Faculty of Public Health

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Browsing Faculty of Public Health by Subject "SPATIOTEMPORAL RELATIONSHIPS BETWEEN DOG BITES"

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    SPATIOTEMPORAL RELATIONSHIPS BETWEEN DOG BITES, DOG VACCINATION COVERAGES, DOG AND HUMAN RABIES IN GHANA: IMPLICATIONS FOR ONE HEALTH COLLABORATION
    (ODEI ERIC, 2024-10-17) ODEI, ERIC
    Introduction Rabies is preventable, yet globally, about 59,000 people die from the disease annually. About forty percent (40%) of these deaths occur in Sub-Saharan Africa (SSA). Rabies remains an important public health concern to human and veterinary health professionals in SSA. In line with the global strategic framework to eliminate dog-mediated human rabies by 2030, Ghana has committed to eliminating human rabies by improving dog vaccination coverages, creating awareness and providing prompt post-exposure treatment using the One Health approach. The study aimed to investigate the spatiotemporal relationships between dog bites, dog vaccination coverages, dog and human rabies cases in Ghana for the period 2015-2021 and to identify existing mechanisms, barriers and enablers of One Health collaboration for elimination of dog-mediated human rabies. Methods A mixed-methods approach was employed. Rabies surveillance data from the Disease Surveillance Department (DSD) of Ghana Health Service (GHS) and Veterinary Services Directorate (VSD) were abstracted for all 260 districts in Ghana and modelled using Besag-Yorke-Mollie model in R-INLA and SaTScan for spatial, temporal and spatiotemporal mapping and cluster analysis. Key informant interviews (KIIs) were conducted with 35 purposively selected officers in GHS and VSD at the national, regional and district levels to determine extent of data-sharing and collaboration between the two sectors. Concurrently, a cross-sectional survey was conducted among 468 frontline staff of the animal health and human health sectors in the same 12 purposively selected districts where KIIs were being conducted to assess their knowledge, perception and practices with respect to One Health collaboration for rabies elimination. A desk review of national policy documents on dog and human rabies elimination in Ghana was conducted to understand the policy environment. Results In the period 2015-2021, average annual reported dog bites, human rabies cases, dog rabies cases, and dogs vaccinated were 16,675, 19, 86, and 60,952 respectively translating into average annual dog bite incidence of 58.9 per 100,000 population, average annual human rabies incidence of 0.07 per 100,000 population, average annual dog rabies incidence of 8 per 100,000 dogs and vaccination coverage of 5.7%. Dog bites were spatiotemporally associated with dog vaccination coverage (RR:1.77; 95% Credible Interval (CI):1.26-2.46) but much less significantly so with dog rabies (RR:1.03; 95% CI:1.01-1.06) and human rabies cases (RR: 1.03; 95% CI: 1.00-1.06). Key Informant Interviews revealed that the approach to dog vaccinations were more reactionary than proactive with vaccinations being carried out in response to suspected rabies cases or dog bites. There was poor collaboration for routine data-sharing between the human health and veterinary services due to lack of a clear policy. Unwillingness and inability of pet owners to bear cost of vaccination and inadequate law enforcement regarding responsible pet ownership contributed to the low dog vaccination coverage. Conclusion and Recommendations Lack of One Health policy accounts for the poor collaboration for routine data sharing between the two sectors. Weak legislation and inadequate law enforcement are major drivers of the low dog vaccination coverages. Finalizing and implementing the One Health policy alongside stronger legislation with law enforcement on dog vaccinations are urgently required to ensure the achievement of ‘zero by 30’ target.