Conference abstract

Household exposure and animal-bite surveillance following human rabies detection in Southern Ghana

Pan African Medical Journal - Conference Proceedings. 2017:5(6).13 Dec 2017.
doi: 10.11604/pamj-cp.2017.5.6.526

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Keywords: Human rabies, investigation, post-exposure prophylaxis, animal-bite surveillance, Ghana
Abstract

Household exposure and animal-bite surveillance following human rabies detection in Southern Ghana

Kofi Afakye1,2,&, Ernest Kenu3, Kofi Nyarko1,4, Sherry Johnson1,2, Florence Wongnaah5, George Bonsu4

1Ghana Field Epidemiology and Laboratory Training Programme, Accra, Ghana, 2School of Veterinary Medicine, University of Ghana, Accra, Ghana, 3School of Public Health, University of Ghana, Accra, Ghana, 4Ghana Health Service, Accra, Ghana, 5Eastern Regional Hospital, Koforidua, Ghana

&Corresponding author
Kofi Afakye, School of Veterinary Medicine, University of Ghana, Accra, Ghana

Abstract

Introduction: rabies remains a neglected tropical zoonotic disease with 100% case fatality rate and estimated 6,000 global mortality annually, yet vaccine preventable. In Ghana, rabies outbreaks receive poor response. We investigated rabies in a 5 year old boy to identify the source of the infection, other exposed persons for post-exposure prophylaxis and describe animal-bite surveillance in Manya Krobo District, Ghana.

Methods: we actively searched for cases and exposures by interviewing household members of the victim, schoolmates, and health professionals using WHO case definition, interview guide and checklists. We reviewed health and veterinary records and reports, and interviewed stakeholders. Descriptive data analyses were carried out and presented using tables and charts. Recorded responses were transcribed into thematic area for further analysis.

Results: the child had dog-bite at the waist, developed hyperactivity, hydrophobia and hyperventilation 2 months later. The child was hospitalized and died from respiratory failure on the third day. Thirty-three persons were exposed to rabies. Female were 66%, age group 5 - 15 years and 30 - 59 year were 33.3% and 39.4% respectively. The third (11/33) was category II exposure by WHO classification and was recommended for PEP. Surveillance records showed 92 persons with animal bites for the past 12 months. Half were females, age group 5 - 14 years and 18 - 59 years were 27% and 34% respectively. Surveillance data quality was poor.

Conclusion: rabies remains public health burden in Ghana with domestic dogs as reservoir of virus. Children are vulnerable to animal bites and secondary exposures. Health education on rabies should be intensified, and robust animal-bite surveillance system put in place.