1
|
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.
Collapse
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
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
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/).
Collapse
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
| |
Collapse
|
4
|
Savadogo M, Tialla D, Ouattara B, Dahourou LD, Ossebi W, Ilboudo SG, Combari AHB, Tarnagda Z, Alambedji RB. Factors associated with owned-dogs' vaccination against rabies: A household survey in Bobo Dioulasso, Burkina Faso. Vet Med Sci 2021; 7:1096-1106. [PMID: 33694291 PMCID: PMC8294405 DOI: 10.1002/vms3.468] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 01/25/2021] [Accepted: 02/22/2021] [Indexed: 12/25/2022] Open
Abstract
Canine vaccination is an effective means for rabies control, a minimum of 70% dog rabies vaccination coverage is required in endemic areas. According to previous investigations, this recommended coverage is always not achieved in Burkina Faso. This study was carried out to investigate reasons for poor vaccination coverage in canine population. Using a structured questionnaires, a cross‐sectional survey was conducted in the city of Bobo Dioulasso to capture data on drivers that affect dog owners’ individual decision to vaccinate or not their dogs. Through a house‐to‐house approach, 239 questionnaires were administrated to dog owners during face to face interviews. The results indicated dog rabies vaccination coverage of 25.9%. Dog breed, origin and confinement status had a significant association with vaccination status (p < 0.05). Owners of exotic and cross‐bred dogs were more likely to adopt vaccination compared to owners of local‐bred dogs. Dogs of bought origin were significantly more likely to be vaccinated among all dogs. Household characteristics including age of owners, level of education, employment status, means of transportation, perception of vaccination cost and level of knowledge about rabies were significantly associated with the vaccination status (p < 0.05). The oldest dog owners, the owners having high level of education, having a car as means of transportation, having good knowledge of rabies and dog rabies vaccination, being employed and perceiving vaccination cost as affordable were more likely to vaccinate their dogs. Combining community awareness and free dog rabies vaccination approaches could improve the vaccination coverage.
Collapse
Affiliation(s)
- Madi Savadogo
- Département de Biologie Médicale et Santé Publique, Institut de Recherche en Sciences de la Santé (IRSS/CNRST), Ouagadougou, Burkina Faso.,Fundamental and Applied Research for Animals and Health (FARAH), Faculty of Veterinary Medicine, University of Liege, Liège, Belgium
| | - Dieudonné Tialla
- Département de Biologie Médicale et Santé Publique, Institut de Recherche en Sciences de la Santé (IRSS/CNRST), Ouagadougou, Burkina Faso.,Ecole Nationale de l'Elevage et de la Santé Animale (ENESA), Ouagadougou, Burkina Faso
| | - Boris Ouattara
- Service de Microbiologie Immunologie et Pathologies Infectieuses, Département de Santé Publique et Environnement, Ecole Inter-Etats des Sciences et Médecine Vétérinaires (EISMV), Dakar, Senegal
| | - Laibané D Dahourou
- Department of Animal Husbandry, Environmental Sciences and Rural Development Institute, University of Dedougou (UDDG), Dedougou, Burkina Faso
| | - Walter Ossebi
- Service d'Economie Rurale et Gestion, Département des Sciences Biologiques et Productions Animales, Ecole Inter-Etats des Sciences et Médecine Vétérinaires (EISMV), Dakar, Sénégal
| | - Sidwatta G Ilboudo
- International Livestock Research Institute (ILRI), Ouagadougou, Burkina Faso
| | - Alima H B Combari
- Department of Animal Production, Environment and Agricultural Research Institute (INERA/CNRST), Ouagadougou, Burkina Faso
| | - Zékiba Tarnagda
- Département de Biologie Médicale et Santé Publique, Institut de Recherche en Sciences de la Santé (IRSS/CNRST), Ouagadougou, Burkina Faso
| | - Rianatou B Alambedji
- Service de Microbiologie Immunologie et Pathologies Infectieuses, Département de Santé Publique et Environnement, Ecole Inter-Etats des Sciences et Médecine Vétérinaires (EISMV), Dakar, Senegal
| |
Collapse
|
5
|
Mbilo C, Kabongo JB, Pyana PP, Nlonda L, Nzita RW, Luntadila B, Badibanga B, Hattendorf J, Zinsstag J. Dog Ecology, Bite Incidence, and Disease Awareness: A Cross-Sectional Survey among a Rabies-Affected Community in the Democratic Republic of the Congo. Vaccines (Basel) 2019; 7:E98. [PMID: 31454908 PMCID: PMC6789516 DOI: 10.3390/vaccines7030098] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 08/20/2019] [Accepted: 08/22/2019] [Indexed: 12/25/2022] Open
Abstract
Despite the existence of safe and efficacious human and animal rabies vaccines, millions of people remain at risk of exposure to this deadly zoonotic disease through bites of infected dogs. Sub-Saharan African countries, such as the Democratic Republic of the Congo (DRC), bear the highest per capita death rates from rabies where dog vaccination and availability of lifesaving post-exposure prophylaxis (PEP) is scarce. Mass dog vaccination is the most cost-effective and sustainable approach to prevent human rabies deaths. We conducted a cross-sectional household survey in a rabies-affected community in Matadi, DRC, to estimate the size of the owned dog population and dog bite incidence and assess knowledge and practices regarding rabies, as preparation for future mass dog vaccination campaigns. Our study revealed that the owned dog population in Matadi was almost ten times larger than assumed by local veterinary officials, with a large proportion of free-roaming unvaccinated dogs. The annual dog bite incidence of 5.2 per 1000 person years was high, whereas community rabies knowledge was low resulting in poor practices. Given these findings, human rabies deaths are likely to occur in this community. Lack of disease awareness could negatively affect participation in future mass dog vaccination campaigns. A public sensitization campaign is needed to promote appropriate rabies prevention (washing bite wounds and PEP) and control (dog vaccination) measures in this community.
Collapse
Affiliation(s)
- Céline Mbilo
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland
- University of Basel, Petersplatz 1, CH-4001 Basel, Switzerland
| | | | - Pati Patient Pyana
- Université Pédagogique Nationale de Kinshasa, BP 8815 Kinshasa, Congo
- Institut National de Recherche Biomédicale (INRB), Avenue de la Démocratie, BP 1197 Kinshasa/Gombe, Congo
| | - Léon Nlonda
- Clinique Vétérinaire d'Etat de Matadi, Matadi, Congo
| | | | - Bobo Luntadila
- Université Pédagogique Nationale de Kinshasa, BP 8815 Kinshasa, Congo
- Institut National de Recherche Biomédicale (INRB), Avenue de la Démocratie, BP 1197 Kinshasa/Gombe, Congo
| | - Badivé Badibanga
- Université Pédagogique Nationale de Kinshasa, BP 8815 Kinshasa, Congo
| | - Jan Hattendorf
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland
- University of Basel, Petersplatz 1, CH-4001 Basel, Switzerland
| | - Jakob Zinsstag
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland.
- University of Basel, Petersplatz 1, CH-4001 Basel, Switzerland.
| |
Collapse
|
6
|
Hergert M, Le Roux K, Nel LH. Characteristics of owned dogs in rabies endemic KwaZulu-Natal province, South Africa. BMC Vet Res 2018; 14:278. [PMID: 30200962 PMCID: PMC6131809 DOI: 10.1186/s12917-018-1604-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 08/31/2018] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Canine rabies has been enzootic in the dog population of the KwaZulu-Natal province of South Africa since the mid-1970s and has been associated with high rates of human exposures and frequent transmissions to other domestic animal species. Several decades of control efforts, consisting primarily of mass vaccination programs, have previously failed to sufficiently curb rabies in the province. Despite this history of canine rabies, the target canine population has never been extensively studied or quantified. For efficient and effective vaccination campaign planning, the target population must be evaluated and understood. This study reports evaluated observations from survey records captured through a cross sectional observational study regarding canine populations and dog owners in rabies enzootic KwaZulu-Natal province, South Africa. The objective of this study was to aid government veterinary services in their current and ongoing efforts to eliminate canine rabies in the province by gaining information about the size and distribution of the owned dog population. RESULTS Thirty-eight percent of the households owned one or more dogs, with rural areas surveyed containing a significantly higher number of owned dogs than urban areas. The mean dog/person ratio for this study was 1:7.7 (range 1:5.4-1:31). The provincial sex ratio was 1.5:1 male to female, with the percentages for male dogs across the communities ranging from 53 to 61.5%. The age structure of this dog population indicates a high turnover rate. Dogs were kept mostly for guarding homes or livestock. Eighty-four percent of dogs had received a rabies vaccine at some point in their lifetime, almost all during a rabies campaign. CONCLUSIONS The study indicates the majority of owned dogs can be handled by at least one member of the household, thus can be made readily accessible for rabies vaccination during a campaign. Characteristics of owned dogs in the province were similar to those studied in other African countries; however, there were remarkable differences in age, sex and husbandry practices compared to dogs in eastern or northern Africa. These geographical differences lend credence to the theory that canine populations are heterogeneous; therefore, target populations should be evaluated prior to intervention planning.
Collapse
Affiliation(s)
- Melinda Hergert
- Department of Paraclinical Sciences, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, 0110 South Africa
| | - Kevin Le Roux
- KwaZulu-Natal Department of Environment, Agriculture and Rural Development, Government Veterinary Services, 458 Townbush Road, Pietermaritzburg, 3202 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, 529 Humboldt St., Suite 1, Manhattan, KS 66502 USA
| |
Collapse
|