Achieving zero by 30 in Bangladesh through a One Health approach

Abstract

Background: Bangladesh is making progress toward achieving zero human dog-mediated rabies deaths by 2030, a global goal set in 2015. Methods: Drawing from multiple datasets, including patient immunization record books and mass dog vaccination (MDV) databases, we conducted a comprehensive analysis between the years 2011 to 2023 to understand the effectiveness of rabies control programmes and predict human rabies cases in Bangladesh by 2030 using time-series forecasting models. We also compared rabies virus sequences in Bangladesh and other South Asian countries from GenBank. Findings: The estimated dog population in Bangladesh was determined to be 1,668,140, with an average dog population density of 12.83 dogs/km2 (95% CI 11.14, 14.53) and a human-to-dog ratio of 86.70 (95% CI 76.60, 96.80). The MDV campaign has resulted in the vaccination of an average of 21,295 dogs (95% CI 18,654, 23,935) per district annually out of an estimated 26,065 dogs (CI 22,898, 29,230), resulting in an estimated vaccine coverage of 81.61% (95% CI 80.90, 82.31). A decreasing trend from predicted and observed human rabies cases was identified, and it is projected that Bangladesh will have zero human rabies cases by 2030 if the current trend persists. The phylogenetic analysis shows that rabies viruses in Bangladesh belong to the Arctic-like-1 group, which differs from those in Bhutan despite sharing a common ancestor. Interpretation: Bangladesh's One Health approach demonstrated that an increase in MDV and anti-rabies vaccine (ARV) resulted in a decline in the relative risk of human rabies cases, indicating that eliminating dog-mediated human rabies could be achievable.