DOI: 10.5061/dryad.8sf7m0chp
title: A cross-sectional survey on bat human interaction in Pakistan: one health perspective

description: 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&lt;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.
description: 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.