An Appraisal of Rabies Occurrence and Control in Kisumu Municipality, Kenya.

BACKGROUND Rabies is a serious neglected disease which occurs worldwide. In urban areas, the control of the diseaseis expected to be hampered by several unique constraints. OBJECTIVE To appraise the occurrence and control of rabies. STUDY DESIGN The tools used in the study included key informant interviews with senior veterinary and medical officers and a questionnaire survey on 15 veterinary officers and 9 human physicians. The occurrence of animal bites and costs involved in treatment was also investigated using retrospective hospital data for the year 2007. SETTING Kisumu Municipality, Kenya. RESULTS The control of rabies was under the Veterinary Department through dog vaccinations and baiting, and also under the Department of Public Health (DPH) through people vaccinations and post exposure treatments. The constraints observed were poor coordination in rabies control efforts, understaffing and limited resources. Animal bites were common with 1270 cases reported during 2007. The post-bite rabies vaccines were mainly purchased from local chemists at KES 7,500 per full dose. This amounted to an annual total cost of KES 9,525,000 (136,071 USD). The bites were mainly from domestic dogs (89%) and occurred commonly in highly populated areas. The mean age of people with bites was 21 (2.5 - 78) years, showing that young people had a higher risk. Males (59%) were at higher risk of bites than females (41%). CONCLUSIONS It would be important for the relevant departments to harmonise their rabies control strategies and also address the prevalent constraints by using local networks. The incidence of rabies and the associated epidemiology needs proper updated documentation with a view of carrying out mass vaccination of dogs at times free of cost to the economically disadvantaged owners.