Rabies burden in Côte d'Ivoire

• Published in: Acta tropica 2022-02, Vol.226, p.106249-106249, Article 106249
• Main Authors: Kallo, Vessaly, Keita, Zakaria, Boka, Marcel, Tetchi, Mathilde, Dagnogo, Komissiri, Ouattara, Max, Amalaman, Djedou Martin, Traore, Sylvain, Gerber, Felix, Lechenne, Monique, Hattendorf, Jan, Hampson, Katie
• Format: Article
• Language: English
• Subjects: Animals; Bites and Stings - epidemiology; Cote d'Ivoire - epidemiology; Cross-Sectional Studies; Dogs; Post-Exposure Prophylaxis; Rabies - epidemiology; Rabies - veterinary
• ISSN: 0001-706X; 1873-6254
• DOI: 10.1016/j.actatropica.2021.106249

•The current study is the first estimate of the burden and financial cost of rabies in Côte d'Ivoire. The results will provide information needed for designing an adequate rabies control strategy. This information is fundamental towards achieving the goals set by the WHO and OIE for the elimination rabies by 2030. It also highlights the benefits that can be expected for the country if rabies could be eliminated.•The data was collected from a cross-sectional survey of 8004 households, of which 4002 were in the department of Bouaké and 4002 in the department of San Pedro. This data was collected in both rural and urban areas. Further data was collected from human rabies control centres and from the respective veterinary services. In Côte d'Ivoire, just as in the majority of developing countries, rabies cases are underestimated. The official data are based on passive surveillance studies which cannot provide true estimates. Therefore, the economic and health burden of rabies is underestimated. To be able to better estimate the true burden of rabies, this study looked at surveillance data of bite records and household survey. The data was collected from a cross-sectional survey of 8004 households, of which 4002 were in the Department of Bouaké and 4002 in the Department of San Pedro. Further data was collected from Human Rabies control centres and from the respective veterinary services. We estimate the burden of rabies through data from the bites surveillance records. Human deaths from rabies were estimated using a series of probability steps to determine the likelihood of clinical rabies in a person after being bitten by a suspected rabid dog. Monte Carlo simulations of a series of interconnected probabilities were used to estimate the rabies burden in the country. The number of deaths from rabies was estimated at 637deaths per year [95% CI 442–849] and human mortality from rabies was estimated at 2.61 per 100′000 [95% CI 1.81–3.56], which represents 24–47 times more cases than the official data. Deaths due to rabies are responsible for 23,252 Disability Adjusted Life Years (DALY) lost each year [95% CI 16,122–30,969]. The estimated annual cost of rabies is 40.15 million USD [95% CI 27.8–53.4]. Overall, 99% of the cost was due to premature deaths. The cost of post-exposure prophylaxis was estimated at 1.6 million USD and represented 1% of the overall cost of rabies. This study highlights the underreporting of rabies cases by the official health information s