Rabies in Uganda: rabies knowledge, attitude and practice and molecular characterization of circulating virus strains

Background

Rabies is a deadly preventable viral disease that affects all warm-blooded animals and widespread in many regions including Africa. The disease remains of major public health importance in Uganda.

The purpose of this study was to establish Knowledge, Attitude, Practice (KAP) of Rabies in Moyo and Ntoroko districts and to characterize Rabies virus (RABV) strains from seven districts of Uganda with consistent prevalence of rabies.

Methods

KAP survey data were collected based on animal biting history by interviewing the head of the veterinary departments, the medical centers and selected households from the study sites. Data were obtained from 84 households in Ntoroko and Moyo districts. Thirty-five (35) brain samples were collected from bovine, dogs, goats, foxes, jackals ad sheep between 2011 and 2013. Samples were tested using fluorescent antibody test (FAT), One step RT-PCR (following RNA extraction) and partial RABV N gene was sequenced by Sanger method before phylogenetic and phylogeographic analyses of sequences.

Results

Scarcity of post-exposure prophylaxis services in the health centers was noted. Poor attitude of wound washing and deficiency of knowledge on how to handle wounds related to dog bites and the significance among household participants lacked. There is a high risk of rabies infection due to a limited dog’s vaccination. Dog biting episodes in humans were of 75.00 and 62.50% in Moyo and Ntoroko districts respectively. Twenty-seven (27) samples tested positive for rabies by FAT and PCR. Ugandan sequences were closely related (97% nucleotide id) to the rabies virus sequences from Tanzania, Rwanda, Burundi, Nigeria, Central African Republic and Sudan with both the “Africa 1A” and “Africa 1B” RABV clades represented. A putative new clade 1D was also detected.

Conclusions

Rabies remains a public health hazard in Uganda. There is urgent need to establish advocacy programs in both schools and communities to curtail the spread of rabies. Increasing the knowledge regarding wound washing, post-exposure prophylaxis and dogs vaccination would enhance prevention of rabies. A strong collaboration between medical and veterinary sectors under a one health platform is required to ensure sufficient preventative services to the communities.

Molecular detection and phylogenetic analysis of lumpy skin disease virus from outbreaks in Uganda 2017-2018

BACKGROUND

Lumpy skin disease (LSD) is an infectious viral disease of cattle caused by a Capripoxvirus. LSD has substantial economic implications, with infection resulting in permanent damage to the skin of affected animals which lowers their commercial value. In Uganda, LSD is endemic and cases of the disease are frequently reported to government authorities. This study was undertaken to molecularly characterize lumpy skin disease virus (LSDV) strains that have been circulating in Uganda between 2017 and 2018. Secondly, the study aimed to determine the phylogenetic relatedness of Ugandan LSDV sequences with published sequences, available in GenBank.

RESULTS

A total of 7 blood samples and 16 skin nodule biopsies were screened for LSDV using PCR to confirm presence of LSDV nucleic acids. PCR positive samples were then characterised by amplifying the GPCR gene. These amplified genes were sequenced and phylogenetic trees were constructed. Out of the 23 samples analysed, 15 were positive for LSDV by PCR (65.2%). The LSDV GPCR sequences analysed contained the unique signatures of LSDV (A11, T12, T34, S99, and P199) which further confirmed their identity. Sequence comparison with vaccine strains revealed a 12 bp deletion unique to Ugandan outbreak strains. Phylogenetic analysis indicated that the LSDV sequences from this study clustered closely with sequences from neighboring East African countries and with LSDV strains from recent outbreaks in Europe. It was noted that the sequence diversity amongst LSDV strains from Africa was higher than diversity from Eurasia.

CONCLUSION

The LSDV strains circulating in Uganda were closely related with sequences from neighboring African countries and from Eurasia. Comparison of the GPCR gene showed that outbreak strains differed from vaccine strains. This information is necessary to understand LSDV molecular epidemiology and to contribute knowledge towards the development of control strategies by the Government of Uganda.

Spatial and temporal distribution of lumpy skin disease outbreaks in Uganda (2002-2016)

BACKGROUND

Lumpy skin disease (LSD) is a devastating transboundary viral disease of cattle which causes significant loss in production. Although this disease has been reported in Uganda and throughout East Africa, there is almost no information about its epidemiology, spatial or spatio-temporal distribution. We carried out a retrospective study on the epidemiology of LSD in Uganda between the years 2002 and 2016, using data on reported outbreaks collected monthly by the central government veterinary administration. Descriptive statistics were computed on frequency of outbreaks, number of cases, vaccinations and deaths. We evaluated differences in the number of reported outbreaks across different regions (agro-ecological zones), districts, months and years. Spatial, temporal and space-time scan statistics were used to identify possible epidemiological clusters of LSD outbreaks.

RESULTS

A total of 1161 outbreaks and 319,355 cases of LSD were reported from 55 out of 56 districts of Uganda. There was a significant difference in incidence between years (P = 0.007) and across different regions. However, there was no significant difference in the number of outbreaks per month (P = 0.443). The Central region reported the highest number of outbreaks (n = 418, 36%) followed by Eastern (n = 372, 32%), Southwestern (n = 140, 12%), Northern (n = 131, 11%), Northeastern (n = 37, 3%), Western (n = 41, 4%) and Northwestern (n = 22, 2%) regions. Several endemic hotspots for the circulation of LSD were identified in the Central and Eastern regions using spatial cluster analyses. Outbreaks in endemic hotspots were less seasonal and had strikingly lower mortality and case-fatality rates than the other regions, suggesting an underlying difference in the epidemiology and impact of LSD in these different zones.

CONCLUSION

Lumpy Skin disease is endemic in Uganda, with outbreaks occurring annually in all regions of the country. We identified potential spatial hotspots for LSD outbreaks, underlining the need for risk-based surveillance to establish the actual disease prevalence and risk factors for disease maintenance. Space-time analysis revealed that sporadic LSD outbreaks tend to occur both within and outside of endemic areas. The findings from this study will be used as a baseline for further epidemiological studies for the development of sustainable programmes towards the control of LSD in Uganda.