Rabies mortality and morbidity associated with animal bites in Africa: a case for integrated rabies disease surveillance, prevention and control: a scoping review

Abstract

ObjectiveThe objective of this scoping review was to map the current situation and available evidence and gaps on rabies morbidity, mortality, integrated rabies surveillance programmes, and existing prevention and control strategies in Africa.MethodsWe conducted a systematic scoping review following the Joanna Briggs methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews checklist. Medline, Embase, CINAHL (EBSCOHost), Scopus, Web of Science and rabies web conferences were used to search for peer-reviewed publications between January 1946 and May 2020. Two researchers reviewed the studies and extracted data based on author (year) and region, study design and data collection duration, participants/comparators, interventions, control conditions/exposures and outcomes (rabies mortality and morbidity) and key findings/gaps/challenges. The results were reported narratively using Arksey and O’Malley’s methodological framework.ResultsElectronic search yielded 2775 records, of which 43 studies were included. A total of 543 714 bite victims were censored through the included studies. Most of the victims were less than 15 years of age. The studies included rabies morbidity (21) and mortality (15) fluctuating in space and time across Africa depending on countries’ rabies prevention and control practices (16). Others were surveillance (nine studies); surveillance and prevention (five studies); management and control (seven studies); and surveillance, prevention and control (six studies). We found challenges in rabies reporting, existing dog vaccination programmes and post-exposure prophylaxis availability or compliance.ConclusionThis study found challenges for dog rabies control and elimination in Africa and the need for a policy to drive the goal of zero dog-transmitted rabies to humans by 2030.This is an open-access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build on this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated and the use is non-commercial (see http://creativecommons.org/licenses/by-nc/4.0/).

Rabies encephalitis in Mauritania

“…The population largely remains ignorant of the risk of rabies in Mauritania and elsewhere [7]. In the literature, almost all studies conducted in different parts of the world showed that dog is the main vector in Africa, Asia, and Latin America [7,[9][10][11]. The incubation period observed in our two cases was 20 and 55 days, respectively.…”

“…In Mauritania, rabies has been known to exist, but reliable epidemiological data on rabies are absent. Many cases of rabies in developing countries are not diagnosed with laboratory confirmation and are often not even reported to health authorities [10]. The affected subjects usually die without appropriate care at home, without diagnosis being made.…”

Diagnosis and management of rabies encephalitis in two patients in northwest Africa: A case series

“…In Mauritania, rabies has been known to exist, but reliable epidemiological data on rabies are absent. Many cases of rabies in developing countries are not diagnosed with laboratory confirmation and are often not even reported to health authorities 13 . Bite victims often do not receive appropriate prophylactic care due to patients' ignorance, lack of awareness among health workers, lack of necessary biological products, or insufficient means to pay the cost of preventive treatment.…”

“…Many cases of rabies in developing countries are not diagnosed with laboratory confirmation and are often not even reported to health authorities. 13 Bite victims often do not receive appropriate prophylactic care due to patients' ignorance, lack of awareness among health workers, lack of necessary biological products, or insufficient means to pay the cost of preventive treatment. The affected subjects usually die without appropriate care at home, without diagnosis being made.…”

Evidence mapping of current status, impact, prevention and control measures from rabies research in Bangladesh (2010–2021): a scoping review protocol

“…Earlier review in similar endemic settings has generated evidence on the status of the rabies and identified the gaps and challenges in prevention and control measures, summarised on the rabies measures which have shown promises and finally recommended adoptable innovations. 30 The current review aims to come up with such findings specific to Bangladesh which will in the future guide the country’s strategy in eliminating rabies. Reiterating the challenge to have basic information on rabies burden to comparative information related to efficiency of public health measures, control strategies and different vaccines and cost-effectiveness of pharmacological interventions, the review will establish an evidence base on rabies status in human, disease impact, knowledge and practice among people, effective prevention and control measures to support the national rabies action strategies.…”