Abstract
Current passive surveillance data for canine rabies, particularly for the regions where the burden is highest, are inadequate for appropriate decision making on control efforts. Poor enforcement of existing legislation and poor implementation of international guidance reduce the effectiveness of surveillance systems, but another set of problems relates to the fact that canine rabies is an untreatable condition which affects very poor sectors of society. This results in an unknown, but potentially large proportion of rabies victims dying outside the health system, deaths that are unlikely to be recorded by surveillance systems based on health center records. This article critically evaluates the potential sources of information on the number of human deaths attributable to canine rabies, and how we might improve the estimates required to move towards the goal of global canine rabies elimination.
Highlights
When assessing the need for and priority of human health interventions, a basic requirement is to measure the impact of a given disease
This study suggested the annual incidence of human rabies in Tanzania was 4.9 deaths/100,000 (Cleaveland et al, 2002)
As the international health community moves towards a global elimination plan for canine rabies (FAO, 2013), it becomes necessary to assess the scale of the disease burden at a regional and global level to evaluate the benefits of global canine rabies elimination
Summary
When assessing the need for and priority of human health interventions, a basic requirement is to measure the impact of a given disease. Perhaps the greatest challenges to accurate case reporting are that (i) canine rabies mostly affects the poorest sectors of society in the world’s poorest countries and (ii) that rabies is a fatal disease This combination means that most victims fail to access treatment, or return home to die having been advised that no effective treatment exists (Sudarshan et al, 2007; Taylor et al, 2015). These deaths, outside of health systems are not captured in surveillance systems based around health system records or in countries lacking civil registration systems to collect vital statistics on births and deaths (and their causes). Taylor et al / Acta Tropica 165 (2017) 133–140 to generate better information on which to base disease control decisions
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