Incidence, Trend, and Mortality of Human Exposure to Rabies in Yemen, 2011-2017: Observational Study

BackgroundRabies remains a neglected and poorly controlled disease throughout the developing world, particularly in Africa and Asia, where most human rabies deaths occur. ObjectiveThis study aimed to describe the epidemiology of rabies exposures, its trend, and its geographical distribut...

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Main Authors: Rihana Taher Abdulmoghni, Ahmed Hasan Al-Ward, Khaled Abdullah Al-Moayed, Mohammed Abdullah AL-Amad, Yousef S Khader
Format: Article
Language:English
Published: JMIR Publications 2021-06-01
Series:JMIR Public Health and Surveillance
Online Access:https://publichealth.jmir.org/2021/6/e27623
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author Rihana Taher Abdulmoghni
Ahmed Hasan Al-Ward
Khaled Abdullah Al-Moayed
Mohammed Abdullah AL-Amad
Yousef S Khader
author_facet Rihana Taher Abdulmoghni
Ahmed Hasan Al-Ward
Khaled Abdullah Al-Moayed
Mohammed Abdullah AL-Amad
Yousef S Khader
author_sort Rihana Taher Abdulmoghni
collection DOAJ
description BackgroundRabies remains a neglected and poorly controlled disease throughout the developing world, particularly in Africa and Asia, where most human rabies deaths occur. ObjectiveThis study aimed to describe the epidemiology of rabies exposures, its trend, and its geographical distribution in Yemen. MethodsCumulative data from a rabies surveillance system for the period 2011-2017 were obtained from the National Rabies Control Program as paper-based annual reports. Data included the number of persons bitten by a suspected rabid animal, their gender and age, and the result of the animal’s laboratory test. Human cases were defined as those exposed to rabies virus bitten by a suspected rabid animal, exposed to a confirmed rabid animal and then received postexposure prophylaxis (PEP), and deaths occurred after exposure to a confirmed rabid animal after having rabies symptoms during 2011-2017. ResultsFrom 2011 to 2017, a total of 76,049 persons were bitten by a suspected rabid animal. Of these, 21,927 (28.83%) were exposed to positively confirmed rabid animals and then received PEP, and 295 (0.38%) rabies-related deaths occurred. Of all cases with rabies exposure, 50,882 (66.91%) were males. The most affected age group by animal bites (31,816/76,041, 41.84%), positive exposure (8945/21,927, 40.79%), and rabies deaths (143/295, 48.47%) was 5-14 years. Rabies vaccines and immunoglobulins quantities were least available in 2016 and 2017. The annual incidence rate of exposure to animal bites and rabies exposure was 50 and 14 per 100,000, respectively. The annual mortality rate was 2 per 1,000,000. The highest incidence rate of animal bites was in Dhamar (112 per 100,000) and Ibb (94 per 100,000), whereas the highest incidence of exposed cases was in Amanat Al Asimah (40 per 100,000) and Ibb (37 per 100,000). Mortality rate was the highest in Amanat Al Asimah (6 deaths per 1,000,000) followed by Ibb and Dhamar (4 deaths per 1,000,000 in both). ConclusionsRabies remains a worrying health problem in Yemen with higher percentage reported among children and males. Targeting school-age populations by education, communication, and information campaigns about preventive measures is strongly recommended. An electronic system should be introduced to improve reporting. It is important to have a sufficient supply of vaccines and immunoglobulins in control units, especially in the at-risk or impacted governorates. Future studies are suggested to determine incidences and risk factors of disease progression.
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spelling doaj.art-8ab3969568f240c8b3d4881e172fbe3a2022-12-21T17:42:54ZengJMIR PublicationsJMIR Public Health and Surveillance2369-29602021-06-0176e2762310.2196/27623Incidence, Trend, and Mortality of Human Exposure to Rabies in Yemen, 2011-2017: Observational StudyRihana Taher Abdulmoghnihttps://orcid.org/0000-0002-8130-8685Ahmed Hasan Al-Wardhttps://orcid.org/0000-0002-0954-9767Khaled Abdullah Al-Moayedhttps://orcid.org/0000-0001-7845-8482Mohammed Abdullah AL-Amadhttps://orcid.org/0000-0002-1566-4964Yousef S Khaderhttps://orcid.org/0000-0002-7830-6857BackgroundRabies remains a neglected and poorly controlled disease throughout the developing world, particularly in Africa and Asia, where most human rabies deaths occur. ObjectiveThis study aimed to describe the epidemiology of rabies exposures, its trend, and its geographical distribution in Yemen. MethodsCumulative data from a rabies surveillance system for the period 2011-2017 were obtained from the National Rabies Control Program as paper-based annual reports. Data included the number of persons bitten by a suspected rabid animal, their gender and age, and the result of the animal’s laboratory test. Human cases were defined as those exposed to rabies virus bitten by a suspected rabid animal, exposed to a confirmed rabid animal and then received postexposure prophylaxis (PEP), and deaths occurred after exposure to a confirmed rabid animal after having rabies symptoms during 2011-2017. ResultsFrom 2011 to 2017, a total of 76,049 persons were bitten by a suspected rabid animal. Of these, 21,927 (28.83%) were exposed to positively confirmed rabid animals and then received PEP, and 295 (0.38%) rabies-related deaths occurred. Of all cases with rabies exposure, 50,882 (66.91%) were males. The most affected age group by animal bites (31,816/76,041, 41.84%), positive exposure (8945/21,927, 40.79%), and rabies deaths (143/295, 48.47%) was 5-14 years. Rabies vaccines and immunoglobulins quantities were least available in 2016 and 2017. The annual incidence rate of exposure to animal bites and rabies exposure was 50 and 14 per 100,000, respectively. The annual mortality rate was 2 per 1,000,000. The highest incidence rate of animal bites was in Dhamar (112 per 100,000) and Ibb (94 per 100,000), whereas the highest incidence of exposed cases was in Amanat Al Asimah (40 per 100,000) and Ibb (37 per 100,000). Mortality rate was the highest in Amanat Al Asimah (6 deaths per 1,000,000) followed by Ibb and Dhamar (4 deaths per 1,000,000 in both). ConclusionsRabies remains a worrying health problem in Yemen with higher percentage reported among children and males. Targeting school-age populations by education, communication, and information campaigns about preventive measures is strongly recommended. An electronic system should be introduced to improve reporting. It is important to have a sufficient supply of vaccines and immunoglobulins in control units, especially in the at-risk or impacted governorates. Future studies are suggested to determine incidences and risk factors of disease progression.https://publichealth.jmir.org/2021/6/e27623
spellingShingle Rihana Taher Abdulmoghni
Ahmed Hasan Al-Ward
Khaled Abdullah Al-Moayed
Mohammed Abdullah AL-Amad
Yousef S Khader
Incidence, Trend, and Mortality of Human Exposure to Rabies in Yemen, 2011-2017: Observational Study
JMIR Public Health and Surveillance
title Incidence, Trend, and Mortality of Human Exposure to Rabies in Yemen, 2011-2017: Observational Study
title_full Incidence, Trend, and Mortality of Human Exposure to Rabies in Yemen, 2011-2017: Observational Study
title_fullStr Incidence, Trend, and Mortality of Human Exposure to Rabies in Yemen, 2011-2017: Observational Study
title_full_unstemmed Incidence, Trend, and Mortality of Human Exposure to Rabies in Yemen, 2011-2017: Observational Study
title_short Incidence, Trend, and Mortality of Human Exposure to Rabies in Yemen, 2011-2017: Observational Study
title_sort incidence trend and mortality of human exposure to rabies in yemen 2011 2017 observational study
url https://publichealth.jmir.org/2021/6/e27623
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