Improving dog bite victim survey and estimation of annual human deaths due to suspected rabies cases in three selected Liberian cities and environs, 2008-2017

PLoS Negl Trop Dis. 2020 Dec 28;14(12):e0008957. doi: 10.1371/journal.pntd.0008957. eCollection 2020 Dec.

Abstract

Rabies remains a public health challenge of unknown magnitude in Liberia in spite of the goal of ensuring that no human in the country dies of rabies by 2030. The annual prevalence of Dog Bite Victims (DBVs) and true load of Annual Human Deaths (AHDs) due to rabies were not known. We investigated three selected cities of Liberia for annual prevalence of DBVs and true load of AHD due to suspected rabies, using 10-year retrospective record, 2008-2017 obtained from Buchanan, Gbarnga, and Voinjama, three socio-economically important cities in post-conflict Liberia. Data were sourced at County Reference Hospitals and at the Liberia National Institute of Health for these cities and their local environs. In addition, household questionnaire survey was used to identify and audit data quality for unreported DBVs, and treatment received from traditional caregivers. The proportion was used to audit the 10-year data on unreported DBVs in the cities. Descriptive statistics was used to summarize annual DBVs over the 10-year period in the three cities, respectively. A standardized clinical decision tree model was used to estimate AHDs due to suspected rabies. Based on questionnaire survey, 140/365, 148/375 and 146/350 DBVs did not visit any orthodox health facility in Buchanan, Gbarnga and Voinjama cities, respectively in 2014. An estimated total of 559 DBVs died of suspected rabies in the three cities and their environs during the 10-year period. Mean yearly prevalence of DBVs was 179±106.82, 393±257.85 and 76.9±38.11 per 100,000 population, while mean AHDs due to suspected rabies was 14.3±8.47, 35.5±23.25, and 6.1±3.21 per 100,000 population in Buchanan, Gbarnga, and Voinjama cities, respectively. The present findings provide annual prevalence of suspected rabies cases, corrected for under-reporting in three selected cities of Liberia. The findings would be useful in planning for stepwise actions towards rabies elimination, ensuring that no human dies of rabies in Liberia by 2030.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Animals
  • Bites and Stings
  • Dog Diseases / epidemiology*
  • Dogs
  • Female
  • Humans
  • Liberia / epidemiology
  • Male
  • Primary Prevention / methods*
  • Rabies / epidemiology*
  • Rabies / mortality
  • Rabies / veterinary*
  • Rabies Vaccines
  • Retrospective Studies
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Rabies Vaccines

Grants and funding

Funding for this study was provided by the John D. and Catherine T. MacArthur Foundation, Chicago, IL (https://www.macfound.org/) (Grant no. 97944, awarded to the University of Ibadan, Nigeria through higher education initiative in Africa support for BOO); and the Deanship of Scientific Research, King Saud University Riyadh, Saudi Arabia (https://dsrs.ksu.edu.sa/en), (grant no. RGP-VPP-275, awarded to AAA). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.