A hundred years of rabies in Kenya and the strategy for eliminating dog-mediated rabies by 2030 (original) (raw)
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The Formation of the Eastern Africa Rabies Network: A Sub-Regional Approach to Rabies Elimination
Tropical medicine and infectious disease, 2017
International rabies networks have been formed in many of the canine-rabies endemic regions around the world to create unified and directed regional approaches towards elimination. The aim of the first sub-regional Eastern Africa rabies network meeting, which included Kenya, Ethiopia, Tanzania, Rwanda, and Uganda, was to discuss how individual country strategies could be coordinated to address the unique challenges that are faced within the network. The Stepwise Approach towards Rabies Elimination and the Global Dog Rabies Elimination Pathway tool were used to stimulate discussion and planning to achieve the elimination of canine-mediated human rabies by 2030. Our analysis estimated a total dog population of 18.3 million dogs in the Eastern Africa region. The current dog vaccination coverage was estimated to be approximately 5% (915,000 dogs), with an estimated 4910 vaccinators available. Assuming that every vaccinator performs rabies vaccination, this equated to each vaccinator cur...
AAS Open Research
Background: Domestic dogs transmit 99% of the estimated 59,000 human rabies deaths occurring globally annually. To achieve the global target of zero human deaths from rabies by 2030, effective mass dog vaccination campaigns that break rabies transmission cycles in dog populations are required. This study describes the design of a dog health and demographic surveillance study established within a human health and demographic surveillance study in Western Kenya. Using baseline data from the dog cohort study, we quantify demographic parameters and describe management practices relevant for rabies transmission. Methods: All dogs in 1213 households participating in a linked human and animal health syndromic surveillance study were recruited. Data on household demographics, dog ownership, dog age and sex ratios, reproductive indices, rabies vaccination, management practices, dog movement and health status were collected at least monthly. Results: 460 of 1213 (38%) of the study households ...
medRxiv, 2020
Background: Rabies a neglected tropical disease, mostly affecting poor and vulnerable populations living in remote rural areas in developing countries. The disease continues to pose a significant public health a threat with an estimated 59,000 dog-transmitted human deaths, of which an estimated 21,476 human deaths occur in Africa each year. The global strategy has been set by the quartite World Health Organization (WHO), the World Organization for Animal Health (OIE), the Food and Agriculture Organization of the United Nations (FAO) and the Global Alliance for Rabies Control (GARC), aiming for "zero human deaths associated with dog transmitted rabies by 2030". African countries, however, face several challenges and there are still gaps in controlling rabies. The aim of this study review is to determine rabies prevalence, mortality and associated risk factors in both human population and animal population and to evaluate the presence or absence of integrated one health surv...
EPIDEMIOLOGY AND CONTROL STRATEGIES OF DOG-MEDIATED HUMAN RABIES IN SOUTHERN AND EASTERN AFRICA
Review Articles, 2018
Background: Rabies is a neglected zoonotic viral disease affecting all terrestrial mammals globally. It is caused by lyssa-viruses spreading to human through bites by infected animals mostly dogs. The disease is 100% preventable through pre and post exposure prophylaxis in human. Objective: To review and describe the epidemiology, control and elimination strategies of dog-mediated human rabies in Southern and Eastern Africa. Method: Systematic literature review was used to collect and analyze rabies data obtained from Southern and Eastern Africa Rabies Group, Pan-African Rabies Control Network, World Organization for Animal Health) and World Health Organization databases. Results: Rabies is endemic, under reported and inconsistently reported in Southern and Eastern Africa. However, rabies control in region has been hampered by factors related to human, socioeconomic, animal, epidemiological, vaccines, limited financial resource, technical, and government and policy factors. Various rabies control strategies have been implanted in different countries of the region to reduce impacts of rabies in human and in animals. Conclusion: Strategies includes prevention of rabies in dogs and human, advocacy, communication and social mobilization, conducting and promoting operational research, enhance partnerships and multi-sectoral collaboration and resource mobilization for rabies control.
Epidemiological dynamics of rabies in Tanzania and its impacts on local communities
2012
Rabies is a fatal viral zoonotic infection caused by a Lyssavirus. Rabies exerts a major public health and economic burden; it is responsible for at least 55,000 deaths worldwide, predominantly in Africa and Asia. More than 90% of rabies deaths are caused by domestic dogs. Global expenditure on rabies prevention and control exceeds US$500 million per annum. Although human rabies is 100% preventable, through vaccination of animal reservoirs and post-exposure prophylaxis (PEP) of people exposed to bites, no effective large-scale control of rabies has been achieved in sub-Saharan Africa. Effective implementation of sustainable rabies control and prevention programs, involves full participation of individuals, veterinary and medical services. Veterinary services must control rabies transmission through mass dog vaccination campaigns because human deaths are caused by epidemics in domestic dogs, medical services must provide PEP to prevent disease in exposed individuals and exposed indiv...
Infectious Diseases of Poverty, 2015
Background: Domestic dogs are the main targets for rabies control as they are the principal reservoir for transmission of the rabies virus to humans and other domestic animals. The purpose of this study was to identify the factors that contribute to the rabies virus infecting the human population in a rural community of Eastern Tanzania. Methods: Using a cross-sectional study design, field visits were conducted to gather information on villagers' knowledge on and practices associated with canine rabies control and dog vaccination campaigns. Results: A total of 248 individuals were interviewed in the Kilosa district, Tanzania. Almost two-thirds (61.3 %) had a primary school education. The majority (91.1 %) of the respondents were aware that rabies is acquired through dog bites and 66.9 % knew about the clinical signs of rabies in an animal. Very few (17.7 %), however, were aware of the clinical signs of rabies in humans. Only 20.4 % of the respondents knew how rabies is controlled in dogs and 71 % were not aware of dog vaccination campaigns. The average number of dogs kept per household was 4 ± 3.3; 70.0 % of the respondents had one to five dogs, 28.3 % had six to dog dogs, and 1.6 % had 16-20 dogs. The dogs were primarily used to guard livestock and property, and to hunt. About 59.7 % of the respondents indicated that rabies was a public health problem. Low vaccination coverage was observed in the study area, with previous mass vaccination campaigns covering only 24.4 % of the dog population. Dogs appeared to have limited value in the studied community. Furthermore, there were no proper waste disposal facilities and oftentimes wild canids and felids visited the villages to scavenge on kitchen leftovers. Conclusion: Although communities in the Kilosa district had knowledge on rabies in dogs, they were not aware of the public health implication of the disease, which thus led a poor response during mass dog vaccination campaigns. Establishment of a well-coordinated rabies control program, strategic public health awareness campaigns, and active and passive surveillance systems for humans and domestic and wild animals should be considered as strategies to control and eradicate rabies.
It is evident that rabies continues to be a neglected tropical disease; however, a recent global drive aims to eliminate canine-mediated human rabies by 2030. Global efforts have been vested into creating and developing resources for countries to take ownership of and overcome the challenges that rabies poses. The disconnect between the numbers of rabies cases reported and the numbers estimated by prediction models is clear: the key to understanding the epidemiology and true burden of rabies lies within accurate and timely data; poor and discrepant data undermine its true burden and negate the advocacy efforts needed to curb this lethal disease. In an effort to address these challenges, the Pan-African Rabies Control Network is developing a regional rabies-specific disease surveillance bulletin based on the District Health Information System 2 platform—a web-based, open access health information platform. This bulletin provides a data repository from which specific key indicators, essential to any rabies intervention program, form the basis of data collection. The data are automatically analyzed, providing useful outputs for targeted intervention. Furthermore, in an effort to reduce reporting fatigue, the data submitted, under authority from the respective governments, can automatically be shared with approved international authorities. The implementation of a rabies-specific bulletin will facilitate targeted control efforts and provide measurements of success, while also acting as a basis for advocacy to raise the priority of this neglected disease.
PloS one, 2018
In the absence of accurate data on trends and the burden of human rabies infection in developing countries, animal bite injuries provide useful information to bridge that gap. Rabies is one of the most deadly infectious diseases, with a case fatality rate approaching 100%. Despite availability of effective prevention and control strategies, rabies still kills 50,000 to 60,000 people worldwide annually, the majority of whom are in the developing world. We describe trends and geographical distribution of animal bite injuries (a proxy of potential exposure to rabies) and deaths due to suspected human rabies in Uganda from 2001 to 2015. We used 2001-2015 surveillance data on suspected animal bite injuries, collected from health facilities in Uganda. To describe annual trends, line graphs were used and linear regression tested significance of observed trends at P<0.05. We used maps to describe geographical distribution of animal bites by district. A total of 208,720 cases of animal bi...