Awareness of rabies and response to dog bites in a Bangladesh community

Ghosh, Sumon; Chowdhury, Sukanta; Haider, Najmul; Bhowmik, Rajub; Rana, Sohel; Marma, Aung Swi Prue; Hossain, Muhammad Belal; Debnath, Nitish C.; Ahmed, Be-Nazir

doi:10.1002/vms3.30

Cited by 56 publications

(75 citation statements)

References 15 publications

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“…The epidemiological characteristics of human rabies cases found in this study were similar to those reported elsewhere in Bangladesh and neighbouring countries. Our study revealed that rabies victims were mostly males of www.nature.com/scientificreports www.nature.com/scientificreports/ less than 15 years of age, which is similar to some other studies in Bangladesh and neighbouring countries 14,16,31 . The bite locations were mostly on the patients' lower limbs, with the majority of the bites being category III 4 .…”

Section: Discussionsupporting

confidence: 90%

“…Our analysis showed that the majority of the rabies victims primarily sought treatment from traditional healers following animal exposure, with no history of taking any PEP. Previous studies in Bangladesh revealed that a good number of animal bite victims first sought treatment from traditional healers instead of taking any modern PEP 16 . These sorts of health-seeking behaviour might be attributed to persevering myths and dogmas among the people of the community, poor socio-economic status, lack of proper education, lack of accessibility and affordability of PEP treatment in local government hospitals, distance to government hospitals from the victims' residence, etc.…”

Section: Discussionmentioning

confidence: 99%

“…These sorts of health-seeking behaviour might be attributed to persevering myths and dogmas among the people of the community, poor socio-economic status, lack of proper education, lack of accessibility and affordability of PEP treatment in local government hospitals, distance to government hospitals from the victims' residence, etc. 16 . The following measures should be taken to prevent the dog mediated human rabies: setting up awareness and education campaigns and implementing dog bite prevention strategies, especially targeting the children, encouraging and educating about responsible dog ownership and conceptualizing cultural differences that impact the societal role and value of dogs.…”

Section: Discussionmentioning

confidence: 99%

“…IDH (NRPCC) is the primary referral centre for animal bites and rabies patients in Bangladesh, and hence, most cases of animal bites from different parts of the country come up here for free vaccination and treatment 20 . Other than NRPCC, there are 66 public District Rabies Prevention and Control Centers (DRPCCs) with at least one centre in each of the 64 districts that provide a free anti-rabies vaccine (ARV) and treatment for victims of dog bites 16,21 . However, all the rabies suspect cases have to be referred to IDH (NRPCC) from the DRPCCs and different areas of the country for further management and data recording.…”

Section: Methodsmentioning

confidence: 99%

“…Rabies remains endemic in Bangladesh and has high public health importance 14 . However, the number of deaths from human rabies has decreased by approximately 50 per cent in recent years, resulting from a combined government effort involving advocacy, communication and social mobilization (ACSM), modern treatment for animal bites, mass dog vaccination (MDV) and dog population management (DPM) [15][16][17] . While ACSM and animal bite management have been continuing, MDV was first piloted in Bangladesh in November 2011, covering a small municipality, namely, Cox's Bazar 18 .…”

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confidence: 99%

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Trends and clinico-epidemiological features of human rabies cases in Bangladesh 2006–2018

Ghosh

Rana

Islam

et al. 2020

Sci Rep

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Vaccinating dogs against rabies is an effective means of reducing human rabies. We subjected 1327 clinically diagnosed human rabies death and mass dog vaccination (MDV) data during 2006-2018 to quantify the impacts of MDV on human rabies incidence in Bangladesh and a subset of rabies death data (422) for clinico-epidemiological analysis. A positive and increasing trend of MDV (p = 0.01 and tau = 0.71) and a negative and declining trend (p < 0.001 and tau = −0.88) of human rabies cases (Correlation coefficient: −0.82) have been observed. Among 422 deaths, the majority (78%) of the victims sought treatment from traditional healers, and 12% received post-exposure prophylaxis (PEP). The mean incubation period of rabies in cases with exposure sites on the head & neck (35 days) was shorter than the upper limb (mean = 64 days, p = 0.02) and lower limb (mean = 89 days, p < 0.01). MDV has been found to be effective for reducing human rabies cases in Bangladesh. Creating awareness among the animal bite victims to stop reliance on traditional healers rather seeking PEP, addressing the role of traditional healers through awareness education programme with respect to the treatment of dog bites, ensuring availability of PEP, and continuing to scale up MDV may help to prevent human rabies deaths.Rabies is a zoonotic viral disease responsible for the death of approximately 59,000 people worldwide with more than 3.7 million disability-adjusted life years lost annually 1 . Due to acute progressive encephalitis, rabies is almost always fatal once clinical signs appear. The disease occurs predominantly in impoverished communities, in both rural and urban areas, and has been recognized for over 4000 years 2,3 . Rabies is present across all continents, except Antarctica with more than 95% of human fatalities happening in the areas of Asia and Africa, and approximately 40% of cases in the population are aged below 15 years. Although all warm-blooded animals are susceptible to rabies, domestic dogs are the main cause of rabies virus transmission to humans in up to 99% of cases in rabies-endemic regions 4 . Most cases of rabies are caused by the bite of an infected dog. The effect of rabies virus (RABV) exposure depends on a number of factors, including the gravity of the wound, the anatomical site of the bite on the body, the viral quantity and variant (genotype) inoculated into the wound(s) and the timeliness of post-exposure prophylaxis (PEP) 3 . The clinical manifestation of human rabies can appear in any of two forms: the widely perceived furious (classical or encephalitic) form or the paralytic (or dumb) form 5,6 . Each case of rabies has

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Trends and clinico-epidemiological features of human rabies cases in Bangladesh 2006–2018

Ghosh

Rana

Islam

et al. 2020

Sci Rep

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Major zoonotic diseases of public health importance in Bangladesh

Chowdhury

Aleem

Khan

et al. 2021

Veterinary Medicine & Sci

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Zoonotic diseases cause repeated outbreaks in humans globally. The majority of emerging infections in humans are zoonotic. COVID‐19 is an ideal example of a recently identified emerging zoonotic disease, causing a global pandemic. Anthropogenic factors such as modernisation of agriculture and livestock farming, wildlife hunting, the destruction of wild animal habitats, mixing wild and domestic animals, wildlife trading, changing food habits and urbanisation could drive the emergence of zoonotic diseases in humans. Since 2001, Bangladesh has been reporting many emerging zoonotic disease outbreaks such as nipah, highly pathogenic avian influenza, pandemic H1N1, and COVID‐19. There are many other potential zoonotic pathogens such as Ebola, Middle East respiratory syndrome coronavirus, Kyasanur forest disease virus and Crimean–Congo haemorrhagic fever that may emerge in the future. However, we have a limited understanding of zoonotic diseases’ overall risk in humans and associated factors that drive the emergence of zoonotic pathogens. This narrative review summarised the major emerging, re‐emerging, neglected and other potential zoonotic diseases in Bangladesh and their associated risk factors. Nipah virus and Bacillus anthracis caused repeated outbreaks in humans. More than 300 human cases with Nipah virus infection were reported since the first outbreak in 2001. The highly pathogenic avian influenza virus (H5N1) caused more than 550 outbreaks in poultry, and eight human cases were reported so far since 2007. People of Bangladesh are frequently exposed to zoonotic pathogens due to close interaction with domestic and peri‐domestic animals. The rapidly changing intensified animal–human–ecosystem interfaces and risky practices increase the risk of zoonotic disease transmission. The narrative review's findings are useful to draw attention to the risk and emergence of zoonotic diseases to public health policymakers in Bangladesh and the application of one‐health approach to address this public health threat.

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Epidemiological study of human rabies cases in Bangladesh through verbal autopsy

Rana

Siddiqi

Ghosh

et al. 2020

Heliyon

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Identification of risk factors is crucial to find ways to reduce rabies deaths. We investigated the hospital records of rabies deceased through contact tracing of the relatives of the victims using enhanced verbal autopsies (VA) to identify why the people had to die from rabies in recent years in Bangladesh. Patients whose deaths were confirmed by physicians based on the history of animal exposure and clinical signs were taken into account for VA. Socio-demographic profile of the deceased, animal exposure, nature of the wound, and history of postexposure prophylaxis (PEP) data were obtained and analysed. The study found 256 cases in which the cause of death was attributed to rabies, most of the victims were male (71.88%), resided in the rural community (80.47%), dependent (49.22%), and children below the age of 15 years (47.27%). Dogs were the single most responsible (81.64%); however, cats (12.11%), jackals (3.91%) and mongoose (2.34%) were also found accountable for rabies incidence (P < 0.05). Significantly, limbs were the most common (67.97%) site of exposure, and the shortest incubation period was identified in the case of bites to head and face (P < 0.05). The majority (86.72%) of the deceased did not receive any PEP; whereas, 66.80% sought treatment from traditional healers. Among the deceased (13.28%, n ¼ 34) who had received PEP, only 8.82% of them completed the full course of the vaccination regimen (P < 0.01); however, none of them had history of taking rabies immunoglobulin (RIG). The study recommends extensive public health awareness programs in the rural community and establishing methods to improve healthcare-seeking behaviours, including receiving PEP instead of visiting traditional healers. Moreover, the availability and accessibility of PEP in the government hospital facilities are desirable, and laboratory-based surveillance with compatible rapid data reporting may be incorporated in the existing policy.

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Awareness of rabies and response to dog bites in a Bangladesh community

Cited by 56 publications

References 15 publications

Trends and clinico-epidemiological features of human rabies cases in Bangladesh 2006–2018

Trends and clinico-epidemiological features of human rabies cases in Bangladesh 2006–2018

Major zoonotic diseases of public health importance in Bangladesh

Epidemiological study of human rabies cases in Bangladesh through verbal autopsy

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