| Title: |
Documenting challenges in achieving rabies elimination by 2030 in low-middle income countries; a Kenyan case study from Lamu County, 2020–2022: mixed methods approach. |
| Authors: |
Mwanyalu, Nassoro, Mwatondo, Athman, Chuchu, Veronicah, Maina, Kimani, Muturi, Mathew, Mutiiria, Mathew, Chepkwony, Daniel, Owiny, Maurice, Munyua, Peninah |
| Source: |
One Health Outlook; 2/9/2025, Vol. 7 Issue 1, p1-14, 14p |
| Subject Terms: |
RABIES vaccines, HEALTH information systems, HEALTH information exchanges, BITES & stings, MEDICAL personnel |
| Geographic Terms: |
KENYA |
| Abstract: |
Background: Kenya launched a Rabies Elimination Strategy in 2014, aiming to end human rabies deaths by 2030. In March 2022, Lamu County reported increased cases of human dog bites and suspected rabies deaths to the Ministry of Health (MoH). We aimed to establish the extent of the rabies outbreak in humans and animals and determine the challenges to achieving rabies elimination by 2030. Methods: We extracted dog bite reports from the Kenya Health Information System (KHIS), national surveillance database system, and reviewed medical records at health facilities in Lamu County for suspected human rabies deaths from 2020 to 2022. We obtained information about animal bites and illnesses in deceased persons, checked the availability of anti-rabies vaccines in health facilities, and administered rabies knowledge and practice questionnaires to health workers. For categorical data, frequencies and proportions were determined. Results: There were 787 dog bite cases and six human rabies cases. Only a third (2/6) of the rabies cases were uploaded to the KHIS. The county used targeted dog vaccination, and samples were not collected from the biting dogs. Regarding the availability of human rabies vaccines, half (8/16) of the facilities had the human rabies vaccine, and 19% (3/16) had both the human rabies vaccine and rabies immunoglobulin (RIG). Rabies vaccine stock-outs were common at 73% (11/16). Only 25% (18/73) of the health workers reported their first action would be to clean the bite wound with running water and soap for 15 min. Additionally, 86% (54/63) did not know the recommended human rabies vaccine and RIG dosage and schedule, while 25% (18/73) of healthcare workers were satisfied with the existing information-sharing mechanisms between veterinary and human health departments for rabies prevention and control. Conclusions: There was underreporting of rabies cases, a lack of awareness of bite wound management at health facilities, and persistent stockouts of human rabies vaccines. We suggest training healthcare workers on animal bite case management and improving One Health information exchange. Author Summary: Kenya launched a national rabies strategy plan in 2014 with the goal of eliminating dog-mediated rabies by 2030 through mass dog vaccinations, pre-exposure and post-exposure prophylaxis, and enhanced rabies surveillance. During a rabies outbreak investigation in Lamu, using a mixed methods investigation approach, we identified some challenges which include poor rabies surveillance, use of targeted dog vaccination, a lack of one-health collaboration, inadequate knowledge and practice of dog bite wound management by healthcare workers and the animal bite victims which contribute to Kenya's missing rabies elimination milestones despite the existence of the rabies elimination strategy. We recommend enhancing rabies surveillance, adopting one health approach, training healthcare workers on proper animal bite wound management, and upscaling from targeted to mass dog vaccination. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
