Karunanayake Dushantha, Matsumoto Takashi, Wimalaratne Omala, Nanayakkara Susilakanthi, Perera Devika, Nishizono Akira, Ahmed Kamruddin
Department of Rabies Diagnosis and Research, Medical Research Institute, Colombo, Sri Lanka.
Department of Microbiology, Faculty of Medicine, Oita University, Yufu, Japan.
PLoS Negl Trop Dis. 2014 Oct 9;8(10):e3205. doi: 10.1371/journal.pntd.0003205. eCollection 2014 Oct.
Rabies is endemic in Sri Lanka, but little is known about the temporal and spatial trends of rabies in this country. Knowing these trends may provide insight into past control efforts and serve as the basis for future control measures. In this study, we analyzed distribution of rabies in humans and animals over a period of 12 years in Sri Lanka.
Accumulated data from 1999 through 2010 compiled by the Department of Rabies Diagnosis and Research, Medical Research Institute (MRI), Colombo, were used in this study.
The yearly mean percentage of rabies-positive sample was 62.4% (47.6-75.9%). Three-fourths of the rabies-positive samples were from the Colombo, Gampaha, and Kalutara districts in Western province, followed by Galle in Southern province. A high percentage of the rabies samples were from dogs (85.2%), followed by cats (7.9%), humans (3.8%), wild animals (2.0%), and livestock (1.1%). Among wild animals, mongooses were the main victims followed by civets. The number of suspect human rabies cases decreased gradually in Sri Lanka, although the number of human samples submitted for laboratory confirmation increased.
The number of rabid dogs has remained relatively unchanged, but the number of suspect human rabies is decreasing gradually in Sri Lanka. These findings indicate successful use of postexposure prophylaxis (PEP) by animal bite victims and increased rabies awareness. PEP is free of charge and is supplied through government hospitals by the Ministry of Health, Sri Lanka. Our survey shows that most positive samples were received from Western and Southern provinces, possibly because of the ease of transporting samples to the laboratory. Submissions of wild animal and livestock samples should be increased by creating more awareness among the public. Better rabies surveillance will require introduction of molecular methods for detection and the establishment of more regional rabies diagnostic laboratories.
狂犬病在斯里兰卡呈地方性流行，但该国狂犬病的时间和空间趋势鲜为人知。了解这些趋势可能有助于洞察过去的防控工作，并为未来的防控措施提供依据。在本研究中，我们分析了斯里兰卡12年间人类和动物狂犬病的分布情况。
本研究使用了科伦坡医学研究所狂犬病诊断与研究部汇编的1999年至2010年的累积数据。
狂犬病阳性样本的年平均百分比为62.4%（47.6 - 75.9%）。四分之三的狂犬病阳性样本来自西部省的科伦坡、甘帕哈和卡卢特勒区，其次是南部省的加勒。狂犬病样本中很大比例来自狗（85.2%），其次是猫（7.9%）、人类（3.8%）、野生动物（2.0%）和家畜（1.1%）。在野生动物中，獴是主要受害者，其次是果子狸。尽管提交实验室确诊的人类样本数量增加，但斯里兰卡疑似人类狂犬病病例的数量逐渐减少。
斯里兰卡狂犬病狗的数量相对保持不变，但疑似人类狂犬病的数量正在逐渐减少。这些发现表明动物咬伤受害者成功使用了暴露后预防（PEP），并且狂犬病意识有所提高。PEP是免费的，由斯里兰卡卫生部通过政府医院提供。我们的调查显示，大多数阳性样本来自西部和南部省份，可能是因为样本便于运往实验室。应通过提高公众意识来增加野生动物和家畜样本的提交。更好的狂犬病监测将需要引入分子检测方法并建立更多的区域狂犬病诊断实验室。
