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Malan AJ, Coetzer A, Bosch C, Wright N, Nel LH. A Perspective of the Epidemiology of Rabies in South Africa, 1998-2019. Trop Med Infect Dis 2024; 9:122. [PMID: 38922034 PMCID: PMC11209162 DOI: 10.3390/tropicalmed9060122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/15/2024] [Accepted: 05/21/2024] [Indexed: 06/27/2024] Open
Abstract
Despite the implementation of various control strategies aimed at eliminating canine-mediated rabies, the disease is still endemic in up to 150 countries across the world. Rabies remains endemic to South Africa, with various reservoir species (both wildlife species and domestic dogs) capable of maintaining rabies infection, and the epidemiology of the disease is yet to be adequately defined. As such, this study used surveillance data collected between 1998 and 2019 from the two diagnostic laboratories in the country for a statistical space-time analysis to determine regions where significant disease clusters could occur. In addition, the robustness of surveillance activities across the country was evaluated through the mathematical evaluation and visualization of testing rates based on the average number of samples tested per species group. In our study, various significant disease clusters were detected for domestic animals, wildlife and livestock. The significant disease clusters for domestic animals and livestock were primarily restricted to eastern South Africa, while the significant disease clusters in wildlife species were detected across northern and western South Africa. Furthermore, the testing rates identified districts from various provinces where surveillance activities could be considered inadequate, consequently influencing the geographical range of the observed clusters. These results could be used to direct intervention campaigns towards high-risk areas, while also allocating the required resources to improve surveillance in the surrounding areas where surveillance was deemed inadequate.
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Affiliation(s)
- Ayla J. Malan
- Department of Biochemistry, Genetics and Microbiology, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria 0002, South Africa
| | - Andre Coetzer
- Global Alliance for Rabies Control, Manhattan, KS 66502, USA
| | - Cayla Bosch
- Department of Biochemistry, Genetics and Microbiology, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria 0002, South Africa
| | - Nicolette Wright
- Department of Biochemistry, Genetics and Microbiology, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria 0002, South Africa
| | - Louis H. Nel
- Department of Biochemistry, Genetics and Microbiology, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria 0002, South Africa
- Global Alliance for Rabies Control, Manhattan, KS 66502, USA
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Tenzin T, Hikufe EH, Hedimbi N, Athingo R, Shikongo MB, Shuro T, Iipinge J, Herman N, Naunyango M, Haufiku F, Peter J, Hango L, Gottlieb S, Shoombe K, Denzin N, Busch F, Lohr F, Letshwenyo M, Torres G, Freuling CM, Müller T, Shilongo A. Dog ecology and rabies knowledge, attitude and practice (KAP) in the Northern Communal Areas of Namibia. PLoS Negl Trop Dis 2024; 18:e0011631. [PMID: 38315727 PMCID: PMC10881021 DOI: 10.1371/journal.pntd.0011631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 02/21/2024] [Accepted: 01/24/2024] [Indexed: 02/07/2024] Open
Abstract
In 2021, a comprehensive dog demographic questionnaire combined with a KAP survey were conducted in the northern communal areas (NCAs) of Namibia with the aim of gaining a better understanding of dog populations, owner behaviour, and knowledge, attitudes and practices (KAP) relating to rabies. The survey of 3,726 households across the eight regions of the NCAs provided insights that will inform interventions in order to improve human rabies prevention and Namibia's dog rabies control strategy. The results showed a relatively low average human/dog ratio (HDR) of 5.4:1 indicating a surprisingly high dog population of at least 272,000 dogs in the NCAs, 93% of which appear to be owned but are free-roaming. Data analysis revealed opportunities but also highlighted needs for improvements in rabies surveillance and mass dog vaccinations. Although knowledge, attitude, and practice scores towards epidemiologic and clinical aspects, human rabies prevention, and dog rabies vaccination were deemed to be acceptable, the survey nevertheless revealed deficiencies in certain aspects in some of the population. Interestingly, data seemed to indicate relatively high dog bite incidences per 100,000 people, ranging between 262 and 1,369 and a certain number of unreported human rabies cases. Despite the very high number of dogs, only 50% of dog-owning households reported having vaccinated their dogs. In order to address these issues, the planning, announcement, and implementation of mass dog vaccination campaigns needs to be adapted to achieve adequate vaccination coverage. Another focus needs to be on rabies awareness and education if Namibia is to be significantly contributing to the global goal of "Zero by 30".
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Affiliation(s)
- Tenzin Tenzin
- World Organisation for Animal Health (WOAH), Sub-Regional Representation for Southern Africa, Gaborone, Botswana
| | - Emmanuel H. Hikufe
- Directorate of Veterinary Services, Ministry of Agriculture, Water and Land Reform, Windhoek, Namibia
| | - Nehemia Hedimbi
- State Veterinary Office, Ministry of Agriculture, Water & Land Reform, Directorate of Veterinary Services, Kunene region, Opuwo, Namibia
| | - Rauna Athingo
- Animal Disease Control—North, State Veterinary Office, Ministry of Agriculture, Water & Land Reform, Directorate of Veterinary Services, Ongwediva, Namibia
| | - Mainelo Beatrice Shikongo
- State Veterinary Office, Ministry of Agriculture, Water & Land Reform, Directorate of Veterinary Services, Zambezi region, Katima Mulilo, Namibia
| | - Thompson Shuro
- State Veterinary Office, Ministry of Agriculture, Water & Land Reform, Directorate of Veterinary Services, Kavango East region, Rundu, Namibia
| | - Johannes Iipinge
- State Veterinary Office, Ministry of Agriculture, Water & Land Reform, Directorate of Veterinary Services, Oshana region, Ondangwa, Namibia
| | - Nelson Herman
- State Veterinary Office, Ministry of Agriculture, Water & Land Reform, Directorate of Veterinary Services, Oshana region, Ondangwa, Namibia
| | - Matias Naunyango
- State Veterinary Office, Ministry of Agriculture, Water & Land Reform, Directorate of Veterinary Services, Ohangwena region, Eenhana, Namibia
| | - Frenada Haufiku
- State Veterinary Office, Ministry of Agriculture, Water & Land Reform, Directorate of Veterinary Services, Oshikoto region, Omuthiya, Namibia
| | - Josephat Peter
- State Veterinary Office, Ministry of Agriculture, Water & Land Reform, Directorate of Veterinary Services, Omusati region, Outapi, Namibia
| | - Laina Hango
- State Veterinary Office, Ministry of Agriculture, Water & Land Reform, Directorate of Veterinary Services, Omusati region, Outapi, Namibia
| | - Sara Gottlieb
- State Veterinary Office, Ministry of Agriculture, Water & Land Reform, Directorate of Veterinary Services, Kavango East region, Nkurunkuru, Namibia
| | - Kenneth Shoombe
- Animal Disease Control—North, State Veterinary Office, Ministry of Agriculture, Water & Land Reform, Directorate of Veterinary Services, Ongwediva, Namibia
| | - Nicolai Denzin
- Institute of Epidemiology, Friedrich-Loeffler-Institut (FLI), Greifswald-Insel Riems, Germany
| | - Frank Busch
- Institute of International Animal Health/One Health, Friedrich-Loeffler-Institut (FLI), Greifswald-Insel Riems, Germany
| | | | - Moetapele Letshwenyo
- World Organisation for Animal Health (WOAH), Sub-Regional Representation for Southern Africa, Gaborone, Botswana
| | | | - Conrad M. Freuling
- Institute of Molecular Virology and Cell Biology, Friedrich-Loeffler-Institut (FLI), WHO Collaborating Centre for Rabies Surveillance and Research, WOAH Reference Laboratory for Rabies, Greifswald-Insel Riems, Germany
| | - Thomas Müller
- Institute of Molecular Virology and Cell Biology, Friedrich-Loeffler-Institut (FLI), WHO Collaborating Centre for Rabies Surveillance and Research, WOAH Reference Laboratory for Rabies, Greifswald-Insel Riems, Germany
| | - Albertina Shilongo
- Directorate of Veterinary Services, Ministry of Agriculture, Water and Land Reform, Windhoek, Namibia
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Rupprecht CE, Mshelbwala PP, Reeves RG, Kuzmin IV. Rabies in a postpandemic world: resilient reservoirs, redoubtable riposte, recurrent roadblocks, and resolute recidivism. ANIMAL DISEASES 2023; 3:15. [PMID: 37252063 PMCID: PMC10195671 DOI: 10.1186/s44149-023-00078-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/02/2023] [Indexed: 05/31/2023] Open
Abstract
Rabies is an ancient disease. Two centuries since Pasteur, fundamental progress occurred in virology, vaccinology, and diagnostics-and an understanding of pathobiology and epizootiology of rabies in testament to One Health-before common terminological coinage. Prevention, control, selective elimination, and even the unthinkable-occasional treatment-of this zoonosis dawned by the twenty-first century. However, in contrast to smallpox and rinderpest, eradication is a wishful misnomer applied to rabies, particularly post-COVID-19 pandemic. Reasons are minion. Polyhostality encompasses bats and mesocarnivores, but other mammals represent a diverse spectrum of potential hosts. While rabies virus is the classical member of the genus, other species of lyssaviruses also cause the disease. Some reservoirs remain cryptic. Although global, this viral encephalitis is untreatable and often ignored. As with other neglected diseases, laboratory-based surveillance falls short of the notifiable ideal, especially in lower- and middle-income countries. Calculation of actual burden defaults to a flux within broad health economic models. Competing priorities, lack of defined, long-term international donors, and shrinking local champions challenge human prophylaxis and mass dog vaccination toward targets of 2030 for even canine rabies impacts. For prevention, all licensed vaccines are delivered to the individual, whether parenteral or oral-essentially 'one and done'. Exploiting mammalian social behaviors, future 'spreadable vaccines' might increase the proportion of immunized hosts per unit effort. However, the release of replication-competent, genetically modified organisms selectively engineered to spread intentionally throughout a population raises significant biological, ethical, and regulatory issues in need of broader, transdisciplinary discourse. How this rather curious idea will evolve toward actual unconventional prevention, control, or elimination in the near term remains debatable. In the interim, more precise terminology and realistic expectations serve as the norm for diverse, collective constituents to maintain progress in the field.
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Affiliation(s)
- Charles E. Rupprecht
- College of Forestry, Wildlife & Environment, College of Veterinary Medicine, Auburn University, Auburn, AL 36849 USA
| | - Philip P. Mshelbwala
- School of Veterinary Science, University of Queensland, Gatton, Australia
- Department of Veterinary Medicine, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | - R. Guy Reeves
- Max Planck Institut Für Evolutionsbiologie, 24306 Plön, Germany
| | - Ivan V. Kuzmin
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555 USA
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