Uptake of Rabies Control Measures by Dog Owners in Flores Island, Indonesia

Background: Rabies has been a serious public health threat in Flores Island, Indonesia since it was introduced in 1997. To control the disease, annual dog vaccination campaigns have been implemented to vaccinate all dogs free of charge. Nevertheless, the uptake rate of the vaccination campaigns has been low. The objective of this paper is to identify risk factors associated with the uptake of rabies control measures by individual dog owners in Flores Island. Methodology/principal findings: A total of 450 dog owners from 44 randomly selected villages in the Sikka and Manggarai regencies were interviewed regarding their socio-demographic factors, knowledge of rabies, and their uptake of rabies control measures. The majority of dog owners surveyed (>90%) knew that rabies is a fatal disease and that it can be prevented. Moreover, 68% of the dog owners had a high level of knowledge about available rabies control measures. Fifty-two percent of the dog owners had had at least one of their dogs vaccinated during the 2012 vaccination campaign. Vaccination uptake was significantly higher for dog owners who resided in Sikka, kept female dogs for breeding, had an income of more than one million Rupiah, and had easy access to their village. The most important reasons not to join the vaccination campaign were lack of information about the vaccination campaign schedule (40%) and difficulty to catch the dog during the vaccination campaign (37%). Conclusions/significance: Dog owners in Flores Island had a high level of knowledge of rabies and its control, but this was not associated with uptake of the 2012 vaccination campaign. Geographical accessibility was one of the important factors influencing the vaccination uptake among dog owners. Targeted distribution of information on vaccination schedules and methods to catch and restrain dogs in those villages with poor accessibility may increase vaccination uptake in the future. Author Summary: Rabies has been a serious public health threat in Flores Island since its introduction in 1997, with significant economic consequences for the government due to the cost of providing vaccines for humans and dogs. Vaccination of dogs against rabies offers a safe and effective means to prevent rabies in humans in the long term. The local government of Flores Island has implemented dog vaccination campaigns throughout the island, free of charge for all dog owners. However, the uptake rate of vaccinating dogs is too low to control the disease. Identifying factors associated with the dog owners’ decisions to vaccinate their dogs provides information to policy makers to increase vaccination uptake in the future. This study evaluated the impact of rabies knowledge and socio-demographic factors of dog owners on the uptake of the 2012 dog vaccination campaign. Overall, the uptake rate of the 2012 vaccination campaign was low. Levels of knowledge about rabies and its control were high, but not associated with uptake of vaccination. Geographical accessibility was significantly associated with vaccination uptake. Targeted distribution of information in those villages with poor accessibility may increase vaccination uptake in the future. Information should cover vaccination schedules and methods to restrain dogs.