Rabies exposures, post-exposure prophylaxis and deaths in a region of endemic canine rabies

Hampson, K. , Dobson, A., Kaare, M., Dushoff, J., Magoto, M., Sindoya, E. and Cleaveland, S. (2008) Rabies exposures, post-exposure prophylaxis and deaths in a region of endemic canine rabies. PLoS Neglected Tropical Diseases, 2(11), e339. (doi:10.1371/journal.pntd.0000339)

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Publisher's URL: http://dx.doi.org/10.1371/journal.pntd.0000339

Abstract

Thousands of human deaths from rabies occur annually despite availability of effective vaccines for humans following exposure, and for disease control in domestic dog populations. We established a 5-year contact-tracing study in northwest Tanzania to investigate risk factors associated with rabies exposure and to determine why human deaths from canine rabies still occur. We found that children were at greater risk of being bitten and of developing rabies than adults and that incidence of bites by suspected rabid animals was higher in an area with larger domestic dog populations. A large proportion (>20%) of those bitten by rabid animals are not recorded in official records because they do not seek post-exposure prophylaxis (PEP), which is crucial for preventing the onset of rabies. Of those that seek medical attention, a significant proportion do not receive PEP because of the expense or because of hospital shortages; and victims who are poorer, and who live further from medical facilities, typically experience greater delays before obtaining PEP. Our work highlights the need to raise awareness about rabies dangers and prevention, particularly prompt PEP, but also wound management. We outline practical recommendations to prevent future deaths, stressing the importance of education, particularly in poor and marginalized communities, as well as for medical and veterinary workers.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Cleaveland, Professor Sarah and Hampson, Dr Katie
Authors: Hampson, K., Dobson, A., Kaare, M., Dushoff, J., Magoto, M., Sindoya, E., and Cleaveland, S.
College/School:College of Medical Veterinary and Life Sciences > Institute of Biodiversity Animal Health and Comparative Medicine
Journal Name:PLoS Neglected Tropical Diseases
Publisher:Public Library of Science
ISSN:1935-2727
ISSN (Online):1935-2735
Published Online:22 May 2008
Copyright Holders:Copyright © 2008 The Authors
First Published:First published in PLoS Neglected Tropical Diseases 2(11):e339
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher
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