Human rabies: a descriptive observation of 21 children in Kinshasa, the Democratic Republic of Congo

Muyila, Delphin I.; Aloni, Michel Ntetani; Lose-Ekanga, Marie Josée; Nzita, Jules M.; Kalala-Mbikay, Alexandre; Bongo, Henri L.; Esako, Mathilde N.; Malonga-Biapi, Jean Pierre; Mputu-Dibwe, BenoÎt; Aloni, Muriel; Ekila, Mathilde Bothale

doi:10.1179/2047773214y.0000000161

Cited by 18 publications

(26 citation statements)

References 28 publications

(37 reference statements)

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“…Previous studies have shown that the small size of children contributes to their higher risk of developing rabies [28, 29]. A bite in the head and deep wounds were also associated with a higher risk of developing rabies, as previously shown [16, 21, 30, 31].…”

Section: Discussionsupporting

confidence: 52%

Epidemiology, clinical features and risk factors for human rabies and animal bites during an outbreak of rabies in Maputo and Matola cities, Mozambique, 2014: Implications for public health interventions for rabies control

Salomão¹,

Nacima²,

Cuamba

et al. 2017

PLoS Negl Trop Dis

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BackgroundIn Mozambique, the majority of rabies outbreaks are unreported and data on the epidemiological features of human rabies and animal bites are scarce. An outbreak of human rabies in adjacent Maputo and Matola cities in 2014 prompted us to investigate the epidemiology, clinical features and risk factors of human rabies and animal bites in the two cities.Methodology/Principal findingsWe reviewed cases of human rabies and animal bites from April to July 2014, and carried out a community investigation in July and August in the neighborhoods where cases of human rabies resided. This investigation included collection of clinical, demographic and epidemiological information and a case control study to investigate the risk factors associated with human rabies. Fourteen cases of human rabies were detected in Maputo (n = 10) and Matola (n = 3) cities and neighbouring Boane district (n = 1) between April and August 2014, all of whom had been admitted to hospital. All had a recent history of dog bite. Of the 14 rabid dogs, only one had been immunized. 819 cases of animal bites were registered, of which 64.6% (529/819) were from Maputo City. Dogs were responsible for 97.8% (801/819) of all animal bites, but only 27.0% (126/467) were immunized. Factors significantly associated with human rabies were: age <15 years (p = 0.05), bite by stray dog (p = 0.002), deep wound (p = 0.02), bite in the head (p = 0.001), bite by unimmunized dog (p = 0.01), no use of soap and water (p = 0.001), and no post-exposure prophylaxis (p = 0.01).Conclusions/SignificanceImplementation of control measures for rabies is poor in Maputo and Matola cities, where cases of human rabies were strongly associated with bites by stray and unvaccinated dogs and irregular implementation of post-exposure measures.

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Section: Discussionsupporting

confidence: 52%

Epidemiology, clinical features and risk factors for human rabies and animal bites during an outbreak of rabies in Maputo and Matola cities, Mozambique, 2014: Implications for public health interventions for rabies control

Salomão¹,

Nacima²,

Cuamba

et al. 2017

PLoS Negl Trop Dis

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“…7,17 On the other hand, continuing cases of rabies transmitted by dogs, especially in Asia and Africa, reveal the difficulties and challenges for health programs to succeed, 10,11 whereby effective canine rabies vaccination coverage and timely and complete postexposure prophylaxis are fundamental for reducing the incidence of the disease. 16,17 The predominant signs and symptoms we found were similar to those reported in a study conducted in 2008-2009 in the Congo with 21 patients; 18 but differed from research done between 1983-2009 in South Africa with 353 cases, 12 and a study in 1980-1996 in the United States with 32 participants. 13 According to both these studies, hydrophobia and sialorrhea were more frequent.…”

Section: Resultssupporting

confidence: 74%

Raiva humana no Brasil: estudo descritivo, 2000-2017*

Vargas

Romano

Merchán-Hamann

2019

Epidemiologia e Serviços de Saúde

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Objective: to describe the epidemiological profile of human rabies in Brazil. Methods: this is a descriptive study of human rabies cases reported in 2000-2017, with an estimate of incidence and spatial distribution. Results: 188 cases were studied, mostly males (66.5%), rural residents (67.0%), children under 15 years (49.6%), with biting being the most frequent form of exposure (81.9%); frequency was highest in the period 2000-2008 (85.6%), with 46.6% of cases involving dogs and 45.9% bats; median incubation was 50 days, followed by, predominantly, symptoms of fever (92.6%), agitation (85.2%), paresthesia (66.7%), and dysphagia/paralysis (51.9%); the majority (70.2%) did not have prophylaxis and for the rest (29.8%) who did have prophylaxis, it was untimely and/or incomplete; 13 patients were treated according to the Recife Protocol, and two survived. Conclusion: human rabies incidence reduced and its epidemiological profile changed, with predominance of cases transmitted by bats; we suggest that secondary cases be investigated, and that pre-exposure prophylaxis be made available to populations at greater risk of accidents involving bats.

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“…In the Democratic Republic of the Congo (DRC), first reports of rabies date back to 1923 [24] and recurrent outbreaks have occurred across the country ever since [25,26,27]. In 2009, 21 clinically-confirmed rabies cases in children were registered in the Pediatrics Department of a single hospital in the capital city of Kinshasa in only seven months.…”

Section: Introductionmentioning

confidence: 99%

Dog Ecology, Bite Incidence, and Disease Awareness: A Cross-Sectional Survey among a Rabies-Affected Community in the Democratic Republic of the Congo

et al. 2019

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Despite the existence of safe and efficacious human and animal rabies vaccines, millions of people remain at risk of exposure to this deadly zoonotic disease through bites of infected dogs. Sub-Saharan African countries, such as the Democratic Republic of the Congo (DRC), bear the highest per capita death rates from rabies where dog vaccination and availability of lifesaving post-exposure prophylaxis (PEP) is scarce. Mass dog vaccination is the most cost-effective and sustainable approach to prevent human rabies deaths. We conducted a cross-sectional household survey in a rabies-affected community in Matadi, DRC, to estimate the size of the owned dog population and dog bite incidence and assess knowledge and practices regarding rabies, as preparation for future mass dog vaccination campaigns. Our study revealed that the owned dog population in Matadi was almost ten times larger than assumed by local veterinary officials, with a large proportion of free-roaming unvaccinated dogs. The annual dog bite incidence of 5.2 per 1000 person years was high, whereas community rabies knowledge was low resulting in poor practices. Given these findings, human rabies deaths are likely to occur in this community. Lack of disease awareness could negatively affect participation in future mass dog vaccination campaigns. A public sensitization campaign is needed to promote appropriate rabies prevention (washing bite wounds and PEP) and control (dog vaccination) measures in this community.

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Human rabies: a descriptive observation of 21 children in Kinshasa, the Democratic Republic of Congo

Cited by 18 publications

References 28 publications

Epidemiology, clinical features and risk factors for human rabies and animal bites during an outbreak of rabies in Maputo and Matola cities, Mozambique, 2014: Implications for public health interventions for rabies control

Epidemiology, clinical features and risk factors for human rabies and animal bites during an outbreak of rabies in Maputo and Matola cities, Mozambique, 2014: Implications for public health interventions for rabies control

Raiva humana no Brasil: estudo descritivo, 2000-2017*

Dog Ecology, Bite Incidence, and Disease Awareness: A Cross-Sectional Survey among a Rabies-Affected Community in the Democratic Republic of the Congo

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