Epidemiology, clinical features and risk factors for human rabies and animal bites during an outbreak of rabies in Maputo and Matola cities, Mozambique, 2014: Implications for public health interventions for rabies control

Abstract

BackgroundIn Mozambique, the majority of rabies outbreaks are unreported and data on the epidemiological features of human rabies and animal bites are scarce. An outbreak of human rabies in adjacent Maputo and Matola cities in 2014 prompted us to investigate the epidemiology, clinical features and risk factors of human rabies and animal bites in the two cities.Methodology/Principal findingsWe reviewed cases of human rabies and animal bites from April to July 2014, and carried out a community investigation in July and August in the neighborhoods where cases of human rabies resided. This investigation included collection of clinical, demographic and epidemiological information and a case control study to investigate the risk factors associated with human rabies. Fourteen cases of human rabies were detected in Maputo (n = 10) and Matola (n = 3) cities and neighbouring Boane district (n = 1) between April and August 2014, all of whom had been admitted to hospital. All had a recent history of dog bite. Of the 14 rabid dogs, only one had been immunized. 819 cases of animal bites were registered, of which 64.6% (529/819) were from Maputo City. Dogs were responsible for 97.8% (801/819) of all animal bites, but only 27.0% (126/467) were immunized. Factors significantly associated with human rabies were: age <15 years (p = 0.05), bite by stray dog (p = 0.002), deep wound (p = 0.02), bite in the head (p = 0.001), bite by unimmunized dog (p = 0.01), no use of soap and water (p = 0.001), and no post-exposure prophylaxis (p = 0.01).Conclusions/SignificanceImplementation of control measures for rabies is poor in Maputo and Matola cities, where cases of human rabies were strongly associated with bites by stray and unvaccinated dogs and irregular implementation of post-exposure measures.

Animal Bite Patterns and Implementation of Rabies Prevention and Control Program in Animal Bite Treatment Center

“…Moreover, findings of this study affirm with most literatures that dogs (62.41%) were responsible for majority of bite cases [2,15,17,18,22,24,26,27], followed by cat bite (36.75%. ), and other animals (0.84%) such as monkeys, horses, pigs and rabbit.…”

“…This can be attributed to the fact that dogs are domesticated and taken cared of mostly by women, since they are more likely the ones who stay at home. Additionally, victims of animal bite cases in Quezon Province are more likely above 15 years old (61.41%) which negated other studies which tell otherwise [9,[12][13][14][15][16][17][18][19]. Animal bites occur more frequently in adult since it is usually the adult member in the family who is often associated with handling and caring for the animal.…”

The Impact and Control of Emerging and Re-Emerging Viral Diseases in the Environment: An African Perspective

“…However, vaccination can only be done for owned animals. With a high number of stray animals, like dogs, in Africa, both approaches (quarantining and immunization) may not prove effective for control of infections like rabies, for example (Leung and Davis 2017;Salomão et al 2017).…”

Evaluasi Program Pencegahan dan Pengendalian Rabies dalam Rangka Menuju Sumatera Utara Bebas Rabies 2020

“…Rabies merupakan penyakit zoonosis yang tingkat kefatalannya hampir mencapai 100% dan belum ada obat untuk menyembuhkannya, namun rabies dapat dicegah dengan pengenalan dini kasus GHPR dan penatalaksanaan kasus GHPR sedini mungkin. 1,9,11,12 Program P2 rabies bertujuan untuk mengoptimalkan pelaksanaan surveilans epidemiologi rabies, tata laksana kasus dan penanganan sedini mungkin untuk menurunkan kasus GHPR dan lyssa di Sumatera Utara. 9,10 Program P2 rabies di Sumatera Utara belum berjalan dengan optimal, dan belum terkoordinasi dan sistematis.…”