A retrospective evaluation of bites at risk of rabies transmission across 7 years: the need to improve surveillance and reporting systems for rabies elimination
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Date
2018
Journal Title
Journal ISSN
Volume Title
Publisher
PLOS ONE
Abstract
The vast majority of rabies deaths occur in developing countries and rural areas. Due to the
absence of surveillance and the lack of reliable information, many endemic countries are not
able to assess their rabies burden and implement appropriate solutions. This study reports
the incidence of animal bites considered at risk of rabies transmission, along with rates and
determinants of the adherence to post-exposure prophylaxis (PEP) between 2008 and 2014
in Dodoma Region, Tanzania. A retrospective analysis of rabid animal bites considered at
risk of rabies transmission at Dodoma Regional Referral Hospital (DRRH) during 2008±
2014 was conducted. Data were collected from the registers of patients presenting to the
hospital because of a potential rabies exposure. The patients were assessed by a trained
health worker and each bite was considered as ªat risk of rabiesº based on the victim's
description of the event. Overall, 10,771 patients coming from Dodoma Region attended
DRRH because of a bite from a suspected rabid animal, giving a mean incidence of 74 bites
at risk of rabies transmission per 100,000 persons per year. Overall, only 46.0% of people
exposed received a complete course of PEP and 61.6% attended the clinic within 48 hours
after the bite. Multivariate analysis shows that people age >15 years, residence in rural
areas and occurrence during the rainy season were independently associated to delayed
access to care. Male gender, age below 15 years. and bites occurring during the dry season
were associated with completion of PEP. In this area with a high rate of at-risk bites, several
factorsÐmainly related to health care access and to the affordability and delivery of rabies
vaccinesÐstill need to be addressed in order to reduce gender and social inequalities in
rabies prevention and control. Further efforts are required to establish an efficient rabies surveillance
system in Dodoma Region.
Description
Full text article. Also available at https://doi.org/10.1371/journal.pone.0197996
Keywords
Rabies elimination, Rabies transmission, Rabies deaths, Animal bites, Post-exposure prophylaxis, PEP, Rabies exposure
Citation
De Nardo, P., Gentilotti, E., Vairo, F., Nguhuni, B., Chaula, Z., Nicastri, E., ... & Ippolito, G. (2018). A retrospective evaluation of bites at risk of rabies transmission across 7 years: The need to improve surveillance and reporting systems for rabies elimination. PloS one, 13(7), e0197996.