Ecological and Epidemiological Findings Associated with Zoonotic Rabies Outbreaks and Control in Moshi, Tanzania, 2017–2018

Abstract

Approximately 1500 people die annually due to rabies in the United Republic of Tanzania. Moshi, in the Kilimanjaro Region, reported sporadic cases of human rabies between 2017 and 2018. In response and following a One Health approach, we implemented surveillance, monitoring, as well as a mass vaccinations of domestic pets concurrently in >150 villages, achieving a 74.5% vaccination coverage (n = 29, 885 dogs and cats) by September 2018. As of April 2019, no single human or animal case has been recorded. We have observed a disparity between awareness and knowledge levels of community members on rabies epidemiology. Self-adherence to protective rabies vaccination in animals was poor due to the challenges of costs and distances to vaccination centers, among others. Incidence of dog bites was high and only a fraction (65%) of dog bite victims (humans) received post-exposure prophylaxis. A high proportion of unvaccinated dogs and cats and the relative intense interactions with wild dog species at interfaces were the risk factors for seropositivity to rabies virus infection in dogs. A percentage of the previously vaccinated dogs remained unimmunized and some unvaccinated dogs were seropositive. Evidence of community engagement and multi-coordinated implementation of One Health in Moshi serves as an example of best practice in tackling zoonotic diseases using multi-level government efforts. The district-level establishment of the One Health rapid response team (OHRRT), implementation of a carefully structured routine vaccination campaign, improved health education, and the implementation of barriers between domestic animals and wildlife at the interfaces are necessary to reduce the burden of rabies in Moshi and communities with similar profiles.

The Role of Waste Management in Control of Rabies: A Neglected Issue

“…The dog rabies elimination demonstration project from 2010–2016 had reduced the number of rabies cases by 75%, through implementation of educational campaigns, increased surveillance efforts in both the human and animal health sectors, and increased dog vaccination, respectively [ 81 ]. Contrastingly, only 18% of dogs, responsible for 2500 dog bites in the Kilimanjaro region from 2013–2017, were found to be vaccinated [ 83 ]. Even though scavenging habits support possible rabies transmission, 50% of waste is not disposed of properly in Tanzania.…”

Systematic Review of Important Viral Diseases in Africa in Light of the ‘One Health’ Concept

“…The seroprevalence of rabies virus in dogs in households puts household members at risk of contracting the virus. This would explain the high death rate (1500 people per year) each year due to rabies virus infection in Tanzania [70].…”

One Health Landscape in Sub-Saharan African Countries

“…Tanzania Mainland and the Islands of Zanzibar using OH approach [34][35][36][37][38][39][40][41] . Using innovative OH approach involving practitioners and students of One Health, FAO had partnered with the government of Tanzania to deliver rabies control in Moshi, Kilimanjaro Region 27,42 . The challenges with project-based deliveries remain the sustainability, national ownership and resource limitations 29 .…”