Global elimination of dog-borne rabies by 2030: current status and prospects (7)

Foreword: A review paper published online on March 28 by seven authors from the United States, India, Australia, Nigeria and Peru in the professional journal Current Tropical Medicine Reports: Rabies in the Tropics (see References). This article provides a comprehensive and in-depth analysis of the current status and prospects of the implementation of the global plan to eliminate dog-borne rabies by 2030. This blog will introduce the main content of the article in fractions.

Rabies in the tropics

（Rabies in the Tropics）

Table of Contents:

summary

1. Preface

2. Rabies in Africa

2.1 West Africa

2.2 East Africa

2.3 Southern Africa

2.4 Central Africa

3. Rabies in South and Southeast Asia

4. Rabies in the Americas

4.1 Mexico, Central America and the Caribbean

4.2 South America

5. Rabies in Australia

6. Conclusion

2.2 East Africa

A century of rabies surveillance supports the idea that rabies is endemic in Kenya. The country recently embarked on a 15-year strategy to end dog-induced human rabies deaths. Of the 37 animal samples taken from Uganda, 77 percent confirmed positive for rabies virus (RABV), although multiple lisha viruses have been found throughout the continent. In Rwanda, evidence of canine rabies is rare. However, a survey conducted in Kigali (the capital of Rwanda) found that knowledge of rabies and clinical symptoms was high, at 74% and 99%, respectively, but of medical assistance after dog bites was low (20%). The US CDC (Centers for Disease Control and Prevention) said Burundi and Rwanda are hotspots.

Ethiopia has a large number of canine rabies, and based on a comprehensive nationwide analysis between 2010 and 2020, the randomized cumulative prevalence of rabies in animals is 28% (95% CI: 0–81%), compared to 33% (95% CI: 20–47%) in the population. In addition to its significant public health and agricultural significance, canine rabies also endangers animal protection because it spreads across species to the highly endangered Ethiopian wolf.

In Tanzania, there are an estimated 19 to 76 exposures per 100,000 people in both areas. A significant proportion of these communities (25 per cent) do not seek medical care because of poor costs and risk assessment levels. A recent study used Bayesian regression to estimate that 960 people in Madagascar die each year from rabies.

With regard to collaboration within East Africa, the U.S. CDC and other partners support rabies surveillance, prevention, and control activities in the region through funding and capacity building.

2.3 Southern Africa

South Africa was once a bastion for rabies control, but has recently confirmed multiple cases of human rabies, bringing the nationwide death toll to at least 17 in 2021. With strong support from the German government, Namibia has made progress in rabies control (SARE score 2.5). Prior to the implementation of a recent plan, the annual incidence of human rabies in the country was estimated at 1.0-2.4 per 100,000 people between 2011 and 2017.

In addition to mad dogs, there are multiple confirmed cases in jackals and kudu. In Botswana, an outbreak of canine rabies has resulted in the death or disappearance of at least 29 highly endangered African wild dogs. In Zambia and Zimbabwe, analysis of multiple isolates from different species found that RABV (classical rabies virus) belongs to a common viral lineage. In Malawi, where there is a lack of coordinated vaccination of livestock, several deaths from canine rabies have been reported in one hospital.

However, vaccination coverage has improved since the NGO Mission Rabies implemented mass dog vaccination in May 2015 (Figure 1, C); 78% in 2016; In 2017 it was 72%). Elsewhere in Mozambique, 14 cases of human rabies were associated with lower dog vaccination rates (27%).

2.4 Central Africa

In the Democratic Republic of the Congo, the incidence of dog bites is high (5.2 times/1,000 persons/year), while the level of rabies knowledge in the community is low. A study in Cameroon observed the geographic heterogeneity of the domestic canine RABV isolates in 2010 and 2016. In 2019, a report from the Central African Republic found an increase in bites from stray dogs and reported two deaths.

In Chad, before the implementation of free human vaccination, investigators recorded a low proportion of people receiving PEP (post-exposure prevention): 8.5 percent. Data on Angola, Equatorial Guinea and Gabon are not available, but the CDC lists these countries as rabies hotspots.

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