Mortality causes of owned,
free-roaming puppies enrolled
in a health and demographic
surveillance system in South
Africa
M.A. Vergeer
30-01-2015
Supervisors: Dr. D. Klinkenberg and Dr. D. Knobel
University of Utrecht, Faculty of Veterinary Medicine
Abstract
Introduction: Rabies, causing an acute viral encephalitis, is still endemic in
developing countries within Africa and Asia. Canine rabies in dogs and
humans can be controlled through the mass vaccination of dogs against the
virus based on the concept of herd immunity. Herd immunity is influenced
by demographic factors. The aim of this research was to investigate causes
of mortality in puppies from birth up to 120 days old in an owned, freeroaming dog population in South Africa; and to estimate the degree of
achievable mortality rate reduction in this population by subdividing the
mortality causes into avoidable and unavoidable.
Results: A total number of 105 puppies were born alive. From this number
36 puppies got lost, 36 puppies died and 33 puppies were still alive.
Mortality causes resulting from the verbal autopsy questionnaires were
subdivided into accidental, starvation, infection or euthanasia.
Conclusion: By assuming that avoidable mortality causes are starvation,
infection and euthanasia, 81% (95% CI: 67.8%, 94.8%) of the total puppy
mortality could have been prevented by providing good animal nutrition
and veterinary care. The remaining 19% consisted of accidents. We
concluded that puppy mortality could be reduced by 81% by providing good
animal nutrition and veterinary care.
Introduction
Rabies, causing an acute viral encephalitis,
is transmitted by contact with saliva of an
infected carrier on a broken skin.(1) Every
year an estimated 55,000 people die from
rabies, over 99% of these deaths occur in
developing countries where rabies is
endemic in domestic dog populations.(2)
Canine rabies has been eliminated from
domestic dog populations in Western
Europe and North America, but is still a
problem in developing countries within
Africa and Asia.(3) Throughout most of
Africa and Asia, domestic dogs are the
main carrier of rabies.(1) In 2008 the
rabies virus spread in Mpumalanga
province in South Africa, and resulted in a
widespread outbreak with at least 380
suspected
cases in dogs and other
animals and one human death.(4)
Canine rabies in dogs and humans can be
controlled and in certain instances
eradicated by the mass vaccination of
dogs against the virus. The control of
infectious diseases in populations through
mass vaccination is based on the concept
of herd immunity.(5) The proportion of
the population to be vaccinated, in order
to achieve effective herd immunity, is
determined by how infectious the disease
is within the given population. This is
captured by the parameter R0 , the basic
reproduction number of the infection in a
population. When R0 is below 1, it means
that on average one infectious case will
pass the infection on to less than one
other individual and so the infection will
die out in the population. R0 for rabies has
been estimated to be between 1-2 in a
number of dog populations around the
world.(2) Using the standard formula to
relate the required vaccination coverage
to R0 (Pcrit = 1 - 1/R0), a target vaccination
coverage of only 20-40% of the dog
population would be needed to control
rabies in Tanzania where R0 is 1.2 or a little
higher.(2) Herd immunity declines rapidly
in the interval between vaccination
campaigns because of the birth/death
ratio in the domestic dog population. The
mortality and birth rates in dog
populations in developing countries is
generally high, and so therefore, as
vaccinated dogs die and new susceptible
dogs are born into the population, the
level of vaccination coverage declines
below the target threshold of 20-40% and
rabies outbreaks are detected. By
incorporating demographic parameters,
the estimated proportion of the dog
population that has to be vaccinated
during annual campaigns is around 60% in
rural Tanzania.(2)
For this reason it is important to know the
demographics (in particular, rates of birth,
death, in- and out-migration) of the dog
population in endemic areas. With the
formula: Pcrit = 1 – 1/R0 the minimal
vaccination coverage is calculated. To
maintain herd immunity above Pcrit
between campaigns, a larger proportion
of the dog population should thus be
vaccinated: Ptarget = e(v+d+r))T Pcrit, where 1/v
is the duration of vaccine induced
immunity, d is the death rate, r is the rate
of dog population growth and T is the
interval between campaigns.(2) By
decreasing birth rates and mortality rates
the decline in herd immunity will be
slower which will result in a lower Ptarget.
This means that the proportion of the dog
population which has to be vaccinated
declines annually. To reduce the death
rate, it is important to know the mortality
causes in the dog population so
interventions can be developed for
avoidable causes of death to create a
stable and healthy dog population with a
low Ptarget for rabies.
The aim of this research was to investigate
causes of mortality in puppies from birth
University of Utrecht, Faculty of Veterinary Medicine
up to 120 days old in an owned, freeroaming dog population; and to estimate
the achievable degree of mortality
reduction in this population by subdividing
the mortality causes in avoidable and
unavoidable. The results will be part of the
ongoing
health
and
demographic
surveillance
system
in
dogs
in
Bushbuckridge district in Mpumulanga
province
in
South
Africa.
The
demographics will help to estimate the
proportion of dogs that has to be
vaccinated during annual campaigns
against rabies.
Method
The ongoing health and demographic
surveillance system in dogs collects vital
data on rates of birth, mortality and
migration in a population of owned, freeroaming dogs in a rabies-affected,
resource-constrained
community
in
Bushbuckridge
Local
Municipality,
Mpumalanga Province, South Africa. This
location was selected because rabies is
still endemic there. The cohort study took
place from June to November 2014. In
total 166 female dogs were enrolled in this
research with an age of 1 year or older.
Most of the dogs were from the AfriCanis
Landrace breed. All litters born to the
female dogs in the cohort study over the 6
weeks field work period from mid June till
the end of August, were enrolled in the
current study. From the 166 female dogs
in the entire cohort, 20 of them were
pregnant and gave birth in this six-week
period. A total amount of 128 puppies
were born alive. Litters were followed
from birth up to 120 days old, to
determine causes of mortality.
The village where the research took place
is named Hluvukani. This village consists of
two different districts: Claire and
Eglington. Each household has its own
stand number. The address of the
households consists of the district
followed by the stand number.
Identification of the puppies included the
name, sex, district and stand number.
Most puppies didn’t have a name in which
case we identified them by puppy-1,-2,-3
etc. Owners were encouraged to report
any births and deaths of puppies to the
study team. When a litter was born, the
study team visited the litter as soon as
possible to ascertain the litter size and sex
of the puppies. The following data were
recorded for these litters:
 Number and sex of stillborn
puppies
 Number and sex of puppies born
alive
Households with live born puppies were
revisited every week and mortalities were
recorded.
To investigate the causes of mortality, a
verbal autopsy was conducted (see
appendix).
The
verbal
autopsy
questionnaire recorded the circumstances
and clinical signs at the time of death. In
case of a dead puppy the owner was
interviewed using the verbal autopsy
questionnaire. The open part of the
interview was recorded with a voice
recorder. Local environmental managers
were part of the study team to translate
the questionnaire in Xitsonga and the
answers back to English. The verbal
autopsy questionnaire consists of 8
different sections.
1. Background information of the
and household
2. Background information on
interview
3. Background information of
owner/caregiver/respondent
4. Information about the dog
5. Open history questions
6. Questions about accidents as
cause of death
dog
the
the
the
University of Utrecht, Faculty of Veterinary Medicine
7. Questions about diseases as the cause
of death
8. Treatment and record
With these questionnaires a distinction
was made between mortality causes,
namely: accidents, starvation, infection
and euthanasia. An accident means
injuries, traffic accident, poisoning, bites,
burns or drowning (see appendix section
6a). We perceived these causes of death
to be unavoidable, which means there is
no way to prevent it.
The cause of death was determined
infectious when the owner confirmed
symptoms like: coughing, pale mucous
membranes,
pneumonia,
ataxia,
salivating, vomiting, diarrhea, nasal
discharge, fever (see appendix section 6b).
The cause of death was determined
starvation when the owner answered
positively
to
questions
regarding
malnutrition, for instance, was the puppy
very small, was it able to suckle, did it
drink a lot (see appendix section 6b). By
assuming that it is possible to prevent
starvation, infection and euthanasia in
most puppies by providing good care, like
nutrition and veterinary care when
necessary, it was deemed that starvation,
infection and euthanasia as a cause of
Born
Lost
Dead
Still alive and included
in the study
Stolen
Sold/ given away
Total
Accident
Starvation
Euthanasia
Infection
Unknown
Total
death, were specified to be avoidable
causes of death. Beside the dead puppies,
there were also puppies which were
stolen, sold, given away or which died
from an unknown cause of death. These
were not included in the calculations.
Results
In total 128 puppies were born, 52 males,
57 females and 19 of unknown sex. All
litters were followed until they were 120
days old or less if they died, were stolen,
sold or given away. One litter with 20
puppies was excluded from the study
because the owner told us that 17 puppies
were eaten by the mother. This didn’t
sound very plausible. Another litter was
also excluded from the study because 2
puppies were never seen out of 3, so it
was not sure what happened to these
puppies. In the end, 105 puppies were
included into the study, 49 males and 56
females.
Table 1 presents the number of puppies,
subdivided in males and females, that
were born, then lost, dead or still alive
after 120 days. At least 36 puppies out of
105 puppies died, 12 males and 24
females. From the puppies that were
stolen, sold or given away it was unknown
if they were still alive or dead.
Males
Females
Total
49
4
15
19
1
3
1
7
12
18
56
3
14
17
5
3
5
7
4
24
15
105
7
29
36
6
6
6
14
4
36
33
Table 1 Number of puppies that were born, then lost, dead or still alive after 120 days.
University of Utrecht, Faculty of Veterinary Medicine
Table 2 presents the number of puppies
subdivided into avoidable and unavoidable
mortality causes according to our
categorization. Avoidable mortality causes
were starvation, infection and euthanasia.
Unavoidable mortality causes were
accidents.
Males
Females
Total
Avoidable
mortality
causes
11
15
26
Unavoidable
mortality
causes
1
5
6
Table 2 Number of puppies with an avoidable or
unavoidable mortality cause.
As table 2 shows, 81% of the puppy
mortality was avoidable and 19% was
unavoidable. The confidence interval for
the true proportion of puppies that died
because of an avoidable mortality cause is
given by:
𝑝(1−𝑝)
SE(p)=√
𝑛
0.813(1−0.813)
=√
32
= 0.069
p ± 1.96 SE(p)
= (0.813−1.96×0.069, 0.813+1.96×0.069)
= (0.678, 0.948)
Hence, it is for 95% certain that the true
proportion of puppies that died of an
avoidable mortality cause lies between
67.8% and 94.8%.
Discussion
The aim of this research was to investigate
the causes of mortality in puppies from
birth up to 120 days old in an owned, freeroaming dog population and to make an
estimation of the achievable degree of
mortality reduction in this population by
subdividing the mortality causes in
avoidable and unavoidable. We found that
81% (95%CI: 67.8%, 94.8%) was due to
avoidable mortality causes: starvation,
infection and euthanasia. By providing
good animal nutrition and veterinary care
these mortality causes could be
prevented. Accidents applied for 19% of
the total amount of puppy mortality and is
unavoidable. This means puppy mortality
can be reduced with 81% by providing
good animal nutrition and veterinary care.
In which way the avoidable mortality
causes
are
really
avoidable
is
questionable. In the study location the
people were generally poor. The only
reason most people had a dog, was to
guard their houses. Most owners were
afraid of their dog and nearly touched
them. There was no normal nutrition for
the dogs, they ate the scraps of what was
left over from the owner’s food. There
was a veterinary clinic in the village but
the people didn’t visit that often because
they probably couldn’t afford it or they
couldn’t handle their dog. Euthanasia was
performed because there were too many
puppies. Most dogs were not castrated, so
there were a lot of puppies but no
possibilities for the owners to provide
good animal nutrition and veterinary care.
All of this means that puppy mortality will
probably only decrease when dogs are
getting castrated so less dogs will be
neglected and owners can learn how to
handle and care for their dogs. But if the
owners do not have sufficient money for
the care, probably nothing will change.
Some of the unavoidable mortality causes
(injuries, poisoning, burns and drowning)
are probably avoidable when there is a
better understanding of how to handle
dogs. Dogs will also get less injured by
people when there are not so many of
them causing problems. Castration of the
dogs
will help decreasing the dog
population and hopefully mortality caused
by people.
Initially the idea was to do a verbal
autopsy questionnaire and to compare
these results with the outcome of post
mortem examination and histology of the
University of Utrecht, Faculty of Veterinary Medicine
dead puppies. The outcome of post
mortem examination and histology is
considered to be more reliable than the
results from the verbal autopsy
questionnaires. With statistical tests the
reliability from the verbal autopsy
questionnaires can be determined when
compared to the results from post
mortem examination and histology. The
results from post mortem examination
and histology should give a more precise
mortality cause and thereby a more
reliable distinction between avoidable and
unavoidable mortality causes. Then, these
results could be used to suggest
appropriate interventions to reduce the
mortality rate of the puppies; and as a
result, a better estimation of a possible
mortality reduction could be made.
At the end of the fieldwork period only
one post mortem examination of a puppy
was performed. Because of the lack of
post mortem examination results, this
method could not be used in this research.
Therefore, only the results from verbal
autopsy questionnaires were taken into
account. There were several reasons for
the lack of post mortem examinations.
The owners were too late with calling /
didn’t call at all or the mother of the
puppies had hidden them somewhere in
the field. There was no reward for calling if
a puppy died, the owners only got
compensation for their calling costs.
Possibly, if owners would have received a
reward, they would have called more
times or earlier. On the other hand, the
owners might have helped their puppies
die in order to receive that reward.
During the six-week period when new
litters were enrolled, visiting the puppies
was done by ourselves with our car, we
revisited all the owners every week. After
we left, the study team had to continue
the visits but did it on foot. That meant
they saw the owners of the puppies less
frequently (once per month). Because of
this, the reliability of the verbal autopsy
questionnaires decreased. If a puppy had
died and the owner was not interviewed
until a couple of weeks later, they
probably were not so certain about what
they saw at the time the puppy died.
The integrity of the results is also
influenced by the way the questions were
formulated. Most owners were not able to
answer questions like: did the puppy have
tetanus, did the puppy have a fever, did
the puppy have pale gums, did the puppy
have pneumonia, or did the puppy have
rabies? There were also questions which
included words such as malnutrition,
malformation and ectoparasites, which
might have been difficult to understand
for owners.
The results are also affected by the
number of puppies that were included in
the research. In this research one third of
all puppies born alive were excluded
because they were stolen, sold or given
away. This is the same number as the
total amount of puppies that died. There is
probably no way to prevent that puppies
get stolen but it is possible to prevent
puppies to be sold or given away by the
owners. If the owners would have
received a reward or compensation for the
costs of keeping the puppies, it is likely
less puppies would have been sold or
given away. With a larger observed
sample and less puppies in the
‘stolen/given away’ category, the results
might have been more reliable.
The vaccination campaigns will be
administered in the Bushbuckridge district
in Mpumulanga province in north-east
South Africa. Hluvukani is one of the
fifteen villages situated in this district. This
whole area is comprised of 40,000 people,
University of Utrecht, Faculty of Veterinary Medicine
who live in 8,500 households. The
population is unevenly distributed with
approximately half of the population living
on communal lands. The distribution of
the dog population correlates with the
distribution of the human population.
Hluvukani has a population of 9,600
people living in 2,100 households.(4) The
dog population used for this research is
most likely representative for the whole
dog population in Bushbuckridge district.
This location is very similar compared to
the other 14 villages in terms of
households, infrastructure, the way
people live and how they interact with and
care for their dogs.
The results from this study are more
reliable compared to previous studies
which used a different set-up. In this study
a prospective cohort design was used
whereas previous studies used a
retrospective cohort design in which a
sample of owners got interviewed.(1,6,7)
In the studies with the retrospective
cohort design, the recall period often
spans the preceding 12 months or more,
and is therefore subject to memory lapse
or recall bias. Reliable demographic data
from owned dog populations can only be
collected through regularly-repeated
visits.(1,6,7)
This study is part of a large cohort study,
performed with the purpose to create a
stable and healthy dog population with a
low Ptarget for rabies. Ptarget is influenced by
the rate of dog population growth, the
death rate, the duration of vaccine
induced immunity, and the interval
between campaigns. This means that a
low Ptarget will be achieved by decreasing
the number of susceptible dogs or
newborn puppies, and the death rate of
vaccinated dogs. In general the population
turn-over has to drop. This can only be
achieved by the castration of dogs and by
providing good animal nutrition and
veterinary care.(2)
References
(1) Gsell AS, Knobel DL, Kazwala RR,
Vounatsou P, Zinsstag J. Domestic dog
demographic structure and dynamics
relevant to rabies control planning in
urban areas in Africa: The case of Iringa,
Tanzania. BMC Vet Res 2012;8.
(2) Hampson K, Dushoff J, Cleaveland S,
Haydon DT, Kaare M, Packer C, et al.
Transmission dynamics and prospects for
the elimination of canine Rabies. PloS Biol
2009;7(3):0462-0471.
(3) Knobel DL, Cleaveland S, Coleman PG,
Fèvre EM, Meltzer MI, Miranda MEG, et al.
Re-evaluating the burden of rabies in
Africa and Asia. Bull WHO 2005;83(5):360368
(4) Mkhize GC, Ngoepe EC, Du Plessis BJA,
Reininghaus B, Sabeta CT. Re-emergence
of dog rabies in Mpumalanga Province,
South Africa. Vector Borne Zoonotic Dis
2010;10(9):921-926.
(5) Cleaveland S, Kaare M, Knobel D,
Laurenson MK. Canine vaccinationProviding broader benefits for disease
control. Vet Microbiol 2006;117(1):43-50.
(6) Butler JRA, Bingham J. Demography
and dog-human relationships of the dog
population in Zimbabwean communal
lands. Veterinary Record 2000; 147: 442–
446.
(7) Kitala P, McDermott J, Kyule M,
Gathuma J, Perry B, Dog ecology and
demography information to support the
planning of rabies control in Machakos
District, Kenya. Acta Tropica 2001; 78:
217–230.
University of Utrecht, Faculty of Veterinary Medicine
Appendix
VERBAL AUTOPSY QUESTIONNAIRE
This verbal autopsy questionnaire has nine (9) sections as shown below:
1. Background information on dog and household
 Name
 ID no of dog/home address
2. Background information about the interview
 Language
 Interviewer name
 Date of interview
 Date of entry into the computer
3. Background information about owner/care giver/respondent
4. Information about the dog
 Age of the dog
 Date of death
 Where the dog died
5. Open history questions
 Description of illness in caregivers own words
 No specific prompting, and it’s a detailed narrative
 Length of illness
 Type of care given---hospital----home----elsewhere
6a.
Accidents (puppy)
 Injuries
 Accidents
 Poisoning
 Bites
 Burns
 Drowning
6b.
Puppy death
(Puppies<120days)
7a.
Accidents (Adult)
 Injuries
 Accidents
 Poisoning
 Bites
 Burns
 Drowning
7b.
Adult death
(Adults≥12 months)
8.
Treatment and Record
Questionnaire Id
Instruction to interviewer: Introduce yourself and explain the purpose of your visit. Ask to speak
to an adult caretaker who was present during the illness that led to death. If this not possible,
arrange a time to revisit the household when the caretaker will be home.
Section 1:
Background information on dog and household
(to be filled in before interview)
1.1
Address of household;
Village:
☐Eglington
Stand no: _________
☐Clare
1.2
Name of dog: ___________________________________
Microchip number_____________________________________
If no microchip, ID number (“Name”-“Sex”-“Village”-“Stand Number”):
_______________________________________________
1.3
Sex of dog
Male
Female
Unknown
Section 2:
2.1
Background information about the interview
Interview language
☐Xitsonga
☐English
☐Other: Specify_____________________________
2.2
Interviewer name: _______________________________________
2.3
Dates:
Day/month/year;Time
2.3.1 Date of first interview attempt
2.3.2 Date and time arranged for second interview attempt
2.3.3 Date and time arranged for third interview attempt
2.3.4 Date of interview
2.3.5 Date form checked by supervisor
2.3.6 Date entered in computer
Section 3
3.1
Information about respondent
Which person takes care of the dog?
Father of the family
Mother
Child
Other: Specify_______________________________________
3.2
Do you feed the dog regularly? (refers to respondent, not household)
Yes
No
3.3
Do you handle the dog regularly?(refers to respondent, not household)
Yes
(go to section 4)
No
(go to 3.3.1)
3.3.1 Can you handle the dog if needed?(refers to respondent, not household)
Yes
No
Section 4
4.1
Information about the dog
Age of the dog at the time of death
Lower estimate: _ _
Upper estimate: _ _
Unit:
Days
Months
Years
4.2
Do you know the day the dog died
Yes
(go to 4.2.1)
No
(go to 4.3)
4.2.1 what day did the dog die ? (d/m/y) _ _/_ _/_ _ _ _
4.2.2 When did the dog die?
Lower estimate: _ _
Upper estimate: _ _
Unit:
Days
Months
Years
4.3
What was the length of time the dog was ill before it died?
0-6 days
≥7 days but < 14days
≥14 days but < 21days
21 days and above
4.4
Where didthe dog die?
Home/Stand
Neighbourhood
HAC (Hluvukani Animal Clinic)
On the way to HAC
Other: Specify: __________________________________________
Note to interviewer….Is this interview for a puppy or adult
puppy
Section 5:
5.1
Adult
Open history question
Could you tell me about the illness / circumstancesthat led to death?
Prompt:
Was there anything else?
Instruction to interviewer- Allow the respondent to tell you about the illness in his or her own
words. Do not prompt except to ask whether there was anything else after the respondent
finishes. Keep prompting until the respondent says there was nothing else.
While recording, underline any unfamiliar termsand write down principalclinical signs(use the
categories given in Annex)
-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
(Take time to tick items mentioned spontaneously in the open history questionnaire)
If dog was less than 120 days old at the time of death, go to Section 6Puppyaccident/deaths
If the dog was 1 year old or more at the time of death, go to Section 7Adult accident/deaths
Section 6a:
Accident
(Puppy)
Write the number of puppy deaths you are investigating______________
6.
Litter size:
6.0.1 How many puppies were born alive: __________________________
6.0.2 How manypuppies were stillborn:
6.1
___________________________
Did your puppy die from an injury, accident, poisoning, bite, burn or drowning?
Yes
(go to 6.1.1)
No
(go to section 6b)
Don’t know (go to section 6b)
6.1.1 What kind of injury or accident?
Allow respondent to answer spontaneously. If respondent has difficulty identifying the
injury or accident, read the list slowly.
Violence
Motor vehicle accident
Fall
Drowning
Poisoning
Bite or sting by a venomous animal
Burn
Bite or injury from another animal
Other injury:
Specify: __________________________________________
6.2
How long did the puppy survive after the accident / incident ?
Died suddenly
Died within 24 hours
Died 1 day later or more
6.3
Was the puppyill before the accident / incident?
Yes
(For puppies: go to section 6b.)
No
(go to section 8)
Don’t know (go to section 8)
Section6b
6.4
Puppy death
Was the late part of the pregnancy, labour or delivery complicated?
Yes
(go to 6.4.1)
No
(go to 6.5)
Don’t know (go to 6.5)
6.4.1 What complications occurred during the pregnancy, labour or delivery? (record
all responses)
Bitch had convulsions
Puppies stuck
Excessive bleeding
Emergency caesarean section
Others: Specify:______________________________________________
(After respondent finishes prompt) Was there anything else?
(Keep using this prompt until the respondent replies that there were no other
complications.)
6.5
Were there any bruises or marks of injury on the puppy’s body at birth?
Yes
No
Don’t know
6.6
Did the puppy have any malformations at birth?
Yes
(go to 6.6.1)
No
(go to 6.7)
Don’t know (go to 6.7)
6.6.1 Where were the malformations? (Tick one or several boxes)
Head
Body
Fore limbs
Hind limbs
Other: Specify:_____________________________
(After respondent finishes prompt): Were there malformations anywhere else?
(Keep using this prompt until the respondent replies that there were no
malformations anywhere else).
6.7
At the time of birth was the puppy…
Very small
Smaller than usual
About average
Larger than usual
Don’t know
6.8
Was the puppy able to breathe after birth
(Note: this does not include gasps or very brief efforts to breathe)
Yes
No
Don’t know
6.9
Was the puppy able to suckle (or bottle feed) in a normal way after birth?
Yes
No
Don’t know
6.10
During the illness that led to death did the puppy have spasms or convulsions?
Yes
No
Don’t know
6.11
During the illness that led to death, did the puppy have tetanus?
Yes
No
Don’t know
6.12
During the illness that led to death, did the puppy become unresponsive/unconscious?
Yes
No
Don’t know
6.13
During the illness that led to death, did the puppy have difficulty in walking?
Yes
No
Don’t know
6.14
During the illness that led to death, did the puppy have a fever?
Yes
No
Don’t know
6.15
During the illness that led to death, did the puppy have yellow eyes or gums?
Yes
No
Don’t know
6.16
During the illness that led to death, did the puppy have pale eyes or gums?
Yes
No
Don’t know
6.17
If the puppy was more than 10 days old, ask: During the illness that led to death was the
puppy blind?
Yes
No
Don’t know
6.18
During the illness that led to death, did the puppy vomit?
Yes
(go to 6.18.1)
No
(go to 6.19)
Don’t know (go to 6.19)
6.18.1 For how long did the puppy vomit before death?
0-6 days
≥7 days but < 14days
≥14 days but < 21days
21 days and above
6.19
During the illness that led to death, did the puppy have frequent loose or liquid stools?
Yes
(go to 6.19.1)
No
(go to 6.20)
Don’t know (go to 6.20)
6.19.1 For how long did the puppy have loose stool or liquid stool?
0-6 days
≥7 days but < 14days
≥14 days but < 21days
21 days and above
6.19.2 Was there blood in the loose or liquid stools?
Yes
(go to 6.19.2.1.)
No
(go to 6.19.3)
Don’t know (go to 6.19.3)
6.19.2.1. If there was blood in the loose stool, was the stool foul
smelling?
Yes
No
Don’t know
6.19.3 During the time with loose or liquid stools, did the puppy drink lots of
fluid? (Dehydration)
Yes
No
Don’t know
6.20
During the illness that led to death, did you see worms in the stool?
Yes
(go to 6.20.1)
No
(go to 6.21)
Don’t know (go to 6.21)
6.20.1
What colour was the worm?
Red
White (Boiled rice- like)
Don’t know
6.21
During the illness that led to death, did the puppy have a swollen belly?
Yes
No
Don’t know
6.22
During the illness that led to death did the puppy have a cough?
Yes
(go to 6.22.1)
No
(go to 6.23)
Don’t know
(go to 6.23)
6.22.1 For how long did the cough last?
0-6 days
≥7 days but < 14days
≥14 days but < 21days
21 days and above
6.23
During the illness that led to death, did the puppy have a secretion from the nose?
Yes
(go to 6.23.1)
No
(go to 6.24)
Don’t know (go to 6.24)
6.23.1 What kind of secretion? Select more than one if necessary(prompt to
describe)
Watery
Thick
Bloody
Foamy
Greenish
Yellowish
6.24
During the illness that led to death, did the puppy have pneumonia?
Yes
No
Don’t know
6.25
During the illness that led to death, was the puppy salivating a lot?
Yes
No
Don’t know
6.26
Before the illness that led to death, did any dog bite the puppy?
Yes
(go to 6.26.1)
No
(go to 6.27)
Don’t know (go to 6.27)
6.26.1 How long ago was the puppy bitten?
2 weeks or less;
3 weeks to 3 months;
6.27
If the puppy was biting people/animals, did the puppy die on its own or was the dog
killed by people?
Died on its own
Kill by people/owner
6.28
During the illness that led to death, do you think the puppy had rabies?
Yes
No
Don’t know
6.29
During the illness that led to death, did the puppy have a skin condition?
Yes
No
Don’t know
6.30
During the illness that led to death, did the puppy have ectoparasites on its body?
Yes
(go to 6.30.1)
No
(go to 6.31)
Don’t know (go to6.31)
6.30.1What kind of ectoparasite?Select one or more options
Ticks
Fleas
Lice
Others: Specify:__________________________
6.31 During the illness that led to death, did the puppy lose a lot of hair?
Yes
No
Don’t know
SECTION 7a
7.1
ACCIDENT (Adult)
Did your dog die from an injury, accident, poisoning, bite, burn or drowning?
Yes
(go to 7.1.1)
No
(go to section 7b)
Don’t know (go to section 7b)
7.1.1 What kind of injury or accident?
Allow respondent to answer spontaneously. If respondent has difficulty identifying the
injury or accident, read the list slowly.
Violence
Motor vehicle accident
Fall
Drowning
Poisoning
Bite or sting by a venomous animal
Burn
Bite or injury from another animal
Other injury:
Specify: __________________________________________
7.2
How long did the dog survive after the accident / incident ?
Died suddenly
Died within 24 hours
Died 1 day later or more
7.3
Was the dog ill before the accident / incident?
Yes
(go to section 7b)
No
(go to section 8)
Don’t know (go to section 8)
Section 7b:
7.4
Adult dog death
During the illness that led to death, did the dog stop eating?
Yes
No
Don’t know
7.5
During the illness that led to death, was the dog thin/emaciated?
Yes
No
Don’t know
7.6
During the illness that led to death did the dog have spasms or convulsions?
Yes
No
Don’t know
7.7
During the illness that led to death, did the dog have tetanus?
Yes
No
Don’t know
7.8
During the illness that led to death, did the dog become unresponsive/unconscious?
Yes
No
Don’t know
7.9
During the illness that led to death, did the dog have difficulty in walking?
Yes
No
Don’t know
7.10
During the illness that led to death, did the dog cry /whine all through the night?
Yes
No
Don’t know
7.11
During the illness that led to death, did the dog have a fever?
Yes
No
Don’t know
7.12
During the illness that led to death, did the dog vomit?
Yes
(go to 7.12.1)
No
(go to 7.13)
Don’t know (go to 7.13)
7.12.1 For how long did the dog vomit before death?
0-6 days
≥7 days but < 14days
≥14 days but < 21days
21 days and above
7.13
During the illness that led to death, did the dog have frequent loose or liquid stools?
Yes
(go to 7.13.1)
No
(go to 7.14)
Don’t know (go to 7.14)
7.13.1 For how many days did the dog have loose stool or liquid stool?
0-6 days
≥7 days but < 14days
≥14 days but < 21days
21 days and above
7.13.2 Was there blood in the loose or liquid stools?
Yes
No
Don’t know
7.13.3 If there was blood in the loose stool, was the stool foul smelling?
Yes
No
Don’t know
7.13.4 During the time with loose or liquid stools, did the dog drink lots of fluid?
Yes
No
Don’t know
7.14
During the illness that led to death, did you see worms in the stool?
Yes
(go to 7.14.1)
No
(go to 7.15)
Don’t know (go to 7.15)
7.14.1 What colour was the worm?
Red
White (Boiled rice- like)
Don’t know
7.15
During the illness that led to death, did the dog have a swollen belly?
Yes
No
Don’t know
7.16
During the illness that led to death, did the dog have a cough?
Yes
(go to 7.16.1)
No
(go to 7.17)
Don’t know (go to 7.17)
7.16.1 For how long did the dog cough before death?
0-6 days
≥7 days but < 14days
≥14 days but < 21days
21 days and above
7.17
During the illness that led to death, did the dog have difficulty breathing?
Yes
No
Don’t know
7.18
During the illness that led to death, did the dog have a secretion from the nose?
Yes
(go to 7.18.1)
No
(go to 7.19)
Don’t know (go to 7.19)
7.18.1 What kind of secretion? Select more than one if necessary(prompt to
describe)
Watery
Thick
Bloody
Foamy
Greenish
Yellowish
7.19
During the illness that led to death, did the dog have pneumonia?
Yes
No
Don’t know
7.20
During the illness that led to death, did the dog salivate a lot?
Yes
No
Don’t know
7.21
Before the illness that led to death, did any other dog bite the dog?
Yes
(go to 7.21.1)
No
(go to 7.22)
Don’t know (go to 7.22)
7.21.1 How long ago was the dog bitten?
2 weeks or less;
3 weeks to 3 months;
4 to 11 months ,
12 months or more
7.22
If the dog was biting people/animals, did the dog die on its own or was the dog killed by
people?
Died on its own
Kill by people/owner
Don’t know
7.23
During the illness that led to death, do you think the dog had rabies?
Yes
No
Don’t know
7.24
During the illness that led to death, did the dog have skin condition?
Yes
No
Don’t know
7.25
During the illness that led to death, did the dog have ectoparasites on the body?
Yes
(go to 7.25.1)
No
(go to 7.26)
Don’t know (go to 7.26)
7.25.1 What type of ectoparasite?
Ticks
Fleas
Lice
Others: Specify:__________________________
7.26
During the illness that led to death, did the dog lose a lot of hair?
Yes
No
Don’t know
7.27
During the illness that led to death, did the dog have pale eyes or gums?
Yes
No
Don’t know
7.28
During the illness that led to death, did the dog have yellow eyes or gums?
Yes
No
Don’t know
7.29
During the illness that led to death, did the dog have any swelling/growth on any part of
the body?
Yes
No
Don’t know
Section 8:
TREATMENT AND RECORD
I would like to ask a few questions about any medicationyour dog may have received during
the illness that led to death
8.1
Was care sought outside the home while the dog was ill?
Yes
(go to 8.1.1)
No
(go to 8.2)
Don’t know (go to 8.2)
8.1.1
Select all the places that help was sought outside the house? (select one
or more options)
AHT (including dip tank)
HAC (including dip tank/UP)
Pharmacy
Traditional healer
Other: Specify:__________________________________________
8.2
Did the dog receive any medication during the illness?
Yes
(go to 8.2.1)
No
(go to 8.3)
Don’t know (go to 8.3)
8.2.1
What kind of medication did the dog receive?
_________________________________________________________
_________________________________________________________
8.3
Was the dog ever vaccinated?
Yes
(go to 8.3.1)
No
(go to end)
Don’t know (go to end)
8.3.1 Was it vaccinated against rabies?
Yes
(go to 8.3.1.1)
No
(go to 8.3.2)
Don’t know (go to 8.3.2)
8.3.1.1 When was rabies vaccine done?
Less than 1 year ago
1 year ago
2 years ago
3 years ago
Don’t know
8.3.2 Was it vaccinated with “5 in 1” vaccine?
Yes
(go to 8.3.2.1)
No
(go to end)
Don’t know (go to end)
8.3.2.1 When was “5 in 1” vaccine done?
Less than 1 year ago
1 year ago
2 years ago
3 years ago
END OF QUESTIONNAIRE
ANNEX
5.1.1
5.1.2
5.1.3
5.1.4
5.1.5
5.1.6
5.1.7
5.1.9
5.1.10
5.1.11
5.1.12
5.1.13
5.1.15
5.1.16
5.1.18
5.1.19
5.1.21
5.1.22
5.1.23
5.1.24
5.1.24
5.1.25
USE THIS TO GUIDE THROUGH THE REST OF THE QUESTIONNAIRE
DIARRHOEA
COUGH
FEVER/THIRST/WATER
SKIN LESIONS (when/where)
INJURY
UNCONCIOUS
SEIZURES
TETANUS
RABIES/SALIVATION
ASCITES/SWOLLEN STOMACH
STRANGE BEHAVIOUR
DIFFICULT BREATHING (fast or slow )
COMPLICATED BIRTH
MALFORMATION
VERY SMALL AT BIRTH
VERY THIN/emaciated
PNEUMONIA
ACCIDENT
DISTEMPER/PARVO
YELLOW MUCOUS MEMBRANE
PALE MUCOUS MEMBRANE
CONGESTED MUCOUS MEMB (reddish)