Haematophagous bat bites in Ecuadorian Amazon: characterisation and implications for sylvatic rabies prevention.

OBJECTIVE To characterise the risk factors of haematophagous bat bites and to provide information to contribute to the prevention of rabies in Ecuador. DESIGN Cross-sectional study based on interviews with 3518 individuals, from which two sets of variables were generated: characteristics of haematophagous bat attacks in the previous year among humans and risk factors for being bitten. METHODS Data were analysed using multivariate logistic regression models, taking history of bat bites in the previous year as the response variable. RESULTS In the previous year 723 (20.6%, 95%CI 19.3-21.9) of the participants declared having received haematophagous bat bites and 50.4% in the previous month, giving an incidence rate of 10.4% (95%CI 9.6-11.6) per month. Sleeping on the floor or in a hammock (adjusted odds ratio [aOR] 1.58, 95%CI 1.21-2.06), not using a protective bed net (aOR 1.25, 95%CI 1.03-1.50) and living in a dwelling with permanent openings in the structure (aOR 1.49, 95%CI 1.12-1.95) were associated with a higher probability of bat bites. Those most affected were the group aged ≤12 years (age 13-19 years, aOR 0.39, 95%CI 0.32-0.48; age ≥20 years, aOR 0.67, 95%CI 0.50-0.90). CONCLUSION Primary prevention based on pre-exposure vaccination would be justifiable given the high dispersion of the population and the high incidence of bat bites. As a secondary protective measure, communities should work towards increasing the use of protective measures and putting barriers in permanent openings in their dwellings.