Modelling modifiable factors associated with the probability of human rabies deaths among self-reported victims of dog bites in Abuja, Nigeria

Abstract

Canine-mediated rabies kills tens of thousands of people annually in lesser-developed communities of Asia, Africa, and the Americas, primarily through bites from infected dogs. Multiple rabies outbreaks have been associated with human deaths in Nigeria. However, the lack of quality data on human rabies hinders advocacy and resource allocation for effective prevention and control. We obtained 20 years of dog bite surveillance data across 19 major hospitals in Abuja, incorporating modifiable and environmental covariates. To overcome the challenge of missing information, we used a Bayesian approach with expert-solicited prior information to jointly model missing covariate data and the additive effects of the covariates on the predicted probability of human death after rabies virus exposure. Only 1155 cases of dog bites were recorded throughout the study period, out of which 4.2% (N = 49) died of rabies. The odds for risk of human death were predicted to decrease among individuals who were bitten by owned dogs compared to those bitten by free-roaming dogs. Similarly, there was a predicted decrease in the probability of human death among victims bitten by vaccinated dogs compared to those bitten by unvaccinated dogs. The odds for the risk of human death after bitten individuals received rabies prophylaxis were predicted to decrease compared to no prophylaxis. We demonstrate the practical application of a regularised Bayesian approach to model sparse dog bite surveillance data to uncover risk factors for human rabies, with broader applications in other endemic rabies settings with similar profiles. The low reporting observed in this study underscores the need for community engagement and investment in surveillance to increase data availability. Better data on bite cases will help to estimate the burden of rabies in Nigeria and would be important to plan effective prevention and control of this disease.

Molecular Epidemiology and Spatial Distribution of Cat Rabies Cases in Yucatan, Mexico

“…Sociodemographic factors, such as poverty and population density, have been associated with the transmission of canine and human rabies in certain contexts ( [69]. Additionally, ecological factors and attributes of the landscape, such as land cover, have been implicated in rabies transmission by wildlife species, like skunks and raccoons [70].…”

Rabies exposure and prophylaxis among dog owners in Ogun State, Nigeria: a descriptive and categorical analysis of knowledge, attitudes and practices

“…The majority of the respondents had attitudes associated with higher rabies risk, as more than half (50.4%) indicated that they could play with any dog regardless of its vaccination status. Meanwhile, most rabies cases in Nigeria have been attributed to stray, free-roaming, and unvaccinated dogs [5] . Attitudes towards reporting the cases of dog bites in animals and humans to the hospital and submitting samples from suspected rabid animals for laboratory testing pose a higher risk of rabies exposure.…”

“…In Nigeria, a West African country, rabies still poses a significant public health threat. Thousands of people die of rabies annually and prevalence rates ranging from 3% to 28% have been reported among dogs in different regions of the country [5] . The domestic dog is the most common transmitter of rabies in Nigeria and many cases of rabies are due to bites by dogs, especially free-roaming dogs [6] .…”