Awareness of Pet Owners in Riyadh Regarding Pet-Related Health Risks and Their Associated Preventative Measures

Introduction

Pet ownership is an emerging phenomenon in households worldwide; in a survey conducted in the United States that included 41,622 participants, it was estimated that 57% of U.S. households have pets (AVMA, 2018). This was similar to a study conducted in Ontario, Canada, which found that 64% of its participants owned one or more pet (Stull et al, 2012). Another study in Australia found that 61% of Australian households owned a pet. On the other hand, a Swedish study that included almost 40,000 participants found that only 37.5% of participants owned a pet (Müllersdorf et al, 2010). It was also shown that women were more likely to own pets than men (Müllersdorf et al, 2010; Steele and Mor, 2015). Families were more likely to have pets than those who live alone, and household size was positively associated with owning a pet (AVMA, 2018; Steele and Mor, 2015).

Pet ownership is beneficial in many ways. For example, it can help in coping with depressed mood and can increase the activity levels of owners, resulting in a decreased risk of chronic diseases, such as ischemic heart disease (Krause-Parello, 2012; Mubanga et al, 2017).

Although pet ownership is beneficial, it also has risks. For example, it can lead to infections, exacerbate allergies, or cause physical harm. Some infections, moreover, are transmitted from animals to humans (Day, 2016; Stull et al, 2015). The World Health Organization defined zoonosis as “any disease or infection that is naturally transmissible from vertebrate animals to humans,” and therefore animals have a key role in transmitting zoonotic infections (Stull et al, 2015).

In the United States, dog bites have been reported as a major health problem, and it has been estimated that ∼885,000 individuals get bitten annually, causing physical harm or infection, with 88,000 individuals seeking medical care after getting bitten by a dog (Anonymous, n.d.). The groups most vulnerable to these bites are young children, the elderly, pregnant women, and immunocompromised individuals (Stull et al, 2015).

Several suggestions had been published discussing preventive measures for pet-related health risks. These preventive measures include keeping pets on a healthy diet, maintaining good hygienic habits (such as washing hands after handling pets), and treating pet bites properly by using disinfectants (Angulo et al, 1994; Avery and Michaels, 2013; Glaser et al, 1994; Indu and Maguire, 2009) in addition to using ectoparasiticides as a prophylactic measure against parasites (Pereira et al, 2016).

A review of the most common zoonotic viral pathogens in Saudi Arabia revealed that the epidemiological data about pets and pet owners were insufficient. The review also stated that there is a lack of proper case-reporting systems for zoonoses in Saudi Arabia (Al-Tayib, 2019).

No previous studies have been conducted in Saudi Arabia to assess public knowledge, attitudes, and practices about pet-related health risks despite the risks imposed by pet ownership, especially from inappropriate behaviors in dealing with pets. This study aims to determine the sociodemographic characteristics of pet owners and their sources of information about pet-related health risks and to assess pet owners' perception of pet-related health risks and their associated preventative measures. It also evaluates pet owners' preventative practices with regard to pet-related health risks. This study could help stakeholders to properly design awareness campaigns and educational material to raise the level of awareness of pet owners on this topic.

Methods

A cross-sectional descriptive study was conducted in Riyadh throughout a 6-month period from September 2020 to February 2021. It was conducted among pet owners who were visiting pet stores in Riyadh. The city was divided into five sectors; each sector was divided into smaller areas, and pet stores were randomly selected from these areas. Participants were randomly approached with a validated questionnaire.

The sample size was calculated to be 343 on the assumption that the average prevalence of practicing preventive measures to prevent pet-related health risks is 28.45% and that the width is 5%, with a confidence interval of 95%.

Data collection lasted for 5 weeks. Participants were approached during their visits to pet stores and were offered an electronic questionnaire. Data collection by paper was not possible because of the COVID-19 pandemic. Data collectors managed to gather responses from all five areas of Riyadh. The study objectives were explained to participants, and their verbal consent was given before engaging in the study.

All ages and genders were approached for the study; however, the analysis only included people who were 18 years or older and had owned a pet for more than 6 months. Health-care workers were excluded from the study due to the possibility of skewing the sample.

A data collection tool was developed after reviewing previous literature related to this topic (Alho et al, 2018; Steele and Mor, 2015; Stull et al, 2012, 2013, 2015). Two main studies were selected to develop the data collection tool. The authors of these studies gave consent for the items from their questionnaires to be used (Steele and Mor, 2015; Stull et al, 2012).

To ensure the objectives of the study were achieved, the tool was validated by a pilot study that was conducted on 20 subjects to estimate the time needed to fill the survey, its appropriateness, and the clarity of its phrasing. In addition, the tool was revised by experts based on the objectives of the study.

The data collection tool included 37 items that covered the main variables and was divided into three parts. The first part covered the sociodemographic characteristics of pet owners (including gender, age, education, socioeconomic status, etc.) and whether their households included a member at a high risk for pet-related diseases. These included anyone younger than 5 years old, older than 65, pregnant, or immunocompromised.

Educational level was divided into two levels: low and high. A low educational level included Elementary, Middle, High school, and Diploma, whereas a high education level included Bachelor's, Master's, and PhD. Income was divided into three categories: low income (9,999 Saudi Arabian Riyal [SAR] or less), middle income (from 10,000 SAR to 19,999 SAR), and high income (20,000 SAR or more).

The second part of the data collection tool covered pet owners' perceptions and sources of information regarding pet-related health risks and their associated preventative measures.

An assessment of pet owners' attitudes and the level of satisfaction with their understanding of pet-related health risks (such as allergies, infections, physical harm, etc.) was carried out using a scale (strongly agree, agree, neutral, disagree, and strongly disagree). These phrases were then translated into numerical values from 1 being strongly disagree to 5 being strongly agree. These values were used to calculate the mean to give a better understanding of these variables.

The third part covered the measures taken by pet owners to prevent pet-related diseases (veterinarians' visits, pet vaccination, hygienic practices, etc.), however, no samples were taken from the animals or their owners to analyze for zoonotic diseases as this was not the objective of this study.

Results

Out of 508 participants engaged in this study, 402 fit the inclusion criteria. The mean age of participants was 25.5 years, the median was 24 years, and the most common age group was from 20 to 24 years (43.3%). The distribution of gender was almost equal between males and females. The majority of participants were single (82.3%), and 1.74% were divorced. In addition, the majority of participants lived in a villa (70.1%), and 62.4% were highly educated. The results showed that 83.6% of participants lived in a residence with four or more family members. Half of the participants had household members at a high risk for pet-related diseases (Table 1).

The study found that the three most commonly owned pets were cats (77.4%), birds (24.6%), and dogs (9.7%). Most pet owners owned only one type of pet (75.9%). Commercial/dry food was the most common item used to feed their pets (90.8%; Table 2).

The study showed that the majority of participants were satisfied with their understanding of preventative measures of diseases that can occur through pet contact (mean = 3.85). Most of the participants were not concerned that they would get sick through contact with pets (mean = 2.41). Participants' concern that they could become sick through contact with pets was not associated with any demographic variables or with the presence of a household member at a high risk for pet-related diseases. The exception to this was gender, males were more likely to be concerned (p = 0.049).

Physical harm was the most common pet-related health risk about which participants were satisfied with their level of understanding (mean = 3.59), while gastrointestinal infections were the health risks about which participants were least satisfied with their level of understanding (mean = 2.66; Table 3).

The study found that 75.6% of participants had taken their pets for regular veterinarian checkups in the past 12 months. Highly educated participants were more likely to take their pets to the veterinarian for regular checkups (p = 0.028).

Almost 70% of participants had placed their pets on the recommended vaccine program. The majority of participants (82%) allowed their pets to roam freely in the house, whereas only 20% allowed their pets to go outside the house (Table 4).

With regard to pet-related hygiene practices, 62.7% of participants always or often washed their hands after handling their pet or its environment. Age was associated with hand washing after handling a pet or its environment (p = 0.001), with older participants tending to wash their hands more often than younger participants. The majority of participants stated that they wear gloves or use a plastic bag when cleaning their pet's litter (69.2%) and wash their hands afterward (89.6%; Table 5).

Gender was significantly associated (p = 0.001) with taking pets to the veterinarian, with females being more likely to take their pets for regular checkups than males. Females also tended to clean their pet's litter more often than males (p < 0.001), whereas males were more likely to wash their hands after handling their pet or its environment (p = 0.011).

It was found that higher-income participants were more satisfied with their level of understanding of the possible harmful health effects than lower-income participants (p < 0.001), and they were less concerned that they or a family member could get sick because of a pet (p = 0.028). Furthermore, the results show that participants from lower-income groups tended to wash their hands more often than those from other income groups (p = 0.026).

The study found that participants with a higher level of satisfaction with their understanding of how to prevent pet-related diseases were more likely to take their pets for regular veterinary checkups (p < 0.001) and were more likely to have their pets on the recommended vaccination program (p < 0.001). They were also more likely to wash their hands after pet contact (p = 0.008).

The results show that the most common source of information regarding pet-related health risks and their associated preventative measures was social media (45.8%), followed by veterinarians (43.3%). Participants suggested that veterinarians (70.9%) and the Ministry of Health (57.5%) should be responsible for educating pet owners.

Discussion

Pet ownership has been increasing in the last few decades. In the United States, the rate of pet ownership has increased by 1.6% from 2011 to 2016 (AVMA, 2018).

In this study, pet owners were more likely to be young, single, living in a villa, and highly educated. They were also more likely to be living in households with six or more members. Gender distribution was equal. The age of pet owners was significantly younger compared with similar studies conducted in the United States, Canada, Qatar, Australia, and Sweden, where most pet owners were middle-aged. In these previous studies, females were more likely to own pets than males (Alho et al, 2018; AVMA, 2018; Müllersdorf et al, 2010; Steele and Mor, 2015; Stull et al, 2012).

The results of this study show that pet owners came from diverse socioeconomic backgrounds. This indicates that there is no economic barrier to owning a pet; however, there may be economical barriers for treating sick pets because of the limited number of veterinary clinics in the country and the cost of treatment.

The most common type of pet was cats, followed by birds and dogs. A study conducted in Canada found that the most commonly owned pet types were dogs, followed by cats and fish (Stull et al, 2012). In the United States, dogs, cats, and birds were the most common pets (AVMA, 2018). The difference in pet types may be due to cultural variations.

Although most pet owners were satisfied with their knowledge about pet-related health risks and how to prevent them, nearly one-third of pet owners reported being unsatisfied, and nearly one-third of pet owners were concerned that they or a family member could become sick because of a pet. It is safe to say that a sizable percentage of the study population did not feel comfortable with their level of knowledge about pet-related health risks and how to protect themselves, indicating that health care providers need to educate them about this topic.

Pet owners were least satisfied with their level of knowledge regarding gastrointestinal infections that can be transmitted from pets, while they were most satisfied with their knowledge about physical harm and how to prevent it. This could be because bites are very common and represent a major health problem that pet owners are constantly worried about (Anonymous, n.d.).

It is worth noting that the groups most vulnerable to pet-related health risks are young children, the elderly, pregnant women, and immunocompromised individuals (Stull et al, 2015). Almost one half of pet owners had a household member belonging to one of these groups and were thus at a higher risk of getting sick because of pets. Similar findings were reported in a Canadian study (Stull et al, 2012).

The majority of participants took their pets for regular veterinary visits, and their pets were on the recommended vaccination program. In addition, the majority of pet owners had good pet husbandry and hygiene practices, except that the majority allowed their pets to roam freely within the house. This shows that most pet owners are aware of the necessity of good practices when dealing with their pets. The exception of letting their pets roam freely within the house could be due to emotional attachment to their pets, as a large percentage of participants had owned their pets for more than 5 years.

According to the Saudi General Authority for Statistics, 67.02% of Saudis are younger than 34 years of age and 98.4% of Saudi youth use social media (The General Authority for Statistics, 2020). This goes hand in hand with most pet owners' reporting that social media was a major source of information about pet-related health risks. Similar findings were reported for Canada, where the internet was the predominant source of information (Stull et al, 2012). These social media platforms can be a major help in educating the masses about optimal pet husbandry practices.

Most pet owners believed that the Ministry of Health should be responsible for educating people about pet-related health risks and how to prevent them. The Ministry of Health should focus some of its efforts on social media platforms, especially as anyone can post misleading information about a topic that could affect public health.

Conclusion/Recommendations

In conclusion, the pet owners studied were mostly young, highly educated, and single individuals living in large households. Most had good pet husbandry and hygiene practices; however, many had a high-risk household member and yet were not especially cautious in how they dealt with their pets. Therefore, more awareness campaigns are required to raise awareness about the detrimental health hazards that can occur if poor pet husbandry or hygiene practices are used, especially to those that live with a high-risk household member. Most pet owners receive their information from the internet, especially social media, so a good way to raise awareness is to use these networks to launch awareness campaigns and to combat misinformation.

Although this is the first study in Saudi Arabia to determine the sociodemographic characteristics of pet owners and their perceptions of pet-related health risks and how to prevent them, the results cannot be generalized to the whole country, as samples were taken from only one city. Additional studies are required to investigate different regions. Additional analytical studies may be required to assess the knowledge of pet owners regarding pet-related health risks, as this study measured the perception of pet owners regarding these health risks.