Wallace Ryan MacLaren, Mehal Jason, Nakazawa Yoshinori, Recuenco Sergio, Bakamutumaho Barnabas, Osinubi Modupe, Tugumizemu Victor, Blanton Jesse D, Gilbert Amy, Wamala Joseph
United States Centers for Disease Control and Prevention, Atlanta, GA, USA.
Uganda Virus Research Institute, Kampala, Uganda.
Infect Dis Poverty. 2017 Jun 1;6(1):97. doi: 10.1186/s40249-017-0306-2.
Rabies is a neglected disease despite being responsible for more human deaths than any other zoonosis. A lack of adequate human and dog surveillance, resulting in low prioritization, is often blamed for this paradox. Estimation methods are often employed to describe the rabies burden when surveillance data are not available, however these figures are rarely based on country-specific data.
In 2013 a knowledge, attitudes, and practices survey was conducted in Uganda to understand dog population, rabies vaccination, and human rabies risk factors and improve in-country and regional rabies burden estimates. Poisson and multi-level logistic regression techniques were conducted to estimate the total dog population and vaccination coverage.
Twenty-four villages were selected, of which 798 households completed the survey, representing 4 375 people. Dog owning households represented 12.9% of the population, for which 175 dogs were owned (25 people per dog). A history of vaccination was reported in 55.6% of owned dogs. Poverty and human population density highly correlated with dog ownership, and when accounted for in multi-level regression models, the human to dog ratio fell to 47:1 and the estimated national canine-rabies vaccination coverage fell to 36.1%. This study estimates there are 729 486 owned dogs in Uganda (95% CI: 719 919 - 739 053). Ten percent of survey respondents provided care to dogs they did not own, however unowned dog populations were not enumerated in this estimate. 89.8% of Uganda's human population was estimated to reside in a community that can support enzootic canine rabies transmission.
This study is the first to comprehensively evaluate the effect of poverty on dog ownership in Africa. These results indicate that describing a dog population may not be as simple as applying a human: dog ratio, and factors such as poverty are likely to heavily influence dog ownership and vaccination coverage. These modelled estimates should be confirmed through further field studies, however, if validated, canine rabies elimination through mass vaccination may not be as difficult as previously considered in Uganda. Data derived from this study should be considered to improve models for estimating the in-country and regional rabies burden.
狂犬病是一种被忽视的疾病，尽管它导致的人类死亡比任何其他动物源性疾病都多。人们常常将这种矛盾现象归咎于缺乏足够的人类和犬类监测，导致其优先级较低。当没有监测数据时，通常会采用估算方法来描述狂犬病负担，然而这些数据很少基于特定国家的数据。
2013年在乌干达进行了一项知识、态度和行为调查，以了解犬类数量、狂犬病疫苗接种情况以及人类狂犬病风险因素，并改进该国及该地区的狂犬病负担估算。采用泊松回归和多水平逻辑回归技术来估算犬类总数和疫苗接种覆盖率。
选取了24个村庄，其中798户家庭完成了调查，代表4375人。养狗家庭占人口的12.9%，共养了175只狗（平均每25人养一只狗）。据报告，55.6%的家养犬有疫苗接种史。贫困和人口密度与养狗高度相关，在多水平回归模型中考虑这些因素后，人犬比例降至47:1，全国犬用狂犬病疫苗接种覆盖率估计降至36.1%。本研究估计乌干达有729486只家养犬（95%可信区间：719919 - 739053）。10%的调查受访者照顾他们没有养的狗，然而本估算未统计无主犬的数量。据估计，乌干达89.8%的人口居住在能够支持犬类狂犬病地方性传播的社区。
本研究首次全面评估了贫困对非洲养狗情况的影响。这些结果表明，描述犬类数量可能不像应用人犬比例那么简单，贫困等因素可能会严重影响养狗情况和疫苗接种覆盖率。然而，这些模型估算应通过进一步的实地研究来证实，如果得到验证，通过大规模疫苗接种消除犬类狂犬病可能不像乌干达此前认为的那么困难。应考虑本研究得出的数据，以改进估算该国及该地区狂犬病负担的模型。
