Hospital records of human rabies and antirabies prophylaxis in Nigeria 1969–1978

Abstract

A survey of human rabies and antirabies prophylaxis was carried out in Nigeria by the use of questionnaires, and review of hospital records and case notes. 169 cases of laboratory or clinically diagnosed human rabies were recorded from 38 hospitals and five state epidemiological units over a 10-year period. 167 (99%) were bitten by dogs, one by a cat and one by a monkey in captivity. Rabies was more frequently encountered in children aged 19 years and under, 70% of cases occurring in this age group. A higher incidence of the disease was also found in the low socio-economic or illiterate group. The lack of awareness of the consequences and seriousness of the disease coupled with the inadequate facilities for post-exposure anti-rabies treatment in rural areas account for the higher rates of rabies in this group. The monthly distribution of the disease shows that more cases of rabies occurred in man during the dry months of the year due to higher incidence of canine rabies during the same period. A total of 7,549 victims of animal bites received post-exposure anti-rabies treatment from 38 hospitals over a 10-year period. The survey also revealed that apart from the normal post-exposure antirabies vaccination, other forms of treatment are sought by dog-bite victims. The dependence on such treatment may contribute to the relatively high incidence of rabies in Nigeria. These studies also show that the antirabies vaccination rate in Nigeria is about 40 to 62 per 100,000 people per annum. The poor state of record keeping, the acute shortage of antirabies vaccine and the failure of some patients to report to hospitals following dog-bites may explain the low rate of post-exposure antirabies vaccination.