Wednesday, May 13, 2015
Recently, two papers were published by our group on Rabies. Rabies is not the animal health problem that we discuss often in this blog, but it is a serious animal disease and more important: rabies is an important zoonosis. Still in 2015, according to estimations from the global disease burden study, approximately 55,000 people die of rabies each year. And more important and, in my personal opinion, striking: these deaths can be prevented. We know how to control rabies. Many countries are free of rabies, while even when a country is not free by vaccination or, as a last resort, by post exposure prophylaxis (PEP), human casus can be prevented.
A study of Ewaldus Wera (from the Kupang State Agricultural Polytechnic and doing is PhD at Wageningen University) that was published in 2013 showed that on Flores Island during the last 12 years in total $US 8.5 mln was spent on control of rabies in dogs. During the same period, a total of $US 4.8 mln was spent on PEP. In total an average of $US 1.1 mln per year. This is a large amount of money for an island with a population of approximately 1.8 mln people ($ 611 per person per year, where the average daily wage is not more than $ 5).
By the establishment of good dog rabies control programs, the total costs of rabies (dog rabies control plus PEP) could be decreased. However, despite the amount of money spent, rabies is not (yet) controlled.
A second study of Ewaldus has recently been published in PLOS Neglected Diseases. In this second study, 450 dog owners in two regions on Flores island were interviewed regarding the uptake of rabies control measures, which is despite the vaccination campaigns that were held not sufficient. The most important reasons to not join vaccination campaigns were a lack of information and the difficulty to catch the dogs during the campaign. Another interesting aspect was the accessibility of the village. Those villages with bad accessibility (which means that you cannot get ther by car, only by motorbike or foot) had a lower uptake of vaccination as well. This means that in the future, we have to think about the setup of vaccination campaigns: make sure that dog owners do receive enough information about the campaign and make sure that the campaign is held in such times that the dog owner is not in the field with his dog(s).
A second PhD student working on rabies is Tariku Jibat. He is working on the College of Veterinary Medicine and Agriculture, Addis Ababa University, Ethiopia and also doing his PhD work in our group in Wageningen. Tariku started later and is now in Ethiopia collecting his field data. However, he did recently publish a review on vaccination coverage rates in Africa in PLOS Neglected Tropical Diseases.In total 16 articles were published on rabies vaccination coverage in Africa. Although free roaming dogs are seen as a vaccination problem, the review showed that most dogs do have an owner. There is also a large proportion of puppies in the total dog population. Uptake of vaccination is 68% (almost the 70 % recommendation of the WHO) when vaccination is free of charge. When owners have to pay, uptake of rabies vaccination is only 18%.