Study design and data collection

A semi-structured open-ended questionnaire was developed to assess perceptions, knowledge, and attitudes toward Zoonosis. The focus of the questionnaire was on animal health workers and livestock keepers in Gwalior-Chambal region of north Madhya Pradesh, India. Knowledge is considered important for identification and perception of Zoonosis. With respect to awareness, essential information that were asked included diseases identification, animal or vector associated with the Zoonosis, clinical signs in humans, and clinical signs in animals. Finally, data were collected on the risk of Zoonosis between localities i.e. urban, peri-urban, and rural.

Statistical analysis

All the statistical values used in the present study were calculated using Microsoft Excel Version 2010.

Results

Zoonotic diseases reported by respondents

All respondents knew that there are certain diseases in their area, which are Zoonosis. Rabies, Malaria, Dengue, Bird Flu, Swine Flu, Chikungunya, Brucellosis, Tuberculosis, Plague, Glanders Diseases, and Parvo were reported as the top eleven diseases (Table 1). Whereas, Rabies, Malaria, Dengue, Swine Flu, Chikungunya, Brucellosis and Tuberculosis were identified as the most important Zoonotic diseaes by all the respondents. Bird flu, Plague, Glanders diseases, and Parvo were mentioned, respectively, 25%, 25%, and 50% by the respondents.

Perception of knowledge of animals/vectors toward Zoonosis

All the respondents (both agro-postoral and smallholder dairy village) have a 100% level of perception of knowledge about the animals/vectors associated with the Zoonosis , namely Rabies , Malaria, Dengue, Brucellosis, and Bovine Tuberculosis, while as the level of perception of knowledge for Chikungunya, Bird Flu, Swine  Flu, Glanders Diseases and Parvo are more than 50%. Plague is the only Zoonotic disease in the study area for which there is least knowledge for animal/ vectors, i.e., 25% (Table 2).

Perception of knowledge of clinical signs of Zoonosis in humans

The maximum number of respondents have good knowledge for clinical signs of Zoonosis in humans in the study area (Table 3), 68.2% of the respondent have knowledge for the clinical sign of malaria (fever), and 59.9% of respondents for chill as a clinical sign. The overall average mean values for clinical signs of malaria are (64.05%). The minimum number of respondents have good knowledge for Rabies, 55.0% of respondents have knowledge about death as a clinical sign for Rabies. In comparison, as 15.8% of respondents have knowledge for madness as a clinical sign and only 11.3% of respondents know barking as a clinical sign. The overall mean value for clinical signs of Rabies is 27.36. For swine flu, 24.6% of respondents have good knowledge for dry cough as a clinical sign and only 6.9% of respondents have knowledge for nausea as a clinical sign, overall mean value for the clinical signs of swine flu is 15.75. 22.3% of respondents know that Cough is a clinical sign for bird flu  and 42.4% of respondents have good knowledge for fever (over 100.4°F or 38°C) as one of the clinical signs for bird flu, the overall mean value for the clinical signs of bird flu is 32.35. 47.2% of respondents have knowledge that joint pain is a clinical sign for chikungunya while only 25.0% of respondents know that joint swelling is a clinical sign for chikungunya and the overall mean value for the clinical signs of chikungunya is 36.1.

Perception of knowledge of clinical signs of Zoonosis in animals

The predominant clinical signs of different Zoonotic diseases in animals identified by the respondents are reported in Table 4. The main clinical signs for Rabies in the animals are madness and death, and in this case, 50.8% of respondents identified the madness as a clinical sign, while 73.3% of respondents identified death as a clinical sign. Emaciation and milk drop are the clinical signs for brucellosis, and 14.5% of respondents identified emaciation as a clinical sign, while 72.6% of respondents identified milk drop as a clinical sign. For bovine tuberculosis, coughing and emaciation are the predominant clinical sign in animals, and 49.2% of respondents have good knowledge about coughing as a clinical sign, and 36.5% of respondents knows emaciation as one of the clinical signs for bovine tuberculosis among livestock.

For foot and mouth disease, eating less and reluctance to move or stand due to sore feet are the main clinical signs among domestic animals. About74.8% of respondents had good knowledge for both of these clinical signs. Clinical signs for hemoregicsepticium are loss of appetite and salivation, and about 31.8% of respondents knowthat loss of appetite is a clinical sign for hemoregicsepticium,while about 41.4% of respondents know that salivation is a clinical sign. Hot limbs and swelling of limbs are the common signs for black quarter diseases, and 23.8% and 26.2% of respondents know about these signs; for Epimoral fever and Glanders disease, clinical signs are very much the same. The important clinical sign for Mastitis diseases is fever and milk with watery appearance, and 73.2% of respondents had good knowledge about the clinical sign.

Discussion

Zoonotic diseases are now more prevalent in almost all parts of the world. The number of studies carried out across the country have revealed most of the victims in these areas are the population with economically poor and mostly those who do not have access to basic facilities. The present study was focused on the Gwalior-Chambal region to study the different Zoonotic diseases and the environmental factors responsible for the transmission of these diseases. These diseases have caused great morbidity and mortality among the people of the region. Different factors are responsible for the transmission of these diseases.

In order to assess and to compare knowledge, attitude, and practices of livestock keepers on Zoonosis in agro-pastoral and smallholder dairy, farming systems, a cross-sectional study was carried out, and it was revealed from the study that the most predominant Zoonotic diseases reported were Rabies, Malaria, Dengue, Swine Flu, Bird Flu, Chikungunya, Bovine Tuberculosis, Brucellosis, Plague, Glanders disease, and Parvo infection. In addition to these Zoonotic diseases, other diseases reported in the study area are foot and mouth diseases, black quarter, ephemeral fever, and mastitis.

In the present study, it was observed that 100% of the respondents in both PAR and cross-sectional study identified Rabies as a Zoonotic disease; also, 100% of respondents identified the animals/ vectors associated with the transmission of Rabies . Most of the respondents were able to identify death as a clinical sign for Rabies, and only less percent of respondents identified barking and madness as a clinical sign for Rabies. Our findings are supported by the study carried out by Swai et al. (2010), who showed that 100% of the respondents in both the PRA and cross-sectional surveys identified Rabies as a Zoonosis. Another similar study reveals that 100% of respondents in both the PRA and cross-sectional studies identified dogs as animals associated with Rabies (Radostits et al., 2000). They also presented that madness was identified in both the PRA and cross-sectional studies as one of the clinical indicators of Rabies in animals (Radostits et al., 2000). A study done by Unger and Munstermann(2004)shows that madness and death are frequently identified by respondents as associated with Rabies  in humans in both the PRA and cross-sectional studies. The identification of Rabies as a Zoonotic disease is due to the knowledge of Rabies and fear of contracting the disease among the livestock keepers. Hence; they report animal bite injuries to hospitals mainly for post-exposure vaccination. The awareness by health staff sometimes plays a critical role in directing people to report such incidences. The fact that high proportion of livestock keepers identified Rabies as a Zoonosis, this could be an indicator that the disease is prevalent.

A study done by Radostits et al. (2000) shows that respondent in both the PRA and cross-sectional studies identified bovine tuberculosis as a Zoonotic disease, and domestic ruminants as the animals associated with bovine tuberculosis. Besides, coughing and emaciation are the clinical signs of tuberculosis in animals identified in both the PRA (Radostits et al., 2000). Our study also reveals the same findings as 77% of respondents in both PRA and cross-sectional study identified tuberculosis as a Zoonotic disease, and about 81% of respondents identified animals associated with bovinetuberculosis. Coughing and emaciation were identified as the clinical symptoms of tuberculosis.

In the present study, it was revealed that 100% of respondents identified brucellosis as a Zoonotic disease both in PRA and cross-sectional studies, which is almost the same as the previous study (Kunda et al., 2004). In northern Tanzania, there were a high proportion of livestock keepers in agro-pastoral systems thatidentified brucellosis as a Zoonosis during the PRA and cross-sectional studies. The reason that why a high proportion of livestock keepers in agro-pastoral systems identified brucellosis as a Zoonosis  during the PRA and cross-sectional studies could be due to the fact that brucellosis is present in their communities, and humans probably became aware of the disease after attending health facilities. All respondents identified that domestic ruminants are associated with brucellosis. The studies carried out by other researchers (Omer et al., 2000; Refai, et al., 1990) showed that domestic ruminants are associated with brucellosis in Africa. The reported clinical signs (drop in milk, andemaciation in humans) aresupported by the previous results (Radostits et al., 2000; Karimi et al, 2020).

Conclusion

People closely associated with animals are less acquainted about the common Zoonotic diseases. Moreover, the rural area populations do not have basic knowledgeabout mode of transmission and identification of Zoonotic diseases. The government should take steps in collaboration with the veterinary department and NGO to overcome the burden of Zoonotic diseases. Some Zoonotic diseases are pandemic, so awareness among common people is the urgency of time. Common vaccination for most Zoonotic diseases should be on a priority basis to minimize the burden of death in human lives and economic burden. Most of the diseases among the victims are due to human-animal contact and careless attitude in handling such animals. There is an urgent intervention by the health department to spread knowledge towards Zoonotic diseases.

Acknowledgement

We are thankful to Jiwaji University Gwalior for thefinancial support of the study (F/DEV/2017/304).

Conflict of Interest Statement

We declare that we have no conflict of interest.

Ethical approval

Ethical clarence number is JU/IHEC/2017-B/01.