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\def\RunningAuthor{Shiny Chrism Queen Nesan G et al.}
\firstPage{116}
\articleType{Original Article}
\receivedDate{06 Dec 2019}
\acceptedDate{02 Mar 2020}
\revisedDate{25 Jan 2020}
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\title{To assess the knowledge, attitude and behaviour on dog bites and its management in the prevention of rabies among general population in an urban area in Tamil Nadu}
\author{Sruthi~N~Anandhan,  
            Shiny~Chrism~Queen~Nesan~G\textsuperscript{*},  
            Charumathi~B, 
            Timsi~Jain~\\[5pt]{Department of Community Medicine, Saveetha Medical College and Hospital, Thandalam, Chennai 602 105, Tamil Nadu, India}}

\begin{abstract}
 Rabies is a major health issue in the urban areas where there are many free roaming dogs. The absence of knowledge among people regarding the management of dog bites results in increased death due to rabies. Myths and indigenous methods have a greater influence on people than the available vaccines with proven efficacy. Rabies is a 100\% fatal disease that can be prevented by timely intervention. Knowledge, attitude and practice among the people play an important role in reducing death due to rabies. So this study aims to assess and evaluate the knowledge, attitude and behaviour on dog bites and its management in the prevention of rabies among general population. A Pretested questionnaire regarding the knowledge, attitude and behaviour on dog bites and it management, containing 34 questions, was used. A cross sectional descriptive study was performed on 205 residents of an urban area (Thirumazhisai) in Tamil Nadu. The data obtained was analysed using SPSS 22. A total of 205 subjects were studied. 52 subjects had heard of rabies and knew that it could be spread by animal bite. Regarding the animals that could spread rabies, 52 subjects reported dogs to be the most common source, the second commonest response being cats (24 subjects). Knowledge, attitude and behaviour study suggests that there is need to create awareness amongst the masses regarding epidemiology of the disease and merits of prompt and appropriate post exposure treatment.
\end{abstract}\def\keywordstitle{Keywords}

\begin{keywords}Attitude,\newline First aid measures,\newline Religious beliefs,\newline Rabid dogs,\newline Vaccine,\newline Wound washing
\end{keywords}
\twocolumn[ \maketitle {\printKwdAbsBox}]
\makeatletter{\raggedright\textsuperscript{*}Corresponding Author\par Name:\ Shiny~Chrism~Queen~Nesan~G~\\ Phone:\ 9500101858~\\  Email:\ shinynesan75@gmail.com 
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\section{Introduction}
 Rabies is a fatal zoonotic disease caused by a single stranded RNA virus from the rhabdoviridae family. Animal bites, commonly dog bites, are a major public health issue for the possibility of contracting rabies \unskip~\citep{745524:17710854}. India contributes to more than 36\% of deaths globally every year, most of which are due to bite by free-roaming dogs \unskip~\citep{745524:17710859}. Rabies is a 100\% fatal disease that can be prevented through timely intervention \unskip~\citep{745524:17710853,745524:17710856}. 

Mortality can be prevented through prompt washing of bite wounds with soap and water along with timely administration of rabies immunoglobulins (RIG) and anti- rabies vaccines \unskip~\citep{745524:17710858}. Despite the availability of vaccines with near hundred percent protections against rabies, it continues to be a major public health problem in developing countries like India \unskip~\citep{745524:17710854}. India is the largest contributor to rabies mortality in the world \unskip~\citep{745524:17710860,745524:17710852}.

 This is due to the misapprehension about the attitude towards dog bite wounds, its first aid, management and vaccination. There are many false beliefs and myths regarding dog bite wound management like application of oils, red chilli powder, turmeric powder on the wound \unskip~\citep{745524:17710858}. People in the rural areas have more faith in the indigenous methods that have an unproven efficacy. They have poor knowledge regarding the availability of rabies vaccines, their efficacy and vaccination of dogs.

Most of the deaths are due to ignorance and lack of access to affordable services \unskip~\citep{745524:17710854}. The only way to avoid deaths due to rabies is by early intervention, vaccination, post exposure prophylaxis and vaccination of dogs. This can be achieved by propagating the awareness about the need for early consultation that can reduce the risk of contracting rabies and by bringing to their knowledge the vulnerability of the disease. The availability of vaccines and their almost hundred percent efficacies should be brought to their knowledge. This study is aimed to bring to light the knowledge of people about rabies and their attitude and practice towards dog bites and its management.
    
\section{Materials and Methods}
 A descriptive cross sectional study was conducted among the residents of an urban area in Tamil Nadu (Thirumazhisai ), selected by simple random sampling method. In a study done by \unskip~\citep{745524:17710854} 75.2\% had heard about rabies. L (relative precision) = 8\% of P using the formula: Z\ensuremath{^{2}}pq/L\ensuremath{^{2}}. The sample size was calculated to be 206; with 5\% refusal rate, the sample size was calculated to be 215. The study was conducted after obtaining approval from the institutional ethical committee. 

Written informed consent was obtained from all the study participants before collecting the required data. The duration taken for the study was 3 months. The subjects were evaluated based on a pre-tested validated structured questionnaire for socio demographic details and questions related with their awareness regarding rabies, knowledge about dog bites, first aid measures adopted by them, knowledge regarding anti-rabies vaccines. The questionnaire contains a total of thirty four questions, which includes sixteen knowledge based questions, eleven attitude based questions and seven practice based questions. 

Data management and analysis was done by using Microsoft Excel and SPSS software. Chi square was used to test the significance and p value {\textless}0.05 was considered significant.
    
\section{\textbf{Results and Discussion}}
\textbf{Socio - Demographic details}

Out of 205 subjects studied, 116(56.6\%) were males and 89(43.4\%) were females. Maximum were between 21-40 years of age 121(59.0\%). Most of them, 74(36.1\%) were undergraduates. 36(17.6\%) subjects had pets at home, out of which men were 29(14.1\%). 

\textbf{Knowledge, attitude and behaviour}

52(25.3\%) subjects had heard of rabies and knew that it could be spread by animal bite. Regarding the animals that could spread rabies, 52(25.3\%) subjects reported dogs to be the most common source, the second commonest response being cats 24(11.7\%) subjects. An association is made between age and knowledge, attitude and behaviour on dog bites and its management among study participants. Out of 205 participants, 52 (25.3\%) knew what rabies is. Among them, majority (53.8\%) belonged to the age group of 21-40 years. Following a dog bite, 195 (95.1\%) participants agreed to take the patient to the hospital and 10 (4.8\%) participants claimed that hospital intervention was not required.  

When questioned about home remedies being sufficient to treat a dog bite, 131 (63.9\%) disagreed to it, 24 (11.7\%) said home remedies are sufficient, out of which 45.8\% belonged to the age group of 21-40 years. 75 (36.58\%) believed turmeric powder can be used as first aid before taking the patient to the hospital. Only 58(28.3\%) knew that vaccines were available for rabies, out of which 55.2\% belonged to the age group of 21-40 years shown in (Table~\ref{tw-55f5e364617d}).

An association is made between educational qualification and knowledge, attitude and behaviour on dog-bites and its management among the study participants. 52 (25.3) knew what rabies is, majority being undergraduates 28 (53.8\%). 37 (18.04\%) participants knew rabies is a fatal disease. 164 (80\%) participants said that 18 injections should be given following a dog bite, out of which 55 (33.5\%) were undergraduates. 

When asked about taking a patient to the hospital following a dog bite, 10 (4.8\%) participants said it was unnecessary, out of which 6 (60\%) were illiterates. 24 (11.7\%) participants said that home remedies were sufficient to treat a dog bite out, of which 8 (33.3\%) were illiterates and 8 (33.3\%) were undergraduates. 75 (36.5\%) participants said turmeric order could be used as a first aid before taking the 


\begingroup
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\caption{\boldmath {Association of age with knowledge, attitude and behavior on dog bites and its management among study participants} }
\label{tw-55f5e364617d}
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\tbltoprule \rowcolor{kwdboxcolor}Variables & \multicolumn{4}{p{\dimexpr(.64\linewidth-2\tabcolsep)}}{\cAlignHack Age (years)} & p value\\
\rowcolor{kwdboxcolor} & {\textless}20 \mbox{}\protect\newline N (\%) & 21-40 \mbox{}\protect\newline N (\%) & 41-60 \mbox{}\protect\newline N (\%) & {\textgreater}60 \mbox{}\protect\newline N (\%) & \\
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 &
   &
   &
   &
   &
  \\
\multicolumn{6}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack Do you know what rabies is?}\\
 &
   &
   &
   &
   &
  \\
No \mbox{}\protect\newline Yes &
  2(1.3\%) \mbox{}\protect\newline 7(13.5\%) &
  93(60.8\%) \mbox{}\protect\newline 28(53.8\%) &
  45(29.4\%) \mbox{}\protect\newline 17(32.7\%) &
  13(8.5\%) \mbox{}\protect\newline 0(0.0\%) &
  0.000\\
 &
   &
   &
   &
   &
  \\
\multicolumn{6}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack Do you think rabies could be spread by animal bite?}\\
 &
   &
   &
   &
   &
  \\
Yes \mbox{}\protect\newline Don't know &
  7(13.5\%) \mbox{}\protect\newline 2(1.3\%) &
  28(53.8\%) \mbox{}\protect\newline 93(60.8\%) &
  17(32.7\%) \mbox{}\protect\newline 45(29.4\%) &
  0(0.0\%) \mbox{}\protect\newline 13(8.5\%) &
  0.000\\
 &
   &
   &
   &
   &
  \\
\multicolumn{6}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack Saliva of patients with rabies can spread rabies?}\\
 &
   &
   &
   &
   &
  \\
Yes \mbox{}\protect\newline Don't know &
  5(11.1\%) \mbox{}\protect\newline 4(2.5\%) &
  23(51.1\%) \mbox{}\protect\newline 98(61.3\%) &
  17(37.8\%) \mbox{}\protect\newline 45(28.1\%) &
  0(0.0\%) \mbox{}\protect\newline 13(8.1\%) &
  0.010\\
 &
   &
   &
   &
   &
  \\
\multicolumn{6}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack Scratch from an infected animal can spread rabies?}\\
 &
   &
   &
   &
   &
  \\
No \mbox{}\protect\newline Yes \mbox{}\protect\newline Don't know &
  0(0.0\%) \mbox{}\protect\newline 7(14.0\%) \mbox{}\protect\newline 2(1.3\%) &
  2(1.6\%) \mbox{}\protect\newline 26(52.0\%) \mbox{}\protect\newline 93(60.8\%) &
  0(0.0\%) \mbox{}\protect\newline 17(34.0\%) \mbox{}\protect\newline 45(29.4\%) &
  0(0.0\%) \mbox{}\protect\newline 0(0.0\%) \mbox{}\protect\newline 13(8.5\%) &
  0.002\\
 &
   &
   &
   &
   &
  \\
\multicolumn{6}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack Should dogs be vaccinated against rabies?}\\
 &
   &
   &
   &
   &
  \\
No \mbox{}\protect\newline Yes \mbox{}\protect\newline Don't know &
  0(0.0\%) \mbox{}\protect\newline 7(17.5\%) \mbox{}\protect\newline 2(1.2\%) &
  4(3.3\%) \mbox{}\protect\newline 19(47.5\%) \mbox{}\protect\newline 98(60.9\%) &
  0(0.0\%) \mbox{}\protect\newline 14(35.0\%) \mbox{}\protect\newline 48(29.8\%) &
  0(0.0\%) \mbox{}\protect\newline 0(0.0\%) \mbox{}\protect\newline 13(8.1\%) &
  0.000\\
 &
   &
   &
   &
   &
  \\
\multicolumn{6}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack \textbf{ Attitude}}\\
 &
   &
   &
   &
   &
  \\
\multicolumn{6}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack Following a dog bite, will you take the patient to the hospital?}\\
 &
   &
   &
   &
   &
  \\
No \mbox{}\protect\newline Yes &
  0(0.0\%) \mbox{}\protect\newline 9(4.6\%) &
  2(20.0\%) \mbox{}\protect\newline 119(61.0\%) &
  4(40.0\%) \mbox{}\protect\newline 58(29.7\%) &
  4(40.0\%) \mbox{}\protect\newline 9(4.6\%) &
  0.000\\
 &
   &
   &
   &
   &
  \\
\multicolumn{6}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack Do you think home remedies are sufficient to treat a dog bite?}\\
 &
   &
   &
   &
   &
  \\
No \mbox{}\protect\newline Yes \mbox{}\protect\newline Don't know &
  7(5.3\%) \mbox{}\protect\newline 0(0.0\%) \mbox{}\protect\newline 2(4.0\%) &
  82(62.6\%) \mbox{}\protect\newline 11(45.8\%) \mbox{}\protect\newline 28(56.0\%) &
  41(31.3\%) \mbox{}\protect\newline 9(37.5\%) \mbox{}\protect\newline 12(24.0\%) &
  1(0.8\%) \mbox{}\protect\newline 4(16.7\%) \mbox{}\protect\newline 8(16.0\%) &
  0.002\\
 &
   &
   &
   &
   &
  \\
\multicolumn{6}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack As first aid, the wound should be thoroughly washed for 10 {\textendash} 15 minutes?}\\
 &
   &
   &
   &
   &
  \\
No \mbox{}\protect\newline Yes \mbox{}\protect\newline Don't know &
  0(0.0\%) \mbox{}\protect\newline 8(7.6\%) \mbox{}\protect\newline 1(2.1\%) &
  37(69.8\%) \mbox{}\protect\newline 53(50.5\%) \mbox{}\protect\newline 31(66.0\%) &
  11(20.8\%) \mbox{}\protect\newline 36(34.3\%) \mbox{}\protect\newline 15(31.9\%) &
  5(9.4\%) \mbox{}\protect\newline 8(7.6\%) \mbox{}\protect\newline 0(0.0\%) &
  0.026\\
 &
   &
   &
   &
   &
  \\
\multicolumn{6}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack As first aid, turmeric powder or other home remedies will suffice?}\\
 &
   &
   &
   &
   &
  \\
No \mbox{}\protect\newline Yes \mbox{}\protect\newline Don't know &
  0(0.0\%) \mbox{}\protect\newline 2(2.7\%) \mbox{}\protect\newline 7(9.6\%) &
  36(63.2\%) \mbox{}\protect\newline 44(58.7\%) \mbox{}\protect\newline 41(56.2\%) &
  20(35.1\%) \mbox{}\protect\newline 25(33.3\%) \mbox{}\protect\newline 17(23.3\%) &
  1(1.8\%) \mbox{}\protect\newline 4(5.3\%) \mbox{}\protect\newline 8(11.0\%) &
  0.029\\
 &
   &
   &
   &
   &
  \\
\multicolumn{6}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack Rabies vaccine should be taken before a dog bite to prevent rabies?}\\
 &
   &
   &
   &
   &
  \\
No \mbox{}\protect\newline Yes \mbox{}\protect\newline Don't know &
  0(0.0\%) \mbox{}\protect\newline 5(15.2\%) \mbox{}\protect\newline 4(2.4\%) &
  4(66.7\%) \mbox{}\protect\newline 14(42.4\%) \mbox{}\protect\newline 103(62.0\%) &
  2(33.3\%) \mbox{}\protect\newline 14(42.4\%) \mbox{}\protect\newline 46(27.7\%) &
  0(0.0\%) \mbox{}\protect\newline 0(0.0\%) \mbox{}\protect\newline 13(7.8\%) &
  0.008\\
 &
   &
   &
   &
   &
  \\
\multicolumn{5}{p{\dimexpr(.80\linewidth-2\tabcolsep)}}{\cAlignHack \textbf{ Practice}} &
  \\
 &
   &
   &
   &
   &
  \\
\multicolumn{6}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack Did you follow any first aid measures?}\\
 &
   &
   &
   &
   &
  \\
No \mbox{}\protect\newline Yes \mbox{}\protect\newline NA &
  0(0.0\%) \mbox{}\protect\newline 0(0.0\%) \mbox{}\protect\newline 9(4.8\%) &
  5(55.6\%) \mbox{}\protect\newline 0(0.0\%) \mbox{}\protect\newline 116(61.7\%) &
  4(44.4\%) \mbox{}\protect\newline 4(100.0\%) \mbox{}\protect\newline 50(26.6\%) &
  0(0.0\%) \mbox{}\protect\newline 0(0.0\%) \mbox{}\protect\newline 13(6.9\%) &
  0.002\\
 &
   &
   &
   &
   &
  \\
\multicolumn{6}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack Did you go to the hospital immediately?}\\
 &
   &
   &
   &
   &
  \\
Yes \mbox{}\protect\newline NA &
  0(0.0\%) \mbox{}\protect\newline 9(4.8\%) &
  5(29.4\%) \mbox{}\protect\newline 116(61.7\%) &
  12(70.6\%) \mbox{}\protect\newline 50(26.6\%) &
  0(0.0\%) \mbox{}\protect\newline 13(6.9\%) &
  0.002\\
 &
   &
   &
   &
   &
  \\
\multicolumn{6}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack Did you get a rabies vaccine?}\\
 &
   &
   &
   &
   &
  \\
Yes \mbox{}\protect\newline NA &
  0(0.0\%) \mbox{}\protect\newline 9(4.8\%) &
  5(29.4\%) \mbox{}\protect\newline 116(61.7\%) &
  12(70.6\%) \mbox{}\protect\newline 50(26.6\%) &
  0(0.0\%) \mbox{}\protect\newline 13(6.9\%) &
  0.002\\
 &
   &
   &
   &
   &
  \\
\multicolumn{6}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack Did you do home remedies?}\\
 &
   &
   &
   &
   &
  \\
No \mbox{}\protect\newline NA &
  0(0.0\%) \mbox{}\protect\newline 9(4.8\%) &
  5(29.4\%) \mbox{}\protect\newline 116(61.7\%) &
  12(70.6\%) \mbox{}\protect\newline 50(26.6\%) &
  0(0.0\%) \mbox{}\protect\newline 13(6.9\%) &
  0.002\\
 &
   &
   &
   &
   &
  \\
\multicolumn{6}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack Did you get a tetanus toxoid injection (TT injection)?}\\
 &
   &
   &
   &
   &
  \\
Yes \mbox{}\protect\newline NA &
  0(0.0\%) \mbox{}\protect\newline 9(4.8\%) &
  5(29.4\%) \mbox{}\protect\newline 116(61.7\%) &
  12(70.6\%) \mbox{}\protect\newline 50(26.6\%) &
  0(0.0\%) \mbox{}\protect\newline 13(6.9\%) &
  0.002\\
 &
   &
   &
   &
   &
  \\
\tblbottomrule 
\end{longtable}
\endgroup
\makeatletter\@ifundefined{TwoColDocument}{}{\twocolumn}\makeatother 

\begingroup
\makeatletter\if@twocolumn\@ifundefined{theposttbl}{\gdef\TwoColDocument{true}\onecolumn\onecolumn}{}\fi\makeatother \setlength\LTcapwidth{\textwidth}
\begin{longtable}{p{\dimexpr.13309999999999999\linewidth-2\tabcolsep}p{\dimexpr.12940000000000001\linewidth-2\tabcolsep}p{\dimexpr.1279\linewidth-2\tabcolsep}p{\dimexpr.12689999999999998\linewidth-2\tabcolsep}p{\dimexpr.13899999999999999\linewidth-2\tabcolsep}p{\dimexpr.13470000000000002\linewidth-2\tabcolsep}p{\dimexpr.147\linewidth-2\tabcolsep}p{\dimexpr.06200000000000001\linewidth-2\tabcolsep}}
\caption{\boldmath {Association of educational qualification with knowledge, attitude and behaviour on dog bites and its management among study participants} }
\label{tw-e9a6a6f984d7}
\def\arraystretch{1.1}\\\endfirsthead \hline \noalign{\vskip3pt} \noalign{\textit{Table \thetable\ continued}} \noalign{\vskip3pt} 
\tbltoprule \rowcolor{kwdboxcolor}\cAlignHack Variable & \multicolumn{6}{p{\dimexpr(.8049000000000001\linewidth-2\tabcolsep)}}{\cAlignHack Educational Qualification} & \cAlignHack P value\\
\rowcolor{kwdboxcolor} & \cAlignHack \textbf{Illiterate } \mbox{}\protect\newline \textbf{\textbf{N (\%)}} & \cAlignHack \textbf{Primary school} \mbox{}\protect\newline \textbf{N (\%)} & \cAlignHack \textbf{High school} \mbox{}\protect\newline \textbf{N (\%)} & \cAlignHack \textbf{Higher secondary} \mbox{}\protect\newline \textbf{N (\%)} & \cAlignHack \textbf{Undergraduate degree }\textbf{N (\%)} & \cAlignHack \textbf{Postgraduate degree   N} \textbf{ (\%)} & \\
\tblmidrule \endhead \hline \noalign{\vskip3pt} \noalign{\textit{\hfill Continued on next page}} \noalign{\vskip3pt} \endfoot \endlastfoot 
\tbltoprule \rowcolor{kwdboxcolor}\cAlignHack Variable & \multicolumn{6}{p{\dimexpr(.8049000000000001\linewidth-2\tabcolsep)}}{\cAlignHack Educational Qualification} & \cAlignHack P value\\
\rowcolor{kwdboxcolor} & \cAlignHack \textbf{Illiterate } \mbox{}\protect\newline \textbf{\textbf{N (\%)}} & \cAlignHack \textbf{Primary school} \mbox{}\protect\newline \textbf{N (\%)} & \cAlignHack \textbf{High school} \mbox{}\protect\newline \textbf{N (\%)} & \cAlignHack \textbf{Higher secondary} \mbox{}\protect\newline \textbf{N (\%)} & \cAlignHack \textbf{Undergraduate degree }\textbf{N (\%)} & \cAlignHack \textbf{Postgraduate degree   N} \textbf{ (\%)} & \\
\tblmidrule 
\multicolumn{8}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack \textbf{Knowledge}}\\
\multicolumn{8}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack Do you think rabies could be spread by animal bite?}\\
 &
   &
   &
   &
   &
   &
   &
  \\
Yes &
  12(23.1\%) &
  0(0.0\%) &
  0(0.0\%) &
  8(15.4\%) &
  28(53.8\%) &
  4(7.7\%) &
  0.000\\
Don't know &
  20(13.1\%) &
  12(7.8\%) &
  32(20.9\%) &
  35(22.9\%) &
  46(30.1\%) &
  8(5.2\%) &
  \\
 &
   &
   &
   &
   &
   &
   &
  \\
\multicolumn{8}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack Saliva of patients with rabies can spread rabies?}\\
 &
   &
   &
   &
   &
   &
   &
  \\
Yes &
  12(26.7\%) &
  0(0.0\%) &
  0(0.0\%) &
  8(17.8\%) &
  23(51.1\%) &
  2(4.4\%) &
  0.001\\
Don't know &
  20(12.5\%) &
  12(7.5\%) &
  32(20.0\%) &
  35(21.9\%) &
  51(31.9\%) &
  10(6.3\%) &
  \\
 &
   &
   &
   &
   &
   &
   &
  \\
\multicolumn{8}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack Scratch from an infected animal can spread rabies?}\\
 &
   &
   &
   &
   &
   &
   &
  \\
No &
  0(0.0\%) &
  0(0.0\%) &
  0(0.0\%) &
  2(100.0\%) &
  0(0.0\%) &
  0(0.0\%) &
  0.000\\
Yes &
  12(24.0\%) &
  0(0.0\%) &
  0(0.0\%) &
  6(12.0\%) &
  28(56.0\%) &
  4(8.0\%) &
  \\
Don't know &
  20(13.1\%) &
  12(7.8\%) &
  32(20.9\%) &
  35(22.9\%) &
  46(30.1\%) &
  8(5.2\%) &
  \\
 &
   &
   &
   &
   &
   &
   &
  \\
\multicolumn{8}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack Should dogs be vaccinated against rabies?}\\
 &
   &
   &
   &
   &
   &
   &
  \\
No &
  0(0.0\%) &
  0(0.0\%) &
  0(0.0\%) &
  0(0.0\%) &
  4(100.0\%) &
  0(0.0\%) &
  0.001\\
Yes &
  12(30.0\%) &
  0(0.0\%) &
  0(0.0\%) &
  6(15.0\%) &
  18(45.0\%) &
  4(10.0\%) &
  \\
Don't know &
  20(12.4\%) &
  12(7.5\%) &
  32(19.9\%) &
  37(23.0\%) &
  52(32.3\%) &
  8(5.0\%) &
  \\
 &
   &
   &
   &
   &
   &
   &
  \\
\multicolumn{8}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack How many doses should be given following a dog bite?}\\
 &
   &
   &
   &
   &
   &
   &
  \\
5 &
  8(32.0\%) &
  0(0.0\%) &
  0(0.0\%) &
  2(8.0\%) &
  13(52.0\%) &
  2(8.0\%) &
  0.012\\
4 &
  0(0.0\%) &
  0(0.0\%) &
  2(6.25\%) &
  0(0.0\%) &
  0(0.0\%) &
  0(0.0\%) &
  \\
3 &
  2(14.3\%) &
  0(0.0\%) &
  4(28.6\%) &
  2(14.3\%) &
  6(42.9\%) &
  0(0.0\%) &
  \\
18 &
  22(13.4\%) &
  12(7.3\%) &
  26(15.9\%) &
  39(23.8\%) &
  55(33.5\%) &
  10(6.1\%) &
  \\
\multicolumn{8}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack \textbf{Attitude}}\\
 &
   &
   &
   &
   &
   &
   &
  \\
\multicolumn{8}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack Following a dog bite, will you take the patient to the hospital?}\\
 &
   &
   &
   &
   &
   &
   &
  \\
No &
  6(60.0\%) &
  2(20.0\%) &
  0(0.0\%) &
  0(0.0\%) &
  2(20.0\%) &
  0(0.0\%) &
  0.001\\
Yes &
  26(13.3\%) &
  10(5.1\%) &
  32(16.4\%) &
  43(22.1\%) &
  72(36.9\%) &
  12(6.2\%) &
  \\
 &
   &
   &
   &
   &
   &
   &
  \\
\multicolumn{8}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack Do you think home remedies are sufficient to treat a dog bite?}\\
 &
   &
   &
   &
   &
   &
   &
  \\
No &
  14(10.7\%) &
  8(6.1\%) &
  18(13.7\%) &
  34(26.0\%) &
  47(35.9\%) &
  10(7.6\%) &
  0.005\\
Yes &
  8(33.3\%) &
  4(16.7\%) &
  4(16.7\%) &
  0(0.0\%) &
  8(33.3\%) &
  0(0.0\%) &
  \\
Don't know &
  10(20.0\%) &
  0(0.0\%) &
  10(20.0\%) &
  9(18.0\%) &
  19(38.0\%) &
  2(4.0\%) &
  \\
 &
   &
   &
   &
   &
   &
   &
  \\
\multicolumn{8}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack As first aid, the wound should be thoroughly washed for 10 {\textendash} 15 minutes?}\\
 &
   &
   &
   &
   &
   &
   &
  \\
No &
  8(15.1\%) &
  4(7.5\%) &
  8(15.1\%) &
  8(15.1\%) &
  21(39.6\%) &
  4(7.5\%) &
  0.072\\
Yes &
  22(21.0\%) &
  6(5.7\%) &
  10(9.5\%) &
  23(21.9\%) &
  38(36.2\%) &
  6(5.7\%) &
  \\
Don't know &
  2(4.3\%) &
  2(4.3\%) &
  14(29.8\%) &
  12(25.5\%) &
  15(31.9\%) &
  2(4.3\%) &
  \\
 &
   &
   &
   &
   &
   &
   &
  \\
\multicolumn{8}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack As first aid, turmeric powder or other home remedies will suffice?}\\
 &
   &
   &
   &
   &
   &
   &
  \\
No &
  4(7.0\%) &
  2(3.5\%) &
  10(17.5\%) &
  21(36.8\%) &
  18(31.6\%) &
  2(3.5\%) &
  0.000\\
Yes &
  16(21.3\%) &
  8(10.7\%) &
  14(18.7\%) &
  11(14.7\%) &
  26(34.7\%) &
  0(0.0\%) &
  \\
Don't know &
  12(16.4\%) &
  2(2.7\%) &
  8(11.0\%) &
  11(15.1\%) &
  30(41.1\%) &
  10(13.7\%) &
  \\
 &
   &
   &
   &
   &
   &
   &
  \\
\multicolumn{8}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack Rabies vaccine should be taken before a dog bite to prevent the transmission of rabies?}\\
 &
   &
   &
   &
   &
   &
   &
  \\
No &
  0(0.0\%) &
  2(50.0\%) &
  0(0.0\%) &
  0(0.0\%) &
  2(50.0\%) &
  0(0.0\%) &
  0.000\\
Yes &
  12(18.8\%) &
  2(3.1\%) &
  2(3.1\%) &
  10(15.6\%) &
  32(50.0\%) &
  6(9.4\%) &
  \\
Don't know &
  20(14.6\% &
  8(5.8\%) &
  30(21.9\%) &
  33(24.1\%) &
  40(29.2\%) &
  6(4.4\%) &
  \\
\multicolumn{8}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack \textbf{Practice}}\\
 &
   &
   &
   &
   &
   &
   &
  \\
\multicolumn{8}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack Have you ever been bitten by a dog?}\\
 &
   &
   &
   &
   &
   &
   &
  \\
No &
  22(11.7\%) &
  12(6.4\%) &
  32(17.0\%) &
  43(22.9\%) &
  67(35.6\%) &
  12(6.4\%) &
  0.000\\
Yes &
  10(58.8\%) &
  0(0.0\%) &
  0(0.0\%) &
  0(0.0\%) &
  7(41.2\%) &
  0(0.0\%) &
  \\
 &
   &
   &
   &
   &
   &
   &
  \\
\multicolumn{8}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack Did you follow any first aid measures?}\\
 &
   &
   &
   &
   &
   &
   &
  \\
No &
  4(44.4\%) &
  0(0.0\%) &
  0(0.0\%) &
  0(0.0\%) &
  5(55.6\%) &
  0(0.0\%) &
  0.000\\
Yes &
  6(75.0\%) &
  0(0.0\%) &
  0(0.0\%) &
  0(0.0\%) &
  2(25.0\%) &
  0(0.0\%) &
  \\
NA &
  22(11.7\%) &
  12(6.4\%) &
  32(17.0\%) &
  43(22.9\%) &
  67(35.6\%) &
  12(6.4\%) &
  \\
 &
   &
   &
   &
   &
   &
   &
  \\
\multicolumn{8}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack Did you go to the hospital immediately?}\\
 &
   &
   &
   &
   &
   &
   &
  \\
Yes &
  10(58.8\%) &
  0(0.0\%) &
  0(0.0\%) &
  0(0.0\%) &
  7(41.2\%) &
  0(0.0\%) &
  0.000\\
NA &
  22(11.7\%) &
  12(6.4\%) &
  32(17.0\%) &
  43(22.9\%) &
  67(35.6\%) &
  12(6.4\%) &
  \\
 &
   &
   &
   &
   &
   &
   &
  \\
\multicolumn{8}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack Did you get a rabies vaccine?}\\
 &
   &
   &
   &
   &
   &
   &
  \\
Yes &
  10(58.8\%) &
  0(0.0\%) &
  0(0.0\%) &
  0(0.0\%) &
  7(41.2\%) &
  0(0.0\%) &
  0.000\\
NA &
  22(11.7\%) &
  12(6.4\%) &
  32(17.0\%) &
  43(22.9\%) &
  67(35.6\%) &
  12(6.4\%) &
  \\
 &
   &
   &
   &
   &
   &
   &
  \\
\multicolumn{8}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack Did you do home remedies?}\\
 &
   &
   &
   &
   &
   &
   &
  \\
No &
  10(58.8\%) &
  0(0.0\%) &
  0(0.0\%) &
  0(0.0\%) &
  7(41.2\%) &
  0(0.0\%) &
  0.000\\
NA &
  22(11.7\%) &
  12(6.4\%) &
  32(17.0\%) &
  43(22.9\%) &
  67(35.6\%) &
  12(6.4\%) &
  \\
 &
   &
   &
   &
   &
   &
   &
  \\
\multicolumn{8}{p{\dimexpr(1\linewidth-2\tabcolsep)}}{\cAlignHack Did you get a tetanus toxoid injection (TT injection)?}\\
 &
   &
   &
   &
   &
   &
   &
  \\
Yes &
  10(58.8\%) &
  0(0.0\%) &
  0(0.0\%) &
  0(0.0\%) &
  7(41.2\%) &
  0(0.0\%) &
  0.000\\
NA &
  22(11.7\%) &
  12(6.4\%) &
  32(17.0\%) &
  43(22.9\%) &
  67(35.6\%) &
  12(6.4\%) &
  \\
\tblbottomrule 
\end{longtable}
\endgroup
\makeatletter\@ifundefined{TwoColDocument}{}{\twocolumn}\makeatother 
 patient to the hospital. 58 (28.3\%) participants knew about rabies vaccine, out of which 30 (51.7\%) were undergraduates as shown in (Table~\ref{tw-e9a6a6f984d7}).

In a Knowledge, Attitude, Behaviour and Practice Study on Dog-Bites and Its Management in the Context of Prevention of Rabies in a Rural Community of Gujarat \unskip~\citep{745524:17710858,745524:17710851} all the individuals knew about rabies and 98.6\% knew about its transmission through dog bites. In comparison to our study, only 25.3\% knew what rabies is and its transmission through dog bites. 

This difference in knowledge could be due to the lack of educational intervention regarding rabies and its fatality. Even though the number of illiterates in our study is only 15.6\%, there is a great influence of myths and indigenous methods among the educated people. Out of the 164 (80\%) participants who said 18 doses are required for a dog bite case, which is a myth, 33.5\% were undergraduates and 23.8\% had completed higher secondary education.

In the study conducted by\unskip~\citep{745524:17710858}, 36.4\% of the participants would like to visit a doctor in case of a dog bite. In comparison to our study, 195 (95.1\%) of participants agreed to take them to the hospital. This difference shows the easy accessibility and trust that has been established between the hospitals and the public. In the same study conducted by U~S Singh \textit{et al}., 86.6\% knew about anti rabies vaccine. In our study, only 28.2\% were aware about anti rabies vaccine. In the study conducted by \unskip~\citep{745524:17710858,745524:17710855} 24.4\% knew that pet dogs should be vaccinated against rabies. 

In our study, only 40 (19.5\%) knew that pet dogs should be vaccinated against rabies. This difference in knowledge is of high significance that awareness should be brought among the people regarding rabies, anti-rabies vaccine, and mode of transmission, vaccination of dogs and fatality of rabies, which is also stated in a study conducted in Maharashtra \unskip~\citep{745524:17710857}. 
    
\section{\textbf{Conclusion}}
Knowledge, attitude and behaviour study suggests that there is need to create awareness amongst the masses regarding epidemiology of the disease and merits of prompt and appropriate post exposure treatment.
    
\section{\textbf{Acknowledgement}}
We thank all the residents who participated in-the study.
    

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