Long term trends and spatial distribution of animal bite injuries and deaths due to human rabies infection in Uganda, 2001-2015

Abstract

BackgroundIn the absence of accurate data on trends and the burden of human rabies infection in developing countries, animal bite injuries provide useful information to bridge that gap. Rabies is one of the most deadly infectious diseases, with a case fatality rate approaching 100%. Despite availability of effective prevention and control strategies, rabies still kills 50,000 to 60,000 people worldwide annually, the majority of whom are in the developing world. We describe trends and geographical distribution of animal bite injuries (a proxy of potential exposure to rabies) and deaths due to suspected human rabies in Uganda from 2001 to 2015.MethodsWe used 2001–2015 surveillance data on suspected animal bite injuries, collected from health facilities in Uganda. To describe annual trends, line graphs were used and linear regression tested significance of observed trends at P<0.05. We used maps to describe geographical distribution of animal bites by district.ResultsA total of 208,720 cases of animal bite injuries were reported. Of these, 27% were in Central, 22% in Eastern, 27% in Northern and 23% in Western regions. Out of 48,720 animal bites between 2013 and 2015, 59% were suffered by males and 81% were persons aged above 5 years. Between 2001 and 2015, the overall incidence (per 100,000 population) of animal bites was 58 in Uganda, 76 in Northern, 58 in Central, 53 in Western and 50 in Eastern region. From 2001 to 2015, the annual incidence (per 100,000 population) increased from 21 to 47 (P = 0.02) in Central, 27 to 34 (P = 0.04) in Eastern, 23 to 70 (P = 0.01) in Northern and 16 to 46 (P = 0.001) in Western region. A total of 486 suspected human rabies deaths were reported, of which 29% were reported from Eastern, 28% from Central, 27% from Northern and 17% from Western region.ConclusionAnimal bite injuries, a potential exposure to rabies infection, and mortality attributed to rabies infection are public health challenges affecting all regions of Uganda. Eliminating rabies requires strengthening of rabies prevention and control strategies at all levels of the health sector. These strategies should utilize the “One Health” approach with strategic focus on strengthening rabies surveillance, controlling rabies in dogs and ensuring availability of post exposure prophylaxis at lower health facilities.

Epidemiological Patterns of Animal Bites in the Najafabad, Center of Iran (2012–2017)

“…The results of this study showed that the incidence of animal bites in the Najaf Abad has been increased; in this survey, the average incidence of animal bites in Najaf Abad per 100,000 people has increased from 204.46 in 2012 to 219.98 in 2017. A Ugandan study also founded an elevating shift to study the long-term trends in the incidence of animal biting and deaths from 2001 to 2015 [20]. A study in Bhutan for the purpose of the occurrence of prophylaxis after exposure from 2005 to 2008 also confirms the increase in the incidence of animal bites [21].…”

Trends and spatial distribution of animal bites and vaccination status among victims and the animal population, Uganda: A veterinary surveillance system analysis, 2013 – 2017

“…Other studies have also shown that passive surveillance for rabies results in underreporting (19), particularly in developing countries (20,21). Analysis of ESD rabies surveillance data from 2001-2015 found that animal bites were increasing in Uganda (14), and it is reasonable to assume that complete reporting in NADDEC might have shown a similar trend. A full evaluation of both rabies surveillance systems and the challenges to complete reporting is important to enable the system to contribute to its fullest extent in Uganda.…”

“…Surveillance data of animal bites among humans provides vital information to guide resource allocation in the control and prevention of rabies (13). An analysis of human rabies surveillance data from the Epidemiology and Surveillance Division (ESD) of the Ministry of Health in 2001-2015 in Uganda revealed 208,720 animal bites, with 486 suspected human rabies deaths (14). However, Uganda also captures rabies-related data in a veterinary surveillance system, at National Animal Disease Diagnostic Epidemiology Centre (NADDEC).…”

Rapid Epidemiological Appraisal of Spatial Distribution of Animal Bite Injury Cases and Rabies Post Exposure Prophylaxis in Kisumu County, Kenya

“…Animal bite of humans provides an important source of epidemiological information which is crucial in enhancing rabies surveillance in humans and animals [1]. Animal bite injury is a serious public health problem and an economic burden especially in developing countries where canine rabies vaccination coverage is very low [2].…”