Assessment of the impact on paediatric rabies at Queen Elizabeth Central Hospital, Blantyre, Malawi, following a mass canine rabies vaccination programme

Abstract

Purpose: Background: Rabies is a common infection in the domestic and wild animal population of Malawi. Significant numbers of children die a terrible death each year as a consequence. Many more individuals are bitten by potentially infected dogs each month and require post exposure vaccination. However, rabies is a preventable infection against which there is a good vaccine for both animals and humans. Previous work suggests that if canine vaccine coverage can reach 70%, there will be consequent fall in human incidence. Objectives: To determine the impact of a comprehensive canine vaccine campaign on paediatric rabies cases. Methods & Materials: Retrospective case note analysis. All historic paediatric rabies cases presenting to Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi, between May 2012 and May 2017, have been identified and analysed. Data analysis compared paediatric rabies case numbers pre and post a comprehensive canine vaccine campaign which commenced in May 2015, in the Blantyre District. Results: In total 14 paediatric rabies cases were found during the study period. More males than females were affected (males: 10 (71%); females: 4 (29%)). The average age was seven years (range 3–11). The average length of stay in hospital was three days until death (range 1–7). Geographical locations of dog bites since data collection (May 2012) included Limbe, Lundu, Bangwe, Chileka, Mulanje, Muwalo, Nkhataumbera, Thyolo, Zomba, Mpemba and Mangochi region (four were unknown). Since May 2015 only two patients were admitted to QECH, but none of them came from Blantyre city nor district. Conclusion: This study underlines the importance of eliminating human rabies through canine rabies vaccination. Further funding of these campaigns will prevent unnecessary child deaths.