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Vol. 5(6), pp. 279-285, June 2013
DOI: 10.5897/IJMMS2013.0931
ISSN 2006-9723 ©2013 Academic Journals
http://www.academicjournals.org/IJMMS
International Journal of Medicine
and Medical Sciences
Full Length Research Paper
Perception of the public on the common zoonotic
diseases in Jimma, Southwestern Ethiopia
Dawit Tesfaye1*, Daryos Fekede1, Worku Tigre2 Alemayahu Regassa1 and Amene Fekadu1
1School of Veterinary Medicine, Hawassa University, Ethiopia.
2College of Agriculture and Veterinary Medicine, Jimma University, Ethiopia.
Accepted 18 April, 2013
This study was conducted with the objective of assessing the perception of the public on common
zoonotic diseases in Southwestern Ethiopia using a face-to-face interviewing technique. The
respondents were stratified into four groups, namely: farmers (n=48), smallholder dairy farmers (n=44),
butchers (n=34) and city residents (n=49). Many of them (97.1%) knew rabies was a zoonotic disease
contracted via the bite and contact with saliva of a rabid dog. There was no statistically significant
difference (P>0.05) in the level of awareness about rabies in the four respondents groups. Taeniasis
was the second most recognised zoonotic disease (84.3%). Anthrax was known by 55.4% of
respondents, whereas only 29.1% of them knew tuberculosis can be transmitted from cattle to humans.
There was a significant (P<0.05) difference in the level of awareness with regard to zoonotic
tuberculosis in the study groups where small holder dairy farmers had the highest awareness and
traditional farmers had the lowest awareness. Majority of the respondents consume raw milk (66.8%),
however, only 11.4% of them have knowledge about transmission of TB through raw milk and meat
consumption. Awareness about echinococcosis was lower (4%) than other zoonotic diseases. The
zoonotic importance of brucellosis was reported by none of the respondents. In general, the present
study revealed a very low level of awareness by the public about major zoonotic diseases, signifying
the need for public health promotion through education and inter-disciplinary one health approach with
close collaboration among veterinarians, public health practitioners and policy makers.
Key words: Perception, public, transmission, zoonotic, disease, Ethiopia.
INTRODUCTION
The link among humans, animal populations and the
surrounding environment is v ery close in many
developing countries, where animals provide
transportation, draught power, fuel, clothing and sources
of protein (that is, meat, eggs, and milk). In the absence
of proper care, this linkage can lead to a serious risk to
public health with huge economic consequences (WHO,
2010).
Zoonoses are defined as those diseases and infections
naturally transmitted between people and vertebrate ani-
mals (WHO, 2005). Zoonoses constitute a diverse group
of viral, bacterial, rickettsial, fungal, parasitic, and prion
disease with a variety of animal reservoirs, including wild
life, livestock, pet animals, and birds (Nkuchia et al.,
2007). The transmission may occur through direct contact
with the animal, through vectors (such as fleas or ticks),
or through food or water contamination (James, 2005).
Globally, zoonoses are said to account for 60% of all
infectious disease pathogens and 75% of all emerging
pathogens (WHO, 2004). In both developing and
developed countries, a number of new zoonoses have
emerged. This might be the result of either newly discovered
*Corresponding author. E-mail: dawit89@yahoo.com
280 Int. J. Med. Med. Sci.
pathogens or agents that are already known, usually
appearing in animal species in which the disease had not
previously been detected (Jonathan and Joshua, 2006).
Many diseases that affect humans which are new,
emerging and re-emerging, were caused by pathogens
that originated from animals. Moreover, a number of
zoonotic diseases, including rabies, brucellosis, bovine
tuberculosis and echinococcosis continue to affect
humans and animals in many countries, particularly
developing nations (Meslin et al., 2000).
It has been observe that 75% of emerging pathogens
fall within the category of zoonotic diseases (WHO,
2005). Zoonotic diseases cause mortality and morbidity in
people, while also imposing significant economic losses
in the livestock sector. Their burden tends to fall most
heavily on poor societies (WHO, 2005). They have both
direct and indirect effects on livestock health and
production (Smits and Cutler, 2004). Indirect effects
occur as a result of the risk of human disease, the
economic impact on livestock producers through barriers
to trade, the costs associated with control programmes,
the increased cost of marketing produce to ensure it is
safe for human consumption, and the loss of markets
because of decreased consumer confidence (McDermott
and Arimi, 2002).
Different studies conducted so far on animals from
different districts of Jimma zone indicated the occurrence
of zoonotic diseases. For example, Tolosa et al. (2009)
reported the prevalence of 2.93 and 31.44% in Jimma
area for Taenia saginata metacestodes and hydatid cysts,
respectively. Prevalence values ranging from 2.93 to 4.4%
was reported for bovine cysticercosis in cattle slaughtered at
a Jimma abattoir (Megersa et al., 2010; Tolosa, 2010).
Whereas, herd level and individual animal level
prevalence of bovine tuberculosis was found to be 48.6
and 21.4%, respectively in and around Jimma (Tigre et
al., 2012). Moreover, information from Jimma town health
center and Jimma zone health bureau showed that rabies
was one of the ten listed health problems in the area
(personal communication). According to WHO (2011),
rabies is a wide spread zoonotic disease that is found on
all the continents, but more than 95% of human deaths
occur in Asia and Africa.
The perception of the community towards zoonotic
diseases plays an important role for the maintenance of
life cycle and transmission of these diseases to the
different arrays of their hosts. Studying the perception of
the community on the risk factors, routes of transmission
and life cycle of zoonotic diseases is a crucial step
towards the development and implementation of
appropriate disease prevention and control strategies.
Though, the aforementioned zoonotic diseases were
reported and found to be prevalent in Jimma and its
surroundings, there was no study performed to assess of
the overall perception of the community towards major
zoonotic diseases in the area. Therefore, the objective of
this study was to assess the public’s perception regarding
the major zoonotic diseases in and around Jimma town,
Ethiopia.
MATERIALS AND METHODS
Study area
The study was c onducted in Jimma town and its surrounding
villages from November, 2011 to April, 2012. Jimma town, which is
the capital of Jimma zone, is located in Oromia Regional State at
346 km South West of Addis Ababa. The town has a latitude of
about 7°36° to 8°N and longitude of about 35°52 to 37°37° E, and
an elevation ranging from 880 to 3360 m above sea level. The area
receives a mean annual rainfall of about 1,530 mm, which comes
from long and short rainy seasons. The average minimum and
maximum annual temperature ranges between 14.4 and 26.7°C,
respectively. According to CSA (2009), Jimma town has a total
population of 120,600.
Study design and subjects
A questionnaire based cr oss-sectional study design was employed
to look on the perception of the public on zoonotic diseases, that is,
rabies, tuberculosis, anthrax, brucellosis, taeniasis and
echinococcosis. The study populations were residents of Jimma
town and its surrounding. The respondents were stratified into four
groups, namely, farmers, smallholder dairy farmers, butchers, and
city residents. Acc ordingly, 48 farmers, 44 smallholder dairy
farmers, 34 butchers and 49 city residents were included in the
study. The farmers included in the study were found in the villages
around Jimma town and practice the mixed crop-livestock
production system. Smallholder dairy farmers are f ound inside
Jimma town and they are dependent on milk sell for their livelihood.
Sampling method
A simple random sampling method was employed to select the
respondents. Respondents were selected during questionnaire
administration in different parts of the town and peasant
associations around the town. During the questionnaire
administration, any member of the households who was willing to
participate in the interview was taken as a sampling unit.
Study methodology
A semi-structured questionnaire was pre-tested and used for the
face-to-face interview to evaluate the perc eption of the community
about the c ommon zoonotic disease (Unger and Munstermann,
2004). The two common local languages (Amharic and Oromiffa)
were used for the interview. On average, 30 min were spent with
each respondent. The questionnaire contains questions that can
evaluate the perception of the respondents about zoonotic
diseases’ importance, their transmission cycle and major clinical
signs in humans and animals. In addition, the r espondents were
also asked questions regarding the use of traditional medicine for
the treatment of zoonotic diseases in their area. They wer e also
asked if they had encountered anyone infected and/or that had died
of zoonotic disease. Acc ording to the Oxford dictionary, perception,
in this research is defined as the way in which something is
regarded, understood, or interpreted.
Data management and analysis
The data collected was properly coded and entered into a
spreadsheet. Descriptive statistics, namely, mean, frequencies and
Tesfaye et al. 281
Table 1. Socio-demographic characteristics of the study participants.
Characteristic Number %
Age group
15-34 66 27.9
35-49 73 46.3
50-64 30 18.7
> 64 6 7.1
Sex Male 123 71.0
Female 52 29.0
Educational status Illiterate 32 18.4
Basic education 143 81.6
Table 2. Mode of tr ansmission of rabies perceived by respondents.
Transmission
Mode of transmission
Bite Contact with saliva Inhalation
n (%) n (%) n (%)
Dog to dog 161 (92) 21 (12) 15 (8.6)
Dog to human 165 (94.3) 23 (13) 23 (9.7)
percentages were made to summarize the results using STATA
Corp (2009). Logistic regression was used to see the influence of
the different factors on the level of awareness on major zoonotic
diseases. The knowledge of the importance of major zoonotic
diseases was presented in the f orm of binary variable (yes=1 and
no=0) and t aken as the dependent variable, whereas occupation,
sex, religion and level of educations were taken as explanatory
variables. A P-value <0.05 was considered to represent a
significant difference.
RESULTS
Socio-demographic characteristics of respondents
All of the rural residents were people living in villages
surrounding Jimma town, whereas butchers, smallholder
dairy farmers and city residents were found in Jimma
town. Males accounted for 71% (123) and females 29%
(52) of the respondents. The highest numbers of respon-
dents were in age group 35 to 49 years. Regarding the
educational level, 81.6% completed primary, secondary
or higher education (Table 1).
Knowledge and awareness about the common
zoonotic diseases
Rabies
About 97.1% of the respondents said they were familiar
that rabies can be transmitted from dogs to humans. The
study revealed that about 95.8, 97.7, 97, and 89.8% of
the traditional farmers, small holder dairy farmers, butchers,
band city residents interviewed, respectively, know that
rabies is a zoonotic disease transmitted to humans. The
knowledge of rabies as a zoonotic disease among the
different respondent groups was not sig-nificantly
(P>0.05) different. The modes of transmission perceived
by respondents were bites, contact with saliva, and inha-
lation (Table 2). The fate of an untreated person bitten by
a rabid dog, as perceived by respondents, was death
(82.8%), madness (33.7%), behavioral change (29%),
and development of puppies in the abdominal cavity of
the person (20%), but 3.43% of the respondents said
they do not know what would happen to the person.
The major clinical signs of a rabid dog mentioned by
respondents were salivation, biting humans and other
animals, and dropping of tail (Table 3). The major
combination of signs mentioned by the respondents was
salivation plus human bites (Table 4). Among the persons
interviewed, 46.2% of them encountered a rabid dog at
least once in their life in their surroundings, and 28% of
the respondents experienced a dog bite in their family.
Bovine tuberculosis
Of the total respondents, only 29.1% of them knew that
tuberculosis can be transmitted from cattle to humans.
The knowledge of tuberculosis as a zoonotic disease in
the respondents interviewed was 50% in smallholder,
34% in city residents, 20.6% in butchers and 10 .4% in
traditional farmers. The awareness of respondents about
the zoonotic importance of bovine tuberculosis was
significantly higher (P<0.05) in smallholder dairy farmers
282 Int. J. Med. Med. Sci.
Table 3. The clinical signs of rabies mentioned by the respondents.
Clinical sign No. of respondents % Standard error
Salivation 63 36.5 3.65
Bite humans 62 35.6 3.64
Tail dropping 53 30.5 3.49
Bite animals 47 27 3.37
Wandering 44 25.2 3.30
Aggressiveness 35 20 3.04
Reddening of eyes 13 7.5 1.99
Madness 12 6.8 1.92
Hydrophobia 11 6.3 1.85
Anorexia 5 2.8 1.27
*Hb+Sal 48 27.4 3.4
*Ab+Hb 46 26.3 3.3
*Sal+Td+Hb 29 16.5 2.8
*Hb+Sal 15 8.5 2.1
*Combination of signs mentioned by the respondents: Sal=salivation, Td=tail dropping,
Hb=human biting, Ab= animal biting.
Table 4. Proportion of respondents having awareness about transmission of tuberculosis through consumption of raw
meat and milk.
Respondents’ category Number asked Number having awareness % SE P-value
Farmers 48 5 10.4 4.4 -
Smallholder dairy farmers
44 22 50 7.6 0.00
Butchers 34 7 20.6 7.0 0.207
City residents 49 17 34.7 6.8 0.007
Table 5. Mode of transmission of anthrax fr om animals to humans
reported by the respondents.
Mode of transmission No. respondents % SE
Consumption of raw meat 96 54.9 1.13
Contact 25 14.3 2.65
Inhalation 4 2.3 3.77
followed by city residents (Table 5). However, the habit of
raw milk consumption was significantly higher in tradi-
tional farmers (P<0.05) (91.6%) as compared to 54.5% in
smallholder dairy farmers, 58.8% in butchers and 59.2%
in city residents. The risk of raw meat and milk
consumption as perceived by respondents were diarrhea
(unspecified cause), tuberculosis, typhoid, amoeba and
taeniasis.
Taeniasis (Cysticercus bovis)
The overall proportion of respondents having knowledge
of taeniasis as a zoonotic disease was 83.4%. Taeniasis
was perceived by 94.1% of butchers, 90.9% of small
holder, 87.7% of city residents and 64.5% of the
traditional farmers as a zoonotic disease transmitted to
humans when raw meat is consumed. In addition to
consumption of raw meat, 31% of the respondents
reported that it can be transmitted by consumption of raw
milk. The infection of cattle by the eggs of T. saginata
was known only by 27.45% (48/175) of the interviewed
persons. Regarding consumption of raw meat, 69.1%
(121/175) of the respondents have the habit of raw meat
consumption. Among those who consume raw meat,
82.6% (100/121) of them have been infected by T.
saginata at least once previously.
Infection of T. saginata was 66.6, 82.1, 87.1 and 90.3%
in the traditional farmers, small holder dairy farmers,
butchers and city residents, respectively. The infection
rate in the farmers was significantly (P<0.05) lower than
that of the city residents, whereas sex, level of education
and religion of respondents did not show significant level
of variation in the prevalence of taeniasis. However, the
probability of getting infected was observed to be
associated directly and significantly (P<0.05) with age.
Many of the respondents (77.7%) mentioned that tradi-
tional medicine was effective for T. saginata. Traditional
medicine mentioned by respondents was “Enkoko”
(Embelia schimperi), “kosso” (Hagenia abyssinica) and
seed of pumpkin. The knowledge of traditional medicine
for T. saginata in the four respondent groups was not
significantly different (P>0.05).
Echinococcosis
In the study area, Echinococcosis was known only by 4%
(7/175) of interviewed persons as a zoonotic disease
transmitted from dogs to humans. However, 19.4%
(34/175) of the respondents said they had noticed
parasitic disease in dogs, but had no information whether
it can be transmitted to humans or not. The clinical signs
they mentioned for parasitic infestation in dogs by
respondents were reduced appetite, vomiting, excretion
of adult parasites and/or proglotides of cestodes with
feces and eating grass. Among the persons interviewed,
56% (98/175) owned dogs, but only 25.5% (25/98) of
them vaccinate their dogs regularly. Moreover, 31.6% of
them allow their dog to roam outside their compound.
The feeding practice of dog owners was also assessed
and the result showed that 41.8% (41/98) of the dog
owners feed raw condemned visceral organs without
cooking or checking for any abnormality on the organs.
Anthrax
Anthrax was known as a zoonotic disease transmitted to
humans by 51, 51, 67.6, and 79.6% of farmers, small
holders, butchers, and city residents, respectively. The
modes of transmission reported by respondents were
consumption of raw meat from infected animal, contact,
and inhalation (Table 5). Most of the respondents repor-
ted that consumption of meat from infected animals was
the major source of infection for humans.
Brucellosis
Respondents were asked if they were aware of a disease
that can cause abortion in cattle and transmitted to
humans. But none of the respondents were aware of
such a disease.
DISCUSSION
The most frequently known zoonotic diseases among the
respondents in the study area were rabies (97.1%),
followed by taeniasis (83.4%), anthrax (55.4%), bovine
tuberculosis (29.1%) and hydatidosis (4%). This study
Tesfaye et al. 283
indicated a relatively lower level of awareness of the
respondents in the study area as compared to the report
of Girma et al. (2012) who indicated that all respondents
in Addis Ababa mentioned rabies as a zoonotic disease,
followed by anthrax (94.27%), taeniasis (89.06%), bovine
tuberculosis (88.54%) and brucellosis (49.48%). The dif-
ference in the overall awareness between the two study
sites for the common zoonotic diseases could be due to
variations in the living style between the two settings,
where in Addis Ababa, as a capital city, information might
be acquired more easily than in the current study area.
With regard to the perception of rabies as a zoonotic
disease, there was no significantly (P>0.05) different level
of awareness among the different respondent groups
which can imply that rabies is a well known disease in the
area. This is evidenced by the fact that a higher
proportion (94.3%) of the respondents knew the means of
transmission of rabies from dog to humans. Moreover,
82.9% of the respondents said that untreated cases of
rabies in humans can result in death. Another 25.7% of
the study participants reported that at least one family
member was bitten by a suspected rabid dog previously.
This is in line with the work of Girma et al. (2012) who
reported rabies as the most frequently (100%) mentioned
zoonotic diseases in Addis Ababa. However, 20% of the
respondents in the current study seem to misunderstand
the consequence of untreated rabies cases in humans
where development of puppies in the abdominal cavity of
the person was mentioned. This signifies the need for
awareness creation about rabies in the area. Among the
respondents who owned dogs, only, 25.6% of them
reported that they were treating or vaccinating their dogs.
The poor management of owned dogs and the presence
of high populations of unvaccinated stray dogs are
responsible for the frequent occurrence of rabies
(Deressa et al., 2010). Globally, about 55,000 persons
die annually due to rabies where rabid dog bites account
for 99% of the infection (WHO, 2011).
Of the total respondents, only 29.1% of them knew
tuberculosis can be transmitted from cattle to humans.
This is in line with the work of Amenu et al. (2010) who
reported that a high number of respondents had no
detailed and accurate knowledge about zoonotic tuber-
culosis. In this study, inhalational route and consumption
of raw milk and meat were mentioned as transmission
routes from cattle to humans. There was a significant
(P<0.05) difference in the level of awareness with regard
to the zoonotic tuberculosis in the study groups where
small holder dairy farmers had the highest awareness and
traditional farmers had the lowest awareness. However,
traditional farmers were found as the major consumers of
raw milk. This might put traditional framers as the most
vulnerable group as far as zoonotic tuberculoses is
concerned. The relatively higher level of awareness
among the smallholder dairy farmers could be attributed
to their living inside the town that might facilitate to have
information about the zoonotic importance of bovine
tuberculosis from private veterinary practitioners. Ashford
284 Int. J. Med. Med. Sci.
et al. (2001) stated that in countries where bovine
tuberculosis is common and pasteurization of milk has
not been practiced widely, an estimated 10 to 15% of
human tuberculosis cases are caused by Mycobacterium
bovis.
The overall proportion of respondents having the
knowledge that taeniasis is a zoonotic disease was
83.4%. Raw/undercooked meat consumption as a vehicle
for transmission of taeniasis to humans was indicated by
82.3%. But 31% of them said raw milk can also transmit
T. saginata which shows lack of knowledge about the
disease to some extent. Respondents in the current study
area seem to have relatively lower awareness about T.
saginata as compared to a study conducted at Arsi-
Negele district, Southern Ethiopia, by Amenu et al. (2010)
who indicated that 96.3% of the respondents knew that
raw meat was a vehicle for disease transmission to
humans. The difference could be due to lack of
information about the disease in the current study area.
However, raw meat consumption in the area is wide
spread (69.1%) and 82.6% of the respondents who con-
sume raw meat had T. saginata previously. An infection
rate of 64.2% was reported in a study conducted by
Abunna et al. (2008) at Hawassa town. The level of
infection in the different educational levels, sex and
religious groups was not significantly different. This could
be due to the deep rooted culture of consuming raw meat
in the different social groups of the country, even by
highly educated individuals (Abunna et al., 2008).
However, the probability of infection was observed to rise
with increasing age. This could be attributed to the fact
that elderly individuals hav e the chance to consume more
raw meat in different social ceremonies such as wedding
and other local holy days, where raw meat is one of the
major food items served almost everywhere in the
country. A similar finding was reported by Megersa et al.
(2010) in Jimma where older people were more infected
with T. saginata than the younger ones. Raw meat
consumption is practiced in some parts of the world as a
cultural heritage passed through many generations.
Countries like Russia, Cuba and many social groups on
the African continent are known to consume raw and/or
undercooked meat (Sua´rez and Santizo, 2005). In spite
of the relative higher perception of the respondents about
the zoonotic importance of taeniasis, the consumption
rate of raw meat and also the infection rate of taeniasis is
found to be high. This seems to be attributed to the deep
rooted culture of raw meat consumption in the country.
To safe guard the public, an intensive awareness
creation programs should be undertaken in the area
regarding the danger of raw meat consumption which not
only predispose to taeniasis , but also to other very
serious food borne pathogens like anthrax and bovine
tuberculosis.
In the current study, only a small proportion (4%) of the
participants had an awareness of echinococcosis. This
disagrees with the work of Tigre (2012) who reported that
32.2% of the study participants had an awareness of
echinococcosis. The variation in the level of awareness
could be due to the difference in the study groups, where
the previous study was conducted only on butchers and
abattoir workers who might be familiar with the problem
unlike our study groups which incorporates a variety of
respondents. The awareness level of participants in this
study was similar to that reported by Kebede et al. (2010)
and Zelalem (2012) who indicated an awareness level of
0 and 8% of the households had awareness about
zoonotic echinococcosis, respectively. The lower level of
awareness about echinococcosis could also be due to
the longer incubation period of the disease in humans, in
which it takes up to 30 years to manifest clinical signs
(CFSPH, 2011).
In this study, 25.5% of the participants owned dog(s)
and 56% of them said they let their dogs freely roam
outside their compound. The presence of large numbers
of non-restricted dogs plays a crucial role not only in
transmission of rabies but also in contaminating the en-
vironment with tapeworm eggs which could subsequently
infect humans. Among the dog owners, 68.9% of them
reported that they fed offal to their dogs regardless of the
safety status of the offal. Feeding the viscera of infected
slaughter animals to dogs was reported to facilitate the
transmission of the sheep strain of Echinococcus
granulosus and this was suggested to consequently
increase the risk that humans will become infected (Moro
and Schantz, 2009). According to a study conducted by
Carmena et al. (1998), the type of feed given to dogs was
found to significantly affect the prevalence of cystic
echinococcosis in humans. Tigre (2012) reported that
only 4.3% of the dog owners treat their dogs with anthel-
minthic drugs periodically around Jimma area. In order to
eliminate the infection risk to humans living in close
association with the infected dog, either euthanasia of
such dogs or chemotherapy under strict safety precaution
has been recommended (Ekerte and Peter, 2004).
The knowledge of the study population about the
zoonotic importance of anthrax was limited. Transmission
through the consumption of raw meat was mentioned by
54.9% of the respondents, whereas contact and
inhalational transmission routes were only mentioned by
14.3 and 2.3% of respondents, respectively. The low
level of awareness about the zoonotic importance of
anthrax in the area is of concern given that the disease is
endemic in most part of the country and the case fatality
rate is very high both in humans and animals. The wide
spread culture of raw meat consumption combined with
the lower level of awareness about anthrax seems to put
the public at a greater risk of contracting the disease.
Among the six common zoonotic diseases, only
brucellosis was not known by any one of the interviewed
persons. This is in contrast to Mihiret-ab (2012) who
reported that 5.6% of the respondents were aware of the
zoonotic importance of brucellosis in and around Dire
Dawa. The absence of awareness in the present study
area might be due to poor or absent awareness creation
activities that should hav e been given by the public health
bureau of the area and the veterinary department.
Conclusively, the public awareness about some
common zoonotic diseases and their means of trans-
mission, especially bovine tuberculosis, echinococcosis,
anthrax and brucellosis was very low. The level of
awareness about rabies in this study was good but im-
provements are needed on the management and proper
handling of dogs. Awareness should be created in the
public regarding the life cycles of the common zoonotic
diseases in the area. The public health department of the
ministry of health should give due emphasis for public
educating and awareness creation on preventive
measures for the existing zoonotic diseases in the area at
the grass root level using the health extension workers.
ACKNOWLEDGEMENTS
The authors are indebted to the respondents for their
time and willingness to participate in this study.
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