Awareness of rabies control and challenges to the intersectoral management of dog bites in Western Cameroon

Abstract
Background: Rabies is a zoonotic and a typical One Health challenge. Intersectoral surveillance is a critical component of rabies control programmes. However, the under-reporting of animal bite cases and the lack of coordination between sectors involved in the surveillance may lead to failure in the control efforts of this public health concern.
Methods: A cross-sectional study was conducted at the operational level. Two separate survey grids were used for simultaneous data collection in the study sites, including 385 dog bite victims within communities and 273 human health and animal health professionals responsible for rabies surveillance in health and veterinary facilities
Results: There was no association (OR: 0,76; CI: 0,452-1,39 and p=0.38) between data loss and professional profile of the surveillance focal points; however, there was a significant association between the under-reporting of physical aggression cases of dog bites by victims and the level of education (OR: 1.75; IC:1.02-2.99 and P=0.0413), and with individuals younger than 20 years and those over 50 years of age (OR:0.39; CI:0.16-0.96 and p=0.0415). Indeed, there was a positively and statistically significant association (OR: 3.11; CI: 1.94-5.00 and p<0.0001) between knowledge of rabies with under-reporting of dog bites by community members; while negatively associated CI: 0.52-1.82 and p=0.9226) with the level of education. Interestingly, there was no significant difference in the under-performance in case reporting whether the surveillance focal points had received prior training on rabies surveillance (OR: 1.14; CI: 0.64-2.01 and p=0.66), had knowledge of operational case definition (OR: 0.93; CI: 0.54- 1.58 and p=0.7851) or /and knew the manifestation of rabies (OR: 0.88; CI: 0.51-1.51and p=0.6408).
Conclusion: The under-reporting of rabies bites in the West region of Cameroon is as a consequence of negligence and lack of application of the one health approach on rabies surveillance by the surveillance focal points in District health sectors, leading to the no-exhaustive collection and patchy dissemination of dog bite data.