asiimwe grace karimu, f. monje, d. mugabi, h. mulondo, c. odong, h. kazoora, t. odoch, c. ohuobunwo,...

The burden of animal bites among humans and control measures in

Mubende district

Asiimwe Grace Karimu, F. Monje, D. Mugabi, H. Mulondo, C. Odong, H. Kazoora , T. Odoch, C. Ohuobunwo, K.

Ssemogerere

Introduction

Methods

Results

Discussions

Conclusion

Recommendations

Presentation outline

Humans acquire rabies through bites by infected animals.

Domestic dogs are most important source of infection to

humans with more than 95% of human cases

Although human rabies encephalitis remains untreatable

the infection is preventable

In 2010, Uganda reported 12,718 cases and 203 deaths

from rabies with 82 (0.6%) cases from Mubende district.

About 23% of land covered by forests

Introduction

General objective.

To describe the burden of animal bites in

humans and possible control measures

Specific objectives

Describe the burden of animal bite cases by

person place and time

Identify possible control measures in place

Objective

Cross sectional study design

Abstracted data from HMIS 031 registers at

Mubende regional referral hospital (MRRH) and

Veterinary department records.

Conducted community survey from selected

subcounties.

Data analysed using Epi info version 5.3.1

software

Methods

R

Veterinary Records

Medical records

In 2010 and 2011, 563 patients reported animal bites from 15 subcounties to MRRH with less than 1% first reporting to vet.

Majority of the bites were due to dogs 540 (96%)

Others; cats 12 (2.1%), jackals 5 (0.9%), goats 3 (0.5%), humans 3 (0.5%).

Results

Bagez

a

Bukuy

a

Butor

ogo

Kalwan

a

Kasam

bya

Kassa

nda

Kigan

da

Kigan

do

Kiteng

a

Kitum

bi

Kiyun

i

Madud

u Mtc

Myanz

i

Nabin

gool

a 0

10

20

30

40

50

60

70

80

39.8

12.1

17.814.2

75.2

Incidence per 10,000 population

Sub county

Incid

ence p

er1

0,0

00popula

tion

Incidence of animal bites reported to MRRH 2010- 2011

Patients aged 3 months to 84 years.

Females 293 (52%) most affected.

Only 541 (96.1%) patients treated with post exposure rabies vaccine

Only 125 (23.1%) of the patients received the recommended 2-3 vaccine doses.

March and August with high incidences

Results…

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 0

5

10

15

20

25

30

35

40

45

14

17

32

40 39

20102011

Months

No.

of

anim

al bit

es r

eport

ed.

No. of animal bites reported in 2010 and 2011

0 – 9 10 -19 20 - 29 30 - 39 40 - 49 50 – 59 60 - 69 70 - 79 80 - 89 0

5

10

15

20

25

30 28.3

Percentage cases

Age group

Perc

enta

ge o

f anim

al bit

es

Percentage of animal bite cases by age groups

Interviewing dog bite patient

Children (10 - 19yrs) more prone to animal

bites.

School going children most affected

Stray dogs seen in communities visited

Stray dog bites common.

Weak departmental collaboration (Hospital,

medical and veterinary dep'ts)

Results …

Community survey –Nabingola s/c

Only 28% of the respondents had knowledge on rabies

Animal bites and human rabies in Mubende

primarily due to stray dogs.

Post exposure prophylaxis is currently

inadequate.

Limited community knowledge on rabies

Irregular control strategies

Conclusions

District recruit Veterinary staff

MAAIF provide vaccines to district for mass

vaccination of pets

Vet Sensitise communities/schools on rabies

Training of VHT to report on zoonoses.

Killing any stray dogs in the community

Strengthening the bond between Health and

Veterinary dep'ts (One Health) in the district

Recommendations

Sensitisation of communities on rabies

Public health action

Kasambya subcounty Kiyuni subcounty

Mubende district local government

MRRH

MUK-COVAB

MAAIF

AFENET

USAID - RESPOND

Acknowledgement

Thank you for listening