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Abstract
Rabies is a fatal zoonotic disease that causes a heavy burden on societies. Namibia, a country in southern Africa, is aiming at controlling the disease in its main reservoir, the domestic dog. To facilitate the implementation comprehensive information on the ecology and epidemiology of the disease and surveillance is of utmost importance. The study presented assesses the baseline data for both human and animal rabies surveillance in Namibia in recent times and establishes correlations with ecological and socio-economic data in order to provide an up-to-date picture on the epidemiology of rabies in Namibia. For instance, it was important to identify the main drivers in the epidemiology, and whether the control strategy by mass vaccination of dogs is undermined by cycles of rabies in wildlife. Rabies in humans was reported mainly from the Northern Communal Areas (NCAs), with a total of 113 cases from 2011 to 2017, representing an incidence of between 1.0 and 2.4 annual human rabies deaths per 100,000 inhabitants. Kavango, the region with the highest human rabies incidence was also the region with the lowest animal rabies surveillance intensity. Generally, the vast majority (77%) of dog samples originated from communal farm land, followed by urban areas (17%), while only a small fraction (3%) was submitted from freehold farm areas. In contrast, kudu and eland submissions were almost exclusively from freehold farmland (76%) and urban areas (19%), whereas the submission of cattle samples was evenly distributed among freehold farms (46%) and communal farm land (46%). The likelihood of sample submission decreased exponentially with distance to one of the two laboratories. Overall, 67% (N = 1,907) of all samples submitted tested rabies-positive, with the highest positivity rate observed in kudus (89%) and jackals (87%). The transmission cycle of rabies in dogs appears restricted to the northern communal areas of Namibia, whilst rabies in wildlife species is predominately reported from farmland in central Namibia, mostly affecting kudu (Tragelaphus strepsiceros) and livestock with a likely reservoir in wildlife canids such as jackals or bat-eared foxes. The analysis confirms the presence of two independent transmission cycles in Namibia with little geographic overlap, thus allowing for a sustainable control of rabies in dogs in the NCAs.
Highlights
Rabies is a fatal viral infection of mammals
Samples are submitted for laboratory confirmation, a letter signed by the diagnostician is sent to the dog bite victim and rabies post exposure prophylaxis (PEP) is provided to the individual free of charge at a clinic in the area
Rabies cases in humans are predominantly reported from the Northern Communal Areas (NCAs), with Kavango, Oshana and Ohangwena regions having the highest case numbers and incidences, the latter ranging from 1.0 and 2.4 per 100,000 inhabitants and per year on average
Summary
Rabies is a fatal viral infection of mammals. The causative agents are members of the Lyssavirus genus, of which rabies virus (RABV) is the prototype [1, 2]. Domestic dogs cause over 95% of all estimated 59,000 human rabies deaths every year with the highest burden of disease in parts of Asia and Africa [3]. As with the entire continent, rabies is endemic in Namibia. Situated in the south-western corner of the African continent (Fig 1), Namibia is a large country of about 824,116 square kilometers, and home to about 2.1 million people [4]. The contribution of agriculture to the gross domestic product by about 3–4% is low [6], agriculture plays either directly or indirectly an important role. It is mainly based on livestock farming, i.e. cattle, sheep and goats under various management systems. The area north of this fence is referred to as the “Northern Communal Areas”
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