Human rabies exposure outbreak investigation in Tembaro district, Ethiopia, 2018

Abstract

Background: Rabies is a fatal viral infection that can infect all mammals. It poses a significant health problem in most of African countries including Ethiopia, where the majority of the cases result from dog bites. This study was conducted to assess the extent of the outbreak, to identify the exposing animals and risk factors for the transmission and to give technical support in the control and prevention measures. Methods and materials: Cross-sectional descriptive study design was used to conduct the study from April 28 to May 16, 2018. Line list of human exposure to rabies cases were collected from health facility. Case detection was actively done in the community. Structured questionnaire was used to assess awareness of the victims regarding rabies. Results: A total of 125 suspected rabies exposures and 9 suspected human rabies deaths were found. The rabies exposure crude attack rate (AR) was 90 per 100000 populations at risk. Age groups 15 to 45 were the most affected with age specific AR of 124 per 100000 populations. The highest AR occurred in Keleta kebele with AR of 85/10,000 population. Dogs, cats, donkeys, foxes, hyena and bat were found the responsible exposing animals. However; dogs were the most common, being responsible for 62 (50%) of the exposures. Among the dogs, 45/62 (72.5%) of them were stray dogs. Among the owned dogs, 54(88%) were not vaccinated. Brain tissue from two dogs was tested and became positive for rabies by Fluorescent Antibody Test (FAT). Among 95 victims interviewed about rabies, only 33 (37%) of them know the symptoms, transmission, and prevention methods of rabies. Conclusion: There was high number of human rabies exposure due to animal bites in Tembaro district. Wild lives escaped from the forests around the Gibe river basin and high prevalence of free roaming and unvaccinated dogs were the likely risk factors for the increment of the rabies exposure. Inter-sectoral collaboration is needed among the district health office, wild life and environmental protection office and the livestock and fishery resource office. Mass dog vaccination and awareness creation in the community about rabies exposure are recommended.