Abstract
Rabies is a vaccine-preventable fatal zoonotic disease. Uganda, through the veterinary surveillance system at National Animal Disease Diagnostics and Epidemiology Centre (NADDEC), captures animal bites (a proxy for rabies) on a monthly basis from districts. We established trends of incidence of animal bites and corresponding post-exposure prophylactic anti-rabies vaccination in humans (PEP), associated mortality rates in humans, spatial distribution of animal bites, and pets vaccinated during 2013-2017. We reviewed rabies surveillance data at NADDEC from 2013-2017. The surveillance system captures persons reporting bites by a suspected rabid dog/cat/wild animal, human deaths due to suspected rabies, humans vaccinated against rabies, and pets vaccinated. Number of total pets was obtained from the Uganda Bureau of Statistics. We computed incidence of animal bites and corresponding PEP in humans, and analyzed overall trends, 2013-2017. We also examined human mortality rates and spatial distribution of animal bites/rabies and pets vaccinated against rabies. We identified 8,240 persons reporting animal bites in Uganda during 2013-2017; overall incidence of 25 bites/ 100,000population. The incidence significantly decreased from 9.2/100,000 in 2013 to 1.3/100,000 in 2017 (OR = 0.62, p = 0.0046). Of the 8,240 persons with animal bites, 6,799 (82.5%) received PEP, decreasing from 94% in 2013 to 71% in 2017 (OR = 0.65, p<0.001). Among 1441 victims, who reportedly never received PEP, 156 (11%) died. Western region had a higher incidence of animal bites (37/100,000) compared to other regions. Only 5.6% (124,555/2,240,000) of all pets in Uganda were vaccinated. There was a decline in the reporting rate (percentage of annual district veterinary surveillance reports submitted monthly to Commissioner Animal Health by districts) of animal bites. While reported animal bites by districts decreased in Uganda, so did PEP among humans. Very few pets received anti-rabies vaccine. Evaluation of barriers to complete reporting may facilitate interventions to enhance surveillance quality. We recommended improved vaccination of pets against rabies, and immediate administration of exposed humans with PEP.
Highlights
Rabies is a fatal viral vaccine-preventable zoonotic disease that can infect warm-blooded animals [1,2,3]
There was a decline in the reporting rate of animal bites
There is a system of reporting suspect human rabies cases by health facility back to the veterinary or AH officer who reports it through the District Veterinary Officer (DVO) to Commissioner for Animal Health (CAH) and National Animal Disease Diagnostics and Epidemiology Centre (NADDEC)
Summary
Rabies is a fatal viral vaccine-preventable zoonotic disease that can infect warm-blooded animals [1,2,3]. Rabies occurs on all continents except Antarctica, with most cases reported in Africa and Asia [7, 8]. Most cases of human rabies are due to bites from infected dogs [7]. The incubation period of rabies is 10 days to 6 months, with most cases manifesting signs between 2 weeks to 3 months after exposure [9]. The average incubation period of rabies is 20–60 days, though it can last up to several years [6, 10]
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