A hundred years of rabies in Kenya and the strategy for eliminating dog-mediated rabies by 2030

Bitek, A. O. et al. (2019) A hundred years of rabies in Kenya and the strategy for eliminating dog-mediated rabies by 2030. AAS Open Research, 1, 23. (doi: 10.12688/aasopenres.12872.2) (PMID:32259023) (PMCID:PMC7117960)

Abstract

Background: Rabies causes an estimated 59,000 human deaths annually. In Kenya, rabies was first reported in a dog in 1912, with the first human case reported in 1928. Here we examine retrospective rabies data in Kenya for the period 1912 – 2017 and describe the spatial and temporal patterns of rabies occurrence in the country. Additionally, we detail Kenya’s strategy for the elimination of dog-mediated human rabies by 2030. Methods: Data on submitted samples and confirmed cases in humans, domestic animals and wildlife were obtained from Kenya’s Directorate of Veterinary Services. These data were associated with the geographical regions where the samples originated, and temporal and spatial trends examined. Results: Between 1912 and the mid 1970’s, rabies spread across Kenya gradually, with fewer than 50 cases reported per year and less than half of the 47 counties affected. Following an outbreak in the mid 1970’s, rabies spread rapidly to more than 85% of counties, with a 4 fold increase in the percent positivity of samples submitted and number of confirmed rabies cases. Since 1958, 7,584 samples from domestic animals (93%), wildlife (5%), and humans (2%) were tested. Over two-thirds of all rabies cases came from six counties, all in close proximity to veterinary diagnostic laboratories, highlighting a limitation of passive surveillance. Conclusions: Compulsory annual dog vaccinations between 1950’s and the early 1970’s slowed rabies spread. The rapid spread with peak rabies cases in the 1980’s coincided with implementation of structural adjustment programs privatizing the veterinary sector leading to breakdown of rabies control programs. To eliminate human deaths from rabies by 2030, Kenya is implementing a 15-year step-wise strategy based on three pillars: a) mass dog vaccination, b) provision of post-exposure prophylaxis and public awareness and c) improved surveillance for rabies in dogs and humans with prompt responses to rabies outbreaks.

• Item Type: Articles
• Additional Information: Version 2; peer review: 4 approved.
• Keywords: Kenya, elimination, epidemiology, rabies.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Hampson, Professor Katie and Cleaveland, Professor Sarah

Creator Roles

Cleaveland, S.: Funding acquisition, Writing – review and editing
Hampson, K.: Conceptualization, Formal analysis, Funding acquisition, Writing – review and editing

• Authors: Bitek, A. O., Osoro, E., Munyua, P. M., Nanyingi, M., Muthiani, Y., Kiambi, S., Muturi, M., Mwatondo, A., Muriithi, R., Cleaveland, S., Hampson, K., Njenga, M. K., Kitala, P.M., and Thumbi, S. M.
• College/School: College of Medical Veterinary and Life Sciences > School of Biodiversity, One Health & Veterinary Medicine
• Journal Name: AAS Open Research
• Publisher: F1000Research
• ISSN: 2515-9321
• ISSN (Online): 2515-9321
• Published Online: 30 July 2018
• Copyright Holders: Copyright © 2019 Bitek AO et al.
• First Published: First published in AAS Open Research 1: 23
• Publisher Policy: Reproduced under a Creative Commons License

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
301620		The Science of Rabies Elimination	Katie Hampson	Wellcome Trust (WELLCOTR)	207569/Z/17/Z	Institute of Biodiversity, Animal Health and Comparative Medicine