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Atuheire CGK, Okwee-Acai J, Taremwa M, Terence O, Ssali SN, Mwiine FN, Kankya C, Skjerve E, Tryland M. Descriptive analyses of knowledge, attitudes, and practices regarding rabies transmission and prevention in rural communities near wildlife reserves in Uganda: a One Health cross-sectional study. Trop Med Health 2024; 52:48. [PMID: 39030649 PMCID: PMC11264860 DOI: 10.1186/s41182-024-00615-2] [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: 03/26/2024] [Accepted: 07/06/2024] [Indexed: 07/21/2024] Open
Abstract
BACKGROUND Despite urban (domestic dog) rabies cycles being the main target for rabies elimination by 2030, sylvatic (wildlife) rabies cycles can act as rabies spillovers especially in settlements contiguous to wildlife reserves. Rural communities next to wildlife reserves are characterized by unique socio-demographic and cultural practices including bat consumption, hunting for bushmeat, and non-vaccination of hunting dogs against rabies among others. This study aimed to compare the knowledge, attitudes, and practices (KAPs) related to rabies transmission and prevention in the three districts of Uganda; (1) Nwoya, neighboring Murchison Falls National Park (MFNP) in the north, (2) Kamwenge neighboring Kibaale National Park (KNP), Queen Elizabeth National Park (QENP) and Katonga Game Reserve (KGR) in the west, and (3) Bukedea, neighboring Pian Upe Game Reserve (PUGR) in the east of Uganda. METHODS A community-based cross-sectional survey was conducted in settlements contiguous to these wildlife reserves. Using a semi-structured questionnaire, data were collected from 843 households owning dogs and livestock. Data were collected between the months of January and April 2023. Stratified univariate analyses by district were carried out using the Chi-square test for independence and Fisher's exact test to compare KAPs in the three study districts. RESULTS The median age of study participants was 42 years (Q1, Q3 = 30, 52) with males comprising the majority (67%, n = 562). The key findings revealed that participants from the Nwoya district in the north (MFNP) had little knowledge about rabies epidemiology (8.5%, n = 25), only 64% (n = 187) of them knew its signs and symptoms such as a rabid dog presenting with aggressiveness and showed negative attitudes towards prevention measures (15.3%, n = 45). Participants in the Kamwenge district-west (KNP, QENP, and KGR) had little knowledge and negative attitude towards wildlife-human interaction pertaining to rabies transmission and prevention especially those with no or primary level of education (20.9%, n = 27) while participants from Bukedea in the east (PUGR) had remarkedly poor practices towards rabies transmission, prevention, and control (37.8%, n = 114). CONCLUSIONS Rabies from sylvatic cycles remains a neglected public health threat in rural communities surrounding national parks and game reserves in Uganda. Our study findings highlight key gaps in knowledge, attitudes, and practices related to rabies transmission and prevention among such communities. Communication and action between veterinary services, wildlife authority, public health teams, social science and community leaders through available community platforms is key in addressing rabies among the sympatric at-risk communities in Uganda.
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Affiliation(s)
- Collins G K Atuheire
- Department of Biosecurity, Ecosystems & Veterinary Public Health, College of Veterinary Medicine, Animal Resources & Biosecurity, Makerere University, P.O Box 7062, Kampala, Uganda.
| | - James Okwee-Acai
- Department of Veterinary Pharmacy, Clinical and Comparative Medicine, College of Veterinary Medicine, Animal Resources & Biosecurity, Makerere University, P.O Box 7062, Kampala, Uganda
| | - Martha Taremwa
- Department of Biosecurity, Ecosystems & Veterinary Public Health, College of Veterinary Medicine, Animal Resources & Biosecurity, Makerere University, P.O Box 7062, Kampala, Uganda
| | - Odoch Terence
- Department of Biosecurity, Ecosystems & Veterinary Public Health, College of Veterinary Medicine, Animal Resources & Biosecurity, Makerere University, P.O Box 7062, Kampala, Uganda
| | - Sarah N Ssali
- School of Women and Gender Studies, College of Humanities, Makerere University, P.O Box 7062, Kampala, Uganda
| | - Frank N Mwiine
- Department of Biomolecular Resources and Bio-Lab Sciences, College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Clovice Kankya
- Department of Biosecurity, Ecosystems & Veterinary Public Health, College of Veterinary Medicine, Animal Resources & Biosecurity, Makerere University, P.O Box 7062, Kampala, Uganda
| | - Eystein Skjerve
- Department of Production Animal Medicine, Norwegian University of Life Sciences, Ås, Norway
| | - Morten Tryland
- Department of Arctic and Marine Biology, UiT-The Arctic University of Norway, Tromsø, Norway
- Department of Forestry and Wildlife Management, Inland Norway University of Applied Sciences, 2480, Koppang, Norway
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Briceño-Loaiza C, Fernández-Sanhueza B, Benavides-Silva C, Jimenez JY, Rubio AV, Ábalos P, Alegría-Morán RA. Spatial clusters, temporal behavior, and risk factors analysis of rabies in livestock in Ecuador. Prev Vet Med 2024; 226:106188. [PMID: 38513566 DOI: 10.1016/j.prevetmed.2024.106188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 02/12/2024] [Accepted: 03/15/2024] [Indexed: 03/23/2024]
Abstract
Rabies, a globally distributed and highly lethal zoonotic neglected tropical disease, has a significant impact in South America. In Ecuador, animal rabies cases are primarily linked to livestock, and hematophagous bats play a crucial role in disease transmission. This study aims to identify temporal trends, spatial patterns, and risk factors for animal rabies in Ecuador between 2014 and 2019. Epidemiological survey reports from the official Animal Rabies Surveillance Program of the Phyto and Zoosanitary Regulation and Control Agency of Ecuador (AGROCALIDAD) were used. The Animal Rabies Surveillance Program from AGROCALIDAD consists of an official passive surveillance program that receives reports from farmers or individuals (both trained or untrained) who have observed animals with neurological clinical signs and lesions compatible with bat bites, or who have seen or captured bats on their farms or houses. Once this report is made, AGROCALIDAD personnel is sent for field inspection, having to confirm the suspicion of rabies based on farm conditions and compatibility of signs. AGROCALIDAD personnel collect samples from all suspicious animals, which are further processed and analyzed using the Direct Fluorescent Antibody (DFA) test for rabies confirmatory diagnosis. In this case, study data comprised 846 bovine farms (with intra-farm sample sizes ranging from 1 to 16 samples) located in different ecoregions of Ecuador; out of these, 397 (46.93%) farms tested positive for animal rabies, revealing six statistically significant spatial clusters. Among these clusters, three high-risk areas were identified in the southeast of Ecuador. Seasonality was confirmed by the Ljung-Box test for both the number of cases (p < 0.001) and the positivity rate (p < 0.001). The Pacific Coastal lowlands and Sierra regions showed a lower risk of positivity compared to Amazonia (OR = 0.529; 95% CI = 0.318 - 0.883; p = 0.015 and OR = 0.633; 95% CI = 0.410 - 0.977; p = 0.039, respectively). The breeding of non-bovine animal species demonstrated a lower risk of positivity to animal rabies when compared to bovine (OR = 0.145; 95% CI = 0.062 - 0.339; p < 0.001). Similarly, older animals exhibited a lower risk (OR = 0.974; 95% CI = 0.967 - 0.981; p < 0.001). Rainfall during the rainy season was also found to decrease the risk of positivity to animal rabies (OR = 0.996; 95% CI = 0.995 - 0.998; p < 0.001). This study underscores the significance of strengthening the national surveillance program for the prevention and control of animal rabies in Ecuador and other countries facing similar epidemiological, social, and geographical circumstances.
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Affiliation(s)
- César Briceño-Loaiza
- Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago, Chile; Agencia de Regulación y Control Fito y Zoosanitario (AGROCALIDAD), Ecuador; Carrera de Agroecología, Instituto Superior Tecnológico Juan Montalvo, Loja, Ecuador
| | - Bastián Fernández-Sanhueza
- Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago, Chile; Escuela de Medicina Veterinaria, Facultad de Recursos Naturales y Medicina Veterinaria, Universidad Santo Tomás, Santiago, Chile
| | - César Benavides-Silva
- Facultad de Historia, Geografía y Ciencia Política, Instituto de Geografía, Pontificia Universidad Católica, Chile; Centro de Investigaciones Territoriales, Universidad Nacional de Loja, Ecuador
| | - José Yaguana Jimenez
- Carrera de Medicina Veterinaria, Facultad Agropecuaria y de Recursos Naturales Renovables, Universidad Nacional de Loja, Ecuador
| | - André V Rubio
- Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago, Chile
| | - Pedro Ábalos
- Facultad de Ciencias Veterinarias y Pecuarias, Universidad de Chile, Santiago, Chile
| | - Raúl A Alegría-Morán
- Escuela de Medicina Veterinaria, Facultad de Recursos Naturales y Medicina Veterinaria, Universidad Santo Tomás, Santiago, Chile.
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Lu R, Lin J, Zhou Y, Chen Q, Fan Z, Wu S, Qin P, Li L. Rabies vaccination adherence and associated factors among rabies-exposed patients in Shenzhen, China: a hospital-based cross-sectional study. Epidemiol Infect 2024; 152:e15. [PMID: 38195536 PMCID: PMC10894897 DOI: 10.1017/s0950268824000049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/17/2023] [Accepted: 01/03/2024] [Indexed: 01/11/2024] Open
Abstract
Adherence to post-exposure prophylaxis and post-exposure vaccination (PEV) is an important measure to prevent rabies. The purpose of this study was to explore the adherence to the vaccination protocol and its influencing factors among rabies-exposed patients in Shenzhen, China. A cross-sectional survey was conducted in a tertiary hospital in Shenzhen, China, to obtain epidemiological characteristics of patients; knowledge, attitude, and practice scores of rabies prevention; and medical records. A total of 326 patients requiring full rabies PEV were included in this study, and only 62% (202) completed the full course of vaccination according to the norms of the vaccination guidelines. After multifactor logistic regression, the factors influencing adherence to vaccination were as follows: age 31 to 40 years, time spent to reach the nearest rabies prevention clinic was >60 min, the time of injury was at night to early morning, the place of injury was a school/laboratory, the animal causing injury was a cat, the health status of the animal causing injury could not be determined, and patients with higher practice scores (all p<0.05). Understanding the factors influencing rabies vaccination adherence among rabies-exposed patients in urban areas of China and promote changes in patients' practice toward rabies prevention is essential for rabies elimination by 2030.
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Affiliation(s)
- Ruiqi Lu
- School of Public Health, Shantou University, Shantou, China
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
| | - Jinsheng Lin
- Emergency Department, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Yang Zhou
- Emergency Department, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Qian Chen
- Emergency Department, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Zaiying Fan
- Emergency Department, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Shuning Wu
- Department of Thyroid and Breast Surgery, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Pei Qin
- Clinical Center for Public Health, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Liping Li
- School of Public Health, Shantou University, Shantou, China
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
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Zhao H, Li P, Bian L, Zhang W, Jiang C, Chen Y, Kong W, Zhang Y. Immune Response of Inactivated Rabies Vaccine Inoculated via Intraperitoneal, Intramuscular, Subcutaneous and Needle-Free Injection Technology-Based Intradermal Routes in Mice. Int J Mol Sci 2023; 24:13587. [PMID: 37686393 PMCID: PMC10488038 DOI: 10.3390/ijms241713587] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
Inoculation routes may significantly affect vaccine performance due to the local microenvironment, antigen localization and presentation, and, therefore, final immune responses. In this study, we conducted a head-to-head comparison of immune response and safety of inactivated rabies vaccine inoculated via intraperitoneal (IP), intramuscular (IM), subcutaneous (SC) and needle-free injection technology-based intradermal (ID) routes in ICR mice. Immune response was assessed in terms of antigen-specific antibodies, antibody subtypes and neutralizing antibodies for up to 28 weeks. A live rabies virus challenge was also carried out to evaluate vaccine potency. The dynamics of inflammatory cell infiltration at the skin and muscle levels were determined via histopathological examination. The kinetics and distribution of a model antigen were also determined by using in vivo fluorescence imaging. Evidence is presented that the vaccine inoculated via the ID route resulted in the highest antigen-specific antibody and neutralizing antibody titers among all administration routes, while IP and IM routes were comparable, followed by the SC route. Antibody subtype analysis shows that the IP route elicited a Th1-biased immune response, while SC and IM administration elicited a prominent Th2-type immune response. Unexpectedly, the ID route leads to a balanced Th1 and Th2 immune response. In addition, the ID route conferred effective protection against lethal challenge with 40 LD50 of the rabies CVS strain, which was followed by IP and IM routes. Moreover, a one-third dose of the vaccine inoculated via the ID route provided comparable or higher efficacy to a full dose of the vaccine via the other three routes. The superior performance of ID inoculation over other routes is related to longer local retention at injection sites and higher lymphatic drainage. Histopathology examination reveals a transient inflammatory cell infiltration at ID and IM injection sites which peaked at 48 h and 24 h, respectively, after immunization, with all side effects disappearing within one week. These results suggest that needle-free injection technology-based ID inoculation is a promising strategy for rabies vaccination in regard to safety and efficacy.
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Affiliation(s)
- Huiting Zhao
- National Engineering Laboratory for AIDS Vaccine, School of Life Sciences, Jilin University, Changchun 130012, China
- Key Laboratory for Molecular Enzymology and Engineering of Ministry of Education, School of Life Sciences, Jilin University, Changchun 130012, China
| | - Peixuan Li
- National Engineering Laboratory for AIDS Vaccine, School of Life Sciences, Jilin University, Changchun 130012, China
- Key Laboratory for Molecular Enzymology and Engineering of Ministry of Education, School of Life Sciences, Jilin University, Changchun 130012, China
| | - Lijun Bian
- National Engineering Laboratory for AIDS Vaccine, School of Life Sciences, Jilin University, Changchun 130012, China
- Key Laboratory for Molecular Enzymology and Engineering of Ministry of Education, School of Life Sciences, Jilin University, Changchun 130012, China
| | - Wen Zhang
- National Engineering Laboratory for AIDS Vaccine, School of Life Sciences, Jilin University, Changchun 130012, China
- Key Laboratory for Molecular Enzymology and Engineering of Ministry of Education, School of Life Sciences, Jilin University, Changchun 130012, China
| | - Chunlai Jiang
- National Engineering Laboratory for AIDS Vaccine, School of Life Sciences, Jilin University, Changchun 130012, China
- Key Laboratory for Molecular Enzymology and Engineering of Ministry of Education, School of Life Sciences, Jilin University, Changchun 130012, China
- NMPA Key Laboratory of Humanized Animal Models for Evaluation of Vaccines and Cell Therapy Products, Jilin University, Changchun 130012, China
| | - Yan Chen
- National Engineering Laboratory for AIDS Vaccine, School of Life Sciences, Jilin University, Changchun 130012, China
- Key Laboratory for Molecular Enzymology and Engineering of Ministry of Education, School of Life Sciences, Jilin University, Changchun 130012, China
- NMPA Key Laboratory of Humanized Animal Models for Evaluation of Vaccines and Cell Therapy Products, Jilin University, Changchun 130012, China
| | - Wei Kong
- National Engineering Laboratory for AIDS Vaccine, School of Life Sciences, Jilin University, Changchun 130012, China
- Key Laboratory for Molecular Enzymology and Engineering of Ministry of Education, School of Life Sciences, Jilin University, Changchun 130012, China
- NMPA Key Laboratory of Humanized Animal Models for Evaluation of Vaccines and Cell Therapy Products, Jilin University, Changchun 130012, China
| | - Yong Zhang
- National Engineering Laboratory for AIDS Vaccine, School of Life Sciences, Jilin University, Changchun 130012, China
- Key Laboratory for Molecular Enzymology and Engineering of Ministry of Education, School of Life Sciences, Jilin University, Changchun 130012, China
- NMPA Key Laboratory of Humanized Animal Models for Evaluation of Vaccines and Cell Therapy Products, Jilin University, Changchun 130012, China
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Mohammad Basir MF, Mohd Hairon S, Tengku Ismail TA, Che' Muda CM, Abdul Halim HI. The Determinants of Non-compliance on Rabies Vaccination in North-West Peninsular Malaysia. J Epidemiol Glob Health 2023; 13:1-10. [PMID: 36622636 PMCID: PMC9828360 DOI: 10.1007/s44197-022-00080-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 11/25/2022] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Rabies post-exposure vaccination (Rabies PEV) remains the most fundamental prevention of human Rabies if administered in a timely and appropriate manner. The study was aimed to determine the proportion and determinants of non-compliance on Rabies PEV among dog bite patients in Perlis, Malaysia from July 2015 to June 2020. METHODS A retrospective cohort study was conducted using Perlis Rabid Potential Animal Bite Registry data. Independent variables and compliance status were obtained from the registry. Logistic regression analysis was utilized on 507 dog bite patients. RESULTS Most of dog bite patients were age group of 46-60 years old (23.1%), male (61.3%), Chinese (49.5%), seeking treatment less than 24 h after the exposure (78.3%), category two of exposure (76.3%) and bitten on lower extremities (57.8%) by an owned dog (58.4%). Only 19.5% were non-compliance to Rabies PEV. Siamese had significantly two-timed (AOR: 2.00; 95% CI 1.06, 3.76) odd higher to become non-compliance. Being bitten during 3rd (AOR: 0.27; 95% CI 0.12, 0.59), 4th (AOR: 0.24; 95% CI 0.11, 0.52) and 5th (AOR: 0.20; 95% CI 0.09, 0.44) year of the outbreak had significantly lower odds to non-comply with Rabies PEV. CONCLUSION 19.5% of dog bite patients still did not comply with the Rabies PEV series. Siamese would likely to non-comply whereas bitten on the 3rd, 4th and 5th years of outbreak less tendency to non-comply. Continuous health promotion to the public in the various languages despite outbreak status are ongoing to improve the perception of risk and benefit toward compliance of Rabies PEV.
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Affiliation(s)
- Mohammad Fazrul Mohammad Basir
- Department of Community Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Suhaily Mohd Hairon
- Department of Community Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia.
| | - Tengku Alina Tengku Ismail
- Department of Community Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Che Muzaini Che' Muda
- Communicable Disease Control Unit, Perlis State Health Department, Ministry of Health Malaysia, 01000, Kangar, Perlis, Malaysia
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Chavarría L, Quinteros E, Sánchez M, Domínguez R. Prophylactic treatment abandonment in people bitten by suspected rabid animals, El Salvador, 2013-2017. J Family Med Prim Care 2022; 11:5148-5154. [PMID: 36505524 PMCID: PMC9730997 DOI: 10.4103/jfmpc.jfmpc_1699_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 01/14/2022] [Accepted: 01/22/2022] [Indexed: 11/07/2022] Open
Abstract
Introduction Around the world 60,000 people die from rabies each year. The main form of exposure to rabies is by the bite of animals infected with the virus. More than 20,000 cases of rabies-transmitting animal bites are reported each year, in El Salvador, a country located in Central America. People exposed should be managed with rabies prophylaxis. Objective To determine the abandonment of post-exposure prophylaxis (PEP) cumulative incidence (CI) in humans bitten by suspected rabid animals in El Salvador from 2013 to 2017. Methodology This is an ecological study based on the cases of bites by suspected rabid animals reported between 2013 and 2017 in the public health system of El Salvador. Descriptive and correlation analysis was performed using Statistical Package for the Social Sciences (SPSS) version 24. The municipality CI, expressed per 100,000 inhabitants. Results The national CI of abandonment PEP in humans bitten by suspected rabid animals was 25.6 × 100,000 inhabitants. Simple bivariate correlation analysis shows that the departments with the highest CI of bites caused by cats, wild animals, and bites on the neck (R 2 = 0.99 P < 0.05) are mostly associated with dropping out of the PEP. Conclusion In El Salvador, the abandonment CI of PEP is lower than other countries, however, bites by rabid suspected animal are frequent, this represents a public health problem due to the presence of the rabies virus in wild animals and the high lethality of the disease. Municipalities where head bites are common are the most related to the abandonment of PEP.
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Affiliation(s)
- Larisa Chavarría
- Governance and Knowledge Management Unit, National Institute of Health, San Salvador, El Salvador,Address for correspondence: Dr. Larisa Chavarría, Family Physician, Governance and Knowledge Management Unit, National Institute of Health, San Salvador, El Salvador. E-mail:
| | - Edgar Quinteros
- Research Unit, National Institute of Health, San Salvador, El Salvador
| | - Mario Sánchez
- Research Unit, National Institute of Health, San Salvador, El Salvador
| | - Rhina Domínguez
- Research Unit, National Institute of Health, San Salvador, El Salvador
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Rupprecht CE, Mani RS, Mshelbwala PP, Recuenco SE, Ward MP. Rabies in the Tropics. CURRENT TROPICAL MEDICINE REPORTS 2022; 9:28-39. [PMID: 35371908 PMCID: PMC8960221 DOI: 10.1007/s40475-022-00257-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2022] [Indexed: 11/25/2022]
Abstract
Purpose of Review Rabies is an ancient yet still neglected tropical disease (NTD). This review focuses upon highlights of recent research and peer-reviewed communications on the underestimated tropical burden of disease and its management due to the complicated dynamics of virulent viral species, diverse mammalian reservoirs, and tens of millions of exposed humans and animals – and how laboratory-based surveillance at each level informs upon pathogen spread and risks of transmission, for targeted prevention and control. Recent Findings While both human and rabies animal cases in enzootic areas over the past 5 years were reported to PAHO/WHO and OIE by member countries, still there is a huge gap between these “official” data and the need for enhanced surveillance efforts to meet global program goals. Summary A review of the complex aspects of rabies perpetuation in human, domestic animal, and wildlife communities, coupled with a high fatality rate despite the existence of efficacious biologics (but no therapeutics), warrants the need for a One Health approach toward detection via improved laboratory-based surveillance, with focal management at the viral source. More effective methods to prevent the spread of rabies from enzootic to free zones are needed.
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Affiliation(s)
- Charles E. Rupprecht
- LYSSA LLC, Atlanta, GA USA
- School of Forestry and Wildlife Sciences, Auburn University, Auburn, AL USA
| | - Reeta S. Mani
- Department of Neurovirology, WHO Collaborating Centre for Reference and Research in Rabies, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka India
| | - Philip P. Mshelbwala
- School of Veterinary Science, The University of Queensland, Brisbane, Australia
- Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | - Sergio E. Recuenco
- Facultad de Medicina San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Michael P. Ward
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, Camden, NSW Australia
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Nyasulu PS, Weyer J, Tschopp R, Mihret A, Aseffa A, Nuvor SV, Tamuzi JL, Nyakarahuka L, Helegbe GK, Ntinginya NE, Gebreyesus MT, Doumbia S, Busse R, Drosten C. Rabies mortality and morbidity associated with animal bites in Africa: a case for integrated rabies disease surveillance, prevention and control: a scoping review. BMJ Open 2021; 11:e048551. [PMID: 34857556 PMCID: PMC8640643 DOI: 10.1136/bmjopen-2020-048551] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 09/08/2021] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE The objective of this scoping review was to map the current situation and available evidence and gaps on rabies morbidity, mortality, integrated rabies surveillance programmes, and existing prevention and control strategies in Africa. METHODS We conducted a systematic scoping review following the Joanna Briggs methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews checklist. Medline, Embase, CINAHL (EBSCOHost), Scopus, Web of Science and rabies web conferences were used to search for peer-reviewed publications between January 1946 and May 2020. Two researchers reviewed the studies and extracted data based on author (year) and region, study design and data collection duration, participants/comparators, interventions, control conditions/exposures and outcomes (rabies mortality and morbidity) and key findings/gaps/challenges. The results were reported narratively using Arksey and O'Malley's methodological framework. RESULTS Electronic search yielded 2775 records, of which 43 studies were included. A total of 543 714 bite victims were censored through the included studies. Most of the victims were less than 15 years of age. The studies included rabies morbidity (21) and mortality (15) fluctuating in space and time across Africa depending on countries' rabies prevention and control practices (16). Others were surveillance (nine studies); surveillance and prevention (five studies); management and control (seven studies); and surveillance, prevention and control (six studies). We found challenges in rabies reporting, existing dog vaccination programmes and post-exposure prophylaxis availability or compliance. CONCLUSION This study found challenges for dog rabies control and elimination in Africa and the need for a policy to drive the goal of zero dog-transmitted rabies to humans by 2030.This is an open-access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build on this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated and the use is non-commercial (see http://creativecommons.org/licenses/by-nc/4.0/).
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Affiliation(s)
- Peter Suwirakwenda Nyasulu
- Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jacqueline Weyer
- Centre for Emerging Zoonosis and Parasitic Diseases, National Institute of Communicable Diseases, Johannesburg, South Africa
- Department of Microbiology and Infectious Diseases, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Rea Tschopp
- Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Adane Mihret
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Abraham Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Samuel Victor Nuvor
- Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Jacques Lukenze Tamuzi
- Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Luke Nyakarahuka
- Department of Biosecurity, Ecosystems and Veterinary Public Health, College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Gideon Kofi Helegbe
- Department of Biochemistry and Molecular Medicine, School of Medicine, University for Development Studies, Tamale, Ghana
| | - Nyanda Elias Ntinginya
- Mbeya Medical Research Centre, National Institute of Medical Research, Mbeya, Tanzania, United Republic of
| | | | - Seydou Doumbia
- Faculty of Medicine and Odontostomatology & University Clinical Research Center, University of Sciences, Techniques and Technology of Bamako, Bamako, Mali
| | - Reinhard Busse
- Department of Health Care Management, Technical University Berlin, Berlin, Germany
| | - Christian Drosten
- Institute of Virology, Charité-University Medicine Berlin, Berlin, Germany
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Knowledge, Attitudes and Practices on Rabies among Human and Animal Health Professionals in Senegal. Pathogens 2021; 10:pathogens10101282. [PMID: 34684231 PMCID: PMC8537254 DOI: 10.3390/pathogens10101282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/24/2021] [Accepted: 09/25/2021] [Indexed: 11/17/2022] Open
Abstract
Rabies is still a public health problem in Senegal. This study aimed to assess the knowledge, attitudes and practices on rabies among human and animal health professionals. It was a cross-sectional, descriptive and analytical study conducted in the Kaffrine district. Data were collected from 28 June to 01 July 2021. An exhaustive recruitment was done, and the final sample size was 95 health professionals. R software was used for descriptive, bivariate and multivariate analyses. Health professionals with sufficient knowledge, positive attitudes and good practices in relation to rabies represented 35.8%, 26.3% and 45.3% of the study respectively. The results of the multivariate analysis showed that professionals who worked in urban areas (AOR = 11.10; 95% CI = [3.50-41.69]) and who worked in animal health (AOR = 7.45; 95% CI = [1.16-70.40]) were more likely to have sufficient knowledge about rabies. Professionals with tertiary education (AOR = 12.40; CI95% = [1.80-268.00]) and with sufficient knowledge (AOR = 3.41; CI95% = [1.01-12.70]) were more likely to have a positive attitude about rabies. Professionals with a positive attitude about rabies (AOR = 3.23; 95% CI = [1.08-10.70]) were more likely to have a good practice when presented with an animal bite case. These results suggest that improving health professionals' knowledge about rabies is essential in order to influence their attitudes and practices against rabies.
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Sessou P, Noudeke N, Thomson DJ, Salako D, Farougou S. Evaluation of the knowledge, attitudes and practices of students at the University of Abomey-Calavi on rabies in Benin Republic, West Africa. Pan Afr Med J 2021; 38:235. [PMID: 34046140 PMCID: PMC8140680 DOI: 10.11604/pamj.2021.38.235.27485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 02/01/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction rabies is a vaccine-preventable viral zoonotic disease. Once clinical symptoms appear, rabies is fatal in almost 100% of cases. The objective of this study was to evaluate the knowledge, attitudes and practices of students at the University of Abomey-Calavi in Benin on rabies in order to explore the factors that promote the occurrence of this zoonosis. Methods for this purpose, a descriptive cross-sectional survey was conducted among 263 randomly-selected students. The collected data were analyzed by R software with logistic regression. Results out of all the 263 respondents, 53.2% (n=140) of the students claimed to have heard of canine rabies, compared to 47.5% (n=125) for human rabies. Stray dogs were recognized by 49.0% (n=129) as a prevailing source of rabies infection in people; bites from these dogs were considered as a means of rabies contagion (41.4%; n=109) and vaccination of dogs was considered by 32.7% (n=86) as a means of rabies control in both people and dogs. In case of a dog bite, 60.5% (n=159) of respondents would visit a western medicine human clinic first. For the fate of the biting dog, 18.6% (n=49) and 27.4% (n=72) of respondents, respectively, prefer to euthanize the dog or take the dog to the veterinarian for observation. Regarding the perceived consequences of inaction after a dog bite, 58.2% (n=140) mentioned the risk of rabies. Students in human or animal health were 3 times more aware on rabies. Conclusion this study identifies the gaps in students´ knowledge, attitudes and practices about effective rabies prevention and control. It will therefore be necessary to intensify awareness and education campaigns among students who could be a good relay of information to other members in their communities.
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Affiliation(s)
- Philippe Sessou
- Research Unit on Communicable Diseases, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Cotonou, Benin
| | - Nestor Noudeke
- Research Unit on Communicable Diseases, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Cotonou, Benin
| | | | - David Salako
- Research Unit on Communicable Diseases, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Cotonou, Benin
| | - Souaïbou Farougou
- Research Unit on Communicable Diseases, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Cotonou, Benin
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Saleem SM, Quansar R, Haq I, Salim Khan SM. Imposing COVID-19 lockdown and reported dog bite cases: An experience from a tertiary antirabies center of North India. J Vet Behav 2021; 42:48-52. [PMID: 36042750 PMCID: PMC9412179 DOI: 10.1016/j.jveb.2021.01.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 11/29/2022]
Abstract
The world was taken aback after the corona pandemic started from China and soon engulfed the whole of the world. Strict restrictions were in place since the beginning, and people were confined to their homes; only emergency services were allowed to work. The study's objectives were to see the effect of lockdown on the number of dog bite cases being reported to our antirabies clinic. The study was conducted in the antirabies clinic of the Department of Community Medicine, Government Medical College, Srinagar, Jammu & Kashmir. This study involved a dog bite victim who approached the said clinic during the lockdown, which was implemented in the wake of COVID-19 from March 21, 2020 to June 03, 2020. We included all the dog bite victims living in the Srinagar city and from the adjoining districts who had been bitten by the street dog during the lockdown phase. Over 5 years, 4,670 (73.6%) dog bites among males were reported. The proportion of dog bites among males varies from 72% to 81% in the 5 years. It can be observed that a maximum of 783 (81.1%) dog bites were reported from males during the lockdown period in 2020. Moreover, 2,847 (44.9%) bites were category II dog bites, while 3,392 (55.1%) were category III dog bites. There were fewer dog bites reported at the first, fourth, seventh, eighth, and ninth weeks while there was a little surge in cases on the 2nd, 3rd, 5th, 6th, and 10th week. Lockdown had indirectly reduced the number of dog bite cases reported to the clinic during different lockdown phases than the previous year's data.
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Kisaka S, Makumbi FE, Majalija S, Bangirana A, Thumbi SM. Epidemiology and preclinical management of dog bites among humans in Wakiso and Kampala districts, Uganda: Implications for prevention of dog bites and rabies. PLoS One 2020; 15:e0239090. [PMID: 32956373 PMCID: PMC7505423 DOI: 10.1371/journal.pone.0239090] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/29/2020] [Indexed: 11/19/2022] Open
Abstract
In rabies endemic areas, appropriate management of dog bites is critical in human rabies prevention. Victims must immediately wash bite wound for 15 minutes with water, soap, and a disinfectant before seeking medical care. This study investigated the epidemiology of dog bites and the determinants of compliance to these pre-clinical guidelines requirements among dog bite victims from high rabies-burden areas of Wakiso and Kampala, Uganda. An explanatory sequential mixed-methods study design was used. Quantitative data were collected from 376 dog-bite patients at two healthcare facilities. Qualitative data were also collected through 13 in-depth interviews with patients, healthcare workers, herbalists, and veterinarians. Qualitative data were analyzed using a deductive thematic approach. Generalized linear models were used to determine factors associated with compliance. Nearly half (190, 51%) of the patients were from Wakiso District and 293 (77.9%) had grade II wounds. Most of the wounds (171, 45.5%) were on the legs. Two-thirds of the bites occurred in public places. Only 70 (19%) of the bite patients had complied with pre-clinical guidelines. Nearly half of the patients had applied substances that were not recommended e.g. herbs (47/193), antiseptics (46/193), "black stone" (25/193), and unknown creams (10/193). Factors negatively associated with compliance included: being aged 15 years or older, adjPR = 0.70 (0.47-0.92) and knowing the dog owner, adjPR = 0.65 (0.36-0.93). However, attainment of secondary or higher education, adjPR = 1.76 (1.24-3.79), being in employment, adjPR = 1.48 (1.09-2.31), perception that the dog was sick, adjPR = 1.47 (1.02-2.72) and knowledge about the dog's subsequent victim(s) adjPR = 0.35 (0.17-0.70) were positively associated with compliance. High occurrence of dog bites in public places by free-roaming dogs suggests the need for deliberate promotion of responsible dog ownership. Additionally, targeted health education may be required to improve the low compliance to pre-clinical guidelines.
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Affiliation(s)
- Stevens Kisaka
- University of Nairobi Institute of Tropical and Infectious Diseases, Nairobi, Kenya
- School of Public Health, Makerere University, Kampala, Uganda
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | | | - Samuel Majalija
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Alexander Bangirana
- Department of Emergency Medicine, Mulago National Referral Hospital, Kampala, Uganda
| | - S. M. Thumbi
- University of Nairobi Institute of Tropical and Infectious Diseases, Nairobi, Kenya
- Rabies Free Africa, Washington State University, Pullman, Washington, United States of America
- Paul G Allen School for Global Animal Health, Washington State University, Pullman, Washington, United States of America
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Advances in RNA Vaccines for Preventive Indications: A Case Study of A Vaccine Against Rabies. Vaccines (Basel) 2019; 7:vaccines7040132. [PMID: 31569785 PMCID: PMC6963972 DOI: 10.3390/vaccines7040132] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 09/15/2019] [Accepted: 09/19/2019] [Indexed: 12/25/2022] Open
Abstract
There is a global need for effective and affordable rabies vaccines, which is unmet by current vaccines due to limitations in their production capacities, required administration schedules, storage requirements, and cost. Many different experimental approaches previously used for bacterial and viral vaccines have been applied to rabies, but with variable success. One of the most promising new concepts is the use of messenger RNA (mRNA) in encoding the main rabies virus antigen, the envelope glycoprotein (RABV-G). CureVac has applied their proprietary technology platform for the production of mRNA to this problem, resulting in the rabies vaccine candidate CV7201. Following preclinical studies in mice and pigs showing that CV7201 could induce neutralizing immune responses that protected against rabies virus, different dosages and routes of administration of CV7201 were tested in a phase 1 human study. This clinical study proved that mRNA vaccination was safe and had an acceptable reactogenicity profile, but immune responses depended on the mode of administration, and they did not unequivocally support CV7201 for further development as a prophylactic vaccine with this particular formulation. Further, preclinical studies using RABV-G mRNA encapsulated in lipid nanoparticles (LNPs) showed an improved response in both mice and nonhuman primates, and these encouraging results are currently being followed up in clinical studies in humans. This review summarizes the recent advances in mRNA vaccines against rabies.
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