Capacity Building Efforts for Rabies Diagnosis in Resource-Limited Countries in Sub-Saharan Africa: A Case Report of the Central Veterinary Laboratory in Benin (Parakou).

Fidelia Djegui,Louis H Nel,Rachidatou Adjin,Morgane Gourlaouen,Stephanie Mauti,Yao Akpo,Corneille Gnanvi,Paola De Benedictis,Rogatien Tohozin,Andre Coetzer,Stefania Leopardi

doi:10.3389/fvets.2021.769114

Abstract

Rabies has been listed as a priority zoonotic disease in many African countries and the countdown to reach the goal of eliminating dog-mediated human rabies deaths by 2030 means that disease control measures need to be applied fast. In this context, an essential pillar of any national plan to control rabies is the implementation of reliable diagnostic techniques to ensure the success of field surveillance systems. Although many African countries have received international support for the control of rabies–some countries, like Benin, have not received a similar level of support. Indeed, until 2018, Benin was not able to diagnose rabies and rabies diagnosis in animals as well as humans relied solely on observed clinical symptoms. Although the Central Veterinary Laboratory (CVL) of Parakou had the equipment to implement two recommended tests, the lack of specific reagents and skills prevented the implementation of a rabies diagnostic service. Here we present the joint efforts of the national authorities in Benin, intergovernmental agencies, and non-governmental organizations to assess the strengths and weaknesses of the government's rabies control efforts. We have applied the Stepwise Approach toward Rabies Elimination (SARE) analysis, implemented rabies diagnostic capacities at the CVL of Parakou, characterized strains of rabies virus circulating in Benin, and finally integrated an inter-laboratory comparison program.

Highlights

The most recent predictive disease burden models suggest that rabies, caused primarily by the Rabies Lyssavirus (RABV), causes an estimated 59,000 human deaths every year, which is likely an underestimation [1]
The Stepwise Approach toward Rabies Elimination (SARE) serves to highlight completed and pending activities that align with key components that make up a successful rabies elimination strategy, and provides an empirical score out of five, which is calculated based on the activities that have been completed according to the workshop participants [7,8,9,10]
After completing the SARE assessment, Benin’s SARE score was determined to be 1.5 out of 5. This broadly signified that Benin had small-scale rabies control programs in place and that the government was working toward developing a national rabies control program

Summary

Introduction

The most recent predictive disease burden models suggest that rabies, caused primarily by the Rabies Lyssavirus (RABV), causes an estimated 59,000 human deaths every year, which is likely an underestimation [1]. Capacity Building for Rabies Diagnosis in Benin caught up in the cycle of neglect where the under-reporting of the disease results in rabies being given a lower priority by stakeholders and decision makers This cycle of neglect can, be broken with the generation of empirical burden data that is generated through laboratory diagnosis and confirmation. In this context, improving the laboratory capacity of a country or a region ensures that animal rabies cases can be diagnosed efficiently, which in-turn ensures that (i) accurate data on the incidence of the disease is collected, (ii) control efforts can be monitored, and (iii) potentially exposed patients can be managed clinically. While these cases were identified in nine of the twelve counties, the majority occurred in the Borgou County where the third largest city of the country, Parakou, is located

Methods

Results

Conclusion