Spatiotemporal analysis of canine rabies in El Salvador: Violence and poverty as social factors of canine rabies

Abstract

BackgroundThe incidence of canine rabies cases in El Salvador has decreased in the last decade since the establishment of intense control programs, such as massive vaccination campaigns implemented by the Ministry of Health. Socioeconomic crises in recent years have limited the access to certain areas across the country and have impacted surveillance and prevention campaigns, which places the country at risk for a resurgence of canine rabies.We aimedto describe the spatiotemporal patterns of canine rabies and its association with critical social factors in El Salvador from 2005 to 2014.MethodWe included 459 cases of canine rabies. Several socioeconomic, demographic, and surveillance variables were modeled using a Poisson regression to evaluate their associations with the incidence of canine rabies. Spatial scan statistics were adjusted or unadjusted with covariates and applied to identify statistically significant clusters of canine rabies. Finally, a canine rabies risk map was created.ResultsA positive association and higher risk of canine rabies were found for low poverty zones, where it is suspected that urban slums contribute to ongoing rabies transmission (RR = 7.74). Violence had a negative association with rabies (RR = 0.663), which is likely due to reporting bias. Significant clusters were identified in all five epidemiological regions, and the Eastern region had the highest risk (RR = 50.62). The influences of the selected variables in cluster detection were confirmed by the adjusted analysis. Higher-risk townships were distributed from the Western to the Eastern regions of the country.ConclusionSocial factors are determinants of rabies in El Salvador and play a major role in national spatial patterns of the disease. There are high-risk areas for canine rabies across the country, and there were two persistent rabies foci during the study period. Examining the role of social factors can provide better insight into rabies in vulnerable countries, and socioeconomic factors can be key elements in developing better policies and interventions for rabies control.

The impact of anthropogenic and environmental factors on human rabies cases in China

“…In line with previous studies (Arias-Orozco et al, 2018;Guo, Yin, et al, 2018;Hampson et al, 2015;Raghavan et al, 2016), we found that rabies distribution was negatively correlated with economic development and positively correlated with human population density. Human rabies mostly occurred in economically underdeveloped areas (RC = 6.53%).…”

“…Local transmission of dog rabies is also associated with dog population size and their distributions (Brunker et al., 2018; Yin et al, 2012; Zhu & Liang, 2012). Economic development is another anthropogenic factor linked to rabies transmission, with higher prevalence associated with lower economically developed areas (Arias‐Orozco et al., 2018; Hampson et al., 2015; Raghavan et al., 2016). Distance from the nearest main roads was also identified as a predictor of RABV transmission, suggesting that transport may facilitate the spread of dog rabies (Brunker et al., 2018).…”

Barriers to attendance of canine rabies vaccination campaigns in Haiti, 2017

“…In this study, most of surveyed individuals were unaware of the vaccination campaign. This finding corroborates previous studies that showed the lack of awareness as a reason for low participation in canines rabies vaccination campaigns (Arias‐Orozco et al., 2018; Bardosh, 2018; Birhane et al., 2016; Castillo‐Neyra et al., 2017; Cleaton et al., 2018; Kazadi et al., 2017; Lembo et al., 2010). Indeed, better education is needed on how vaccination should be conducted every year, highlighting the importance of implementing educational programmes in vulnerable populations to increase rabies awareness and facilitate control interventions.…”

“…The results of this study show that fixed‐point vaccination methods should be a component of Haiti's vaccination campaign, but to achieve adequate herd immunity for rabies elimination additional considerations must be made. Societal changes to improve the value of dogs and dog vaccination could improve attendance, but these types of changes can take many years to develop and are often associated with improvements in the economic health of a society (Arias‐Orozco et al., 2018; Bardosh, 2018). Animal welfare changes, such as training dog owners to walk dogs on leashes or implementing laws to require dogs to remain leashed, could improve the effectiveness of fixed‐point vaccination methods.…”

Spatiotemporal heterogeneity and determinants of canine rabies evidence at Local Government Area Level in Nigeria: Implications for rabies prevention and control

“…The Stepwise Approach towards Rabies Elimination (SARE) was designed to allow rabies endemic countries to objectively measure their strengths and weaknesses, using available canine rabies evidence with scores between 0 and 5. Zero for canine rabies endemic countries and five signifying freedom from canine rabies [ [5] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] ]. Several countries within the Pan-African Rabies Control Network (PARACON), such as Sierra Leone, Angola, Burkina Faso, Niger, Guinea-Bissau have a score of zero.…”