Background and Aim

Serologic evidence has identified Lyssavirus exposure among bats in the Indian subcontinent. This study aims to investigate the perception of people regarding bats and the frequency of bat human interaction with One Health implications.

Material and Method

A cross-sectional study was conducted using a structured questionnaire among individuals (n=1466) in two distinct topographic residential backgrounds (Mountainous and Plain regions) in Punjab and Khyber Pakhtunkhwa province in Pakistan.

Result

A considerable number of respondents (28%) reported bat’s left fruits in their gardens. People who saw bat left fruits in their garden had also reported more bat conflict incidences (32%) as compared to those who had not seen bat left fruit (16%). A higher proportion of respondents from the mountainous districts (23%) reported bat conflict incidents, compared to the plain region respondents (17%). Univariate analysis model also highlighted that topographic residential background (mountainous vs plain residential area) had significance (p<0.05) in describing bat conflict and suspected human rabies-related deaths, in comparison with provincial residential background (Punjab vs Khyber Pakhtunkhwa).  

Conclusion

Our findings indicate the necessity of a One Health comprehensive surveillance system for emerging and re-emerging zoonotic pathogens, including wildlife as a potential Lyssavirus reservoir, within a context of increased public health education efforts targeted at bats. Epidemiologic and ecologic investigations, as well as laboratory characterization of the virus responsible for human deaths in the mountainous regions, in Pakistan, will provide essential information required to develop strategies for zoonotic pathogen prevention and control.

Data was collected on a pre-designed, structured questionnaire from different sites in the 4 aforementioned geographic regions of Punjab and KPK province by trained enumerators. A convenient sampling technique was used to collect data regarding knowledge, attitude, and practices of rabies. For the sake of convenience, to maximize accuracy along with response rate, and to avoid any sort of confusion by the respondents, the questionnaire was translated into the local language in that region. Data was collected after obtaining informed verbal consent using debriefing form. Each respondent including the guardian or parent of the respondent below 16 years of age was informed using the same debriefing form. Verbal consent is preferred because it is socially and culturally acceptable in comparison to written consent which creates a lot of suspicion.

We initially assumed 50% of our respondents might have knowledge and awareness about transmission, clinical signs, and acceptable preventative practices against rabies. This survey included people of both genders, rural and urban locations, and different levels of education. Juveniles (less than 18 years of age) were surveyed as a focus group because they are reported to have the highest exposure rate to rabies disease.