Published in PLoS ONE, this study addresses a critical gap in data needed for health-policy prioritization in low-resource settings. The authors collected and analyzed comprehensive data from health centers in three distinct Ethiopian districts—Bishoftu (urban highland), Lemuna-bilbilo (rural highland), and Yabelo (rural lowland)—followed by an extensive community case search to identify unregistered bite victims. This dual approach allowed for a more accurate estimation of the true incidence of dog bites and suspected rabies exposures.
Across all districts, 655 animal bite victims were traced, and 96.5% involved dog bites. A striking 73.6% of the biting dogs were suspected to be rabid. When district-level exposure data were extrapolated, suspected rabid dog exposures were estimated at 135 bites (urban), 101 bites (rural highland), and 86 bites (rural lowland) per year. These exposures resulted in corresponding death estimates of 1, 4, and 3 deaths per 100,000 population.
The study also assessed the economic impact of post-exposure treatment (PET). Average PET costs varied significantly across regions—23 USD in the urban district, 31 USD in the rural highland district, and 40 USD in the rural lowland district—reflecting disparities in accessibility and economic burden. National extrapolations suggest approximately 3,000 human deaths annually due to rabies in Ethiopia, amounting to 194,000 Disability-Adjusted Life Years (DALYs) lost per year and roughly 97,000 exposed individuals requiring treatment.
The combined PET expenses generate an estimated 2 million USD in annual treatment costs nationwide. These findings underscore the profound health and economic impacts of canine rabies and provide essential evidence to guide rabies control strategies, including vaccination programs, improved access to PET, and targeted community interventions.
Source: Beyene, T., Mourits, M., Kidane, A., & Hogeveen, H. (2018). Estimating the burden of rabies in Ethiopia by tracing dog bite victims. PLoS ONE. Published February 21, 2018.
