Trends and clinico-epidemiological features of human rabies cases in Bangladesh 2006\u20132018

Sumon Ghosh,Md Rashed Ali Shah,Umme Ruman Siddiqi,Md Sohel Rana,Hasan Sayedul Mursalin,Aung Swi Prue Marma,Md Kamrul Islam,Mohammad Abdullah Heel Kafi,Sanya Tahmina Jhora,S M Emran Ali,Najmul Haider,Nitish C Debnath,Rajub Bhowmik,Be-Nazir Ahmed,Shohrab Hossain,Sukanta Chowdhury,Afsana Akter Jahan,Abul Khair Mohammad Shamsuzzaman,Sayed Mohammed Ullah

doi:10.1038/s41598-020-59109-w

Abstract

Vaccinating dogs against rabies is an effective means of reducing human rabies. We subjected 1327 clinically diagnosed human rabies death and mass dog vaccination (MDV) data during 2006–2018 to quantify the impacts of MDV on human rabies incidence in Bangladesh and a subset of rabies death data (422) for clinico-epidemiological analysis. A positive and increasing trend of MDV (p = 0.01 and tau = 0.71) and a negative and declining trend (p < 0.001 and tau = −0.88) of human rabies cases (Correlation coefficient: −0.82) have been observed. Among 422 deaths, the majority (78%) of the victims sought treatment from traditional healers, and 12% received post-exposure prophylaxis (PEP). The mean incubation period of rabies in cases with exposure sites on the head & neck (35 days) was shorter than the upper limb (mean = 64 days, p = 0.02) and lower limb (mean = 89 days, p < 0.01). MDV has been found to be effective for reducing human rabies cases in Bangladesh. Creating awareness among the animal bite victims to stop reliance on traditional healers rather seeking PEP, addressing the role of traditional healers through awareness education programme with respect to the treatment of dog bites, ensuring availability of PEP, and continuing to scale up MDV may help to prevent human rabies deaths.

Highlights

Rabies is a zoonotic viral disease responsible for the death of approximately 59,000 people worldwide with more than 3.7 million disability-adjusted life years lost annually[1]
We obtained data from the record books of patients with animal bites and rabies cases treated at the National Rabies Prevention and Control Center (NRPCC) of the Infectious Disease Hospital (IDH) in Dhaka, Bangladesh, from January 2006 through December 2018
Our study showed that mass dog vaccination (MDV) is one of the most important components of controlling human rabies in Bangladesh

Summary

Introduction

Rabies is a zoonotic viral disease responsible for the death of approximately 59,000 people worldwide with more than 3.7 million disability-adjusted life years lost annually[1]. If coverage of 70% can be achieved in annual pulse vaccination campaigns, the rabies incidence in dogs is likely to be dramatically reduced, and if this coverage is maintained over periods of several years, regional elimination is possible[3,13] This rabies elimination approach has been demonstrated in various settings in Africa, Asia, Europe, and the Americas[3,12,13]. The number of deaths from human rabies has decreased by approximately 50 per cent in recent years, resulting from a combined government effort involving advocacy, communication and social mobilization (ACSM), modern treatment for animal bites, mass dog vaccination (MDV) and dog population management (DPM)[15,16,17]. More comprehensive campaigns of MDV were scaled up throughout the country

Objectives

Methods

Results

Discussion

Conclusion