{l}{i. General objectives}\\
\tabcellsep \tabcellsep \multicolumn{2}{l}{To assess the knowledge and associated risk}\\
\tabcellsep \multicolumn{3}{l}{factors regarding the zoonotic disease among}\\
\tabcellsep \multicolumn{3}{l}{community members of Siddharthanagar Municipality,}\\
\tabcellsep \multicolumn{2}{l}{Bhairahawa, Rupandehi.}\\
\tabcellsep \multicolumn{2}{l}{ii. Specific objectives}\\
\tabcellsep \multicolumn{3}{l}{? To assess the effect of sex, age, ethnicity, education}\\
\tabcellsep \multicolumn{2}{l}{on zoonoses.}\\
\tabcellsep \multicolumn{3}{l}{? To assess the mode of transmission and other}\\
\tabcellsep \multicolumn{2}{l}{factors in zoonoses.}\\
\tabcellsep II.\tabcellsep \multicolumn{2}{l}{Methods and Methodology}\\
\tabcellsep \multicolumn{2}{l}{a) Study area}\\
\tabcellsep \tabcellsep Siddharthanagar\tabcellsep (formerly\tabcellsep Bhairahawa)\\
Volume XIX Issue IV Version I\tabcellsep \multicolumn{3}{l}{municipality is the administrative headquarter of Rupandehi District on the Outer Terai plains of Nepal, 265 km (165 mi) west of Kathmandu Nepal's capital. It is also the "Gateway of Lumbini." Lumbini, the birthplace of Gautama Buddha is 25 km to the west. It borders India, Sonauli in Maharajganj district of Uttar Pradesh. This study were conducted at Bhairahawa periphery, Siddharthanagar Municipality, Rupandehi Nepal.}\\
D D D D ) F\tabcellsep \tabcellsep \\
(\tabcellsep \tabcellsep \\
Medical Research\tabcellsep \tabcellsep \\
Global Journal of\tabcellsep \tabcellsep \\
\tabcellsep \multicolumn{2}{l}{© 2019 Global Journals 1}\end{longtable} \par
 
\caption{\label{tab_0}Z}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{1} \par 
\begin{longtable}{P{0.7576086956521738\textwidth}P{0.09239130434782608\textwidth}}
Do you know about zoonotic disease Yes No\tabcellsep Total\end{longtable} \par
 
\caption{\label{tab_1}Table 1 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{2} \par 
\begin{longtable}{P{0.7576086956521738\textwidth}P{0.09239130434782608\textwidth}}
Do you know about zoonotic disease Yes No\tabcellsep Total\end{longtable} \par
  {\small\itshape [Note: iv. OccupationPeople involved in agriculture (115/303) were mostly interviewed. However, only 42 (36.5\%) have heard about zoonosis.]} 
\caption{\label{tab_2}Table 2 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{3} \par 
\begin{longtable}{P{0.7116279069767442\textwidth}P{0.03953488372093023\textwidth}P{0.09883720930232558\textwidth}}
\multicolumn{2}{l}{Do you know about}\\
\multicolumn{2}{l}{zoonotic disease}\tabcellsep Total\\
Yes\tabcellsep No\end{longtable} \par
 
\caption{\label{tab_3}Table 3 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{4} \par 
\begin{longtable}{P{0.7116279069767442\textwidth}P{0.13837209302325582\textwidth}}
\multicolumn{2}{l}{Do you know about zoonotic}\\
disease\tabcellsep Total\\
Yes\tabcellsep No\end{longtable} \par
 
\caption{\label{tab_5}Table 4 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{5} \par 
\begin{longtable}{P{0.7116279069767442\textwidth}P{0.03953488372093023\textwidth}P{0.09883720930232558\textwidth}}
\multicolumn{2}{l}{Do you know about}\\
\multicolumn{2}{l}{zoonotic disease}\tabcellsep Total\\
Yes\tabcellsep No\end{longtable} \par
 
\caption{\label{tab_6}Table 5 :}\end{figure}
 \begin{figure}[htbp]
\noindent\textbf{6} \par 
\begin{longtable}{P{0.06419939577039274\textwidth}P{0.06933534743202417\textwidth}P{0.4314199395770393\textwidth}P{0.08987915407854984\textwidth}P{0.09244712990936556\textwidth}P{0.1027190332326284\textwidth}}
\tabcellsep Hindu\tabcellsep Count \% Within religion of the respondant\tabcellsep 146 58.6\%\tabcellsep 103 41.4\%\tabcellsep 249 100.0\%\\
Religion of the\tabcellsep Buddhist\tabcellsep Count \% Within religion of the respondant\tabcellsep 18 60.0\%\tabcellsep 12 40.0\%\tabcellsep 30 100.0\%\\
respondant\tabcellsep Christian\tabcellsep Count \% Within religion of the respondant\tabcellsep 12 66.7\%\tabcellsep 6 33.3\%\tabcellsep 18 100.0\%\\
\tabcellsep Islam\tabcellsep Count \% Within religion of the respondant\tabcellsep 0 0.0\%\tabcellsep 6 100.0\%\tabcellsep 6 100.0\%\end{longtable} \par
 
\caption{\label{tab_7}Table 6 :}\end{figure}
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