Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Jan 31, 2021
Date Accepted: May 6, 2021
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Human exposure to rabies in Yemen: Incidence, trend, and mortality 2011-2017
ABSTRACT
Background:
Rabies remains a neglected disease and poorly controlled throughout the developing world, particularly Africa and Asia, where most human rabies deaths occur.
Objective:
This study aimed to describe the epidemiology of rabies, its trend, and its geographical distribution in Yemen
Methods:
Cumulative data from Rabies surveillance system for the period 2011 to 2017 was obtained from the National Rabies Control Program. The data included the number of persons bitten by a suspected animal, their gender and age, and the result of animal’s lab-test. Cases were defined as human victims bitten or injured by animals confirmed to be infected with rabies and received post exposure prophylaxis at any rabies control unit during 2011-2017
Results:
During the period 2011-2017, a total of 76049 persons were bitten or injured by a suspected rabid animal. Of those, 21,927 (29%) were exposed to positively confirmed rabid animal and had PEP. Of all cases 68% were males and 32% were females. About 15% of cases were under five years, 41% aged 5-14 years, 28% aged 15-40 years, and 16% aged > 40 years. One third (36.8%) of reported cases were from Amanat Al Asimah followed by 32% from Ibb governorates, 12% from Dhamar, 8% from Al Hudaydah, 5% from Taizz, and 4% from Amran. The annual mean number of the cases exposed to positively confirmed rabid animal and had PEP was 3132. The annual incidence rate of exposure to positively confirmed rabid animal was 14 per 100,000 population. The annual mean number of deaths was 42 and the annual mean mortality rate was 2 per 1000,000 populations.
Conclusions:
Rabies is still a worrying health problem in Yemen with a higher percentage among children and males. The annual incidence of exposure was 14 per 100,000 population. An electronic system should be introduced to improve reporting. It is important to have sufficient supply of vaccines and immunoglobulins in control units especially in the affected governorates. Education, communication and information campaigns about preventive measures targeting school-age populations are strongly recommended. Moreover, vaccination campaigns in the canine population to avoid animal-to-human transmission is necessary.
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