Aklilu Mesfin, Tadele Wogayehu, Alemu Amelework, Abdela Sintayehu, Getahun Garuma, Hailemariam Alemnesh, Tadesse Yirgalem, Kitila Gutu, Birhanu Endalkachew, Fli Ibsa, Getachew Abebe, Mulugeta Yimer
Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia.
J Trop Med. 2021 Feb 19;2021:6662073. doi: 10.1155/2021/6662073. eCollection 2021.
The study objective was to estimate the burden of human rabies in Ethiopia from 2015-2019. . A descriptive study design was applied to measure the size of the problem.
Retrospective data were used from the Ethiopian Public Health Institute rabies case record book that was registered between 2015 to 2019.
Eighty-seven (87) cases of human rabies were diagnosed clinically in the Ethiopian Public Health Institute over the period of five years (2015-2019) with 100% case fatality. Of these, 83 (95.4%) cases were attributed to dog bites, whereas 1 (1.1%) to a cat and 3 (3.4%) to wild animals. The fatalities were from Oromia ( = 51 (58.6%), 13 (14.9%) were from Amhara, 15 (17.2%) were from Addis Ababa, and 8 (9.2%) from the Southern region. All referred cases had no record of immunization against rabies except eight. Ineffective postexposure treatment was the reason for 5 (5.7%) deaths. Out of 1,652 brain samples of different animals, mainly dogs, submitted for examination, 1,122 (68%) were found to be positive for rabies by the FAT. Dog bites were more common among males than females. The number of dog bite victims who had visited the EPHI counseling office and recommended to take postexposure prophylaxis against rabies both from Addis Ababa and the surrounding areas were 9,592 and 4,192, respectively. Out of these, 5,708 were males and 3,884 females for the capital Addis Ababa. Similarly, 2,439 males and 1,753 females account for areas surrounding Addis Ababa. Among those exposed from Addis Ababa, 1,079 (11.2%) were in the age group less than five, 1696 (17.7%) were in the age group 6-13, and 6,817 (71.1%) in the age group 14 and greater. Victims from outside of the capital Addis Ababa account for 644 (15.4%) for the age group less than 5 years, 964 (23%) for the age group 6-13 and, 2,584 (61.6%) for the age group 14 and greater.
Mechanisms must be sought to reduce the cost of PEP and means of obtaining funds so as to initiate timely treatment for rabies exposed individuals of low socioeconomic status. Besides prevention, strategies should focus on public education and strict dog population control.
本研究的目的是估计2015 - 2019年埃塞俄比亚人间狂犬病的负担。采用描述性研究设计来衡量问题的规模。
使用了埃塞俄比亚公共卫生研究所2015年至2019年登记的狂犬病病例记录册中的回顾性数据。
在埃塞俄比亚公共卫生研究所,五年(2015 - 2019年)期间临床诊断出87例人间狂犬病病例,病死率为100%。其中,83例(95.4%)病例归因于狗咬伤,1例(1.1%)归因于猫咬伤,3例(3.4%)归因于野生动物咬伤。死亡病例来自奥罗米亚州(= 51例(58.6%)),13例(14.9%)来自阿姆哈拉州,15例(17.2%)来自亚的斯亚贝巴,8例(9.2%)来自南部地区。除8例病例外,所有转诊病例均无狂犬病免疫记录。暴露后治疗无效是5例(5.7%)死亡的原因。在提交检查的1652份不同动物(主要是狗)的脑样本中,1122份(68%)经荧光抗体试验检测出狂犬病呈阳性。狗咬伤在男性中比女性更常见。来自亚地斯亚贝巴及其周边地区到埃塞俄比亚公共卫生研究所咨询办公室就诊并被建议接受暴露后狂犬病预防治疗的狗咬伤受害者分别为9592例和4192例。其中,首都亚的斯亚贝巴有5708例男性和3884例女性。同样,亚的斯亚贝巴周边地区有2439例男性和1753例女性。在亚的斯亚贝巴暴露的人群中,1079例(11.2%)年龄小于5岁,1696例(17.7%)年龄在6 - 13岁,6817例(71.1%)年龄在14岁及以上。首都亚的斯亚贝巴以外地区的受害者中,年龄小于5岁的有644例(15.4%),年龄在6 - 13岁的有964例(23%),年龄在14岁及以上的有2584例(61.6%)。
必须寻求降低暴露后预防治疗成本的机制和获取资金的途径,以便为社会经济地位较低的狂犬病暴露个体及时开展治疗。除了预防之外,策略应侧重于公众教育和严格控制犬类数量。