Sumon Ghosha
Chittagong Veterinary and Animal Sciences University, Bangladesh
Title: Trends and Clinico -epidemiological features of HUMAN RABIES cases in Bangladesh 2006-2017
Biography
Biography: Sumon Ghosha
Abstract
Background:
Bangladesh has reduced the death of rabies case-patients by 50% over the last few years. Clinical and epidemiological knowledge of human rabies is crucial to direct further research investigation and to implement disease control measures.
Methods: We used data from the rabies record book of the Infectious Disease Hospital (IDH), Dhaka, Bangladesh from 2006 to 2017. We reviewed the medical records of 422 patients reported from 2011 to 2015 who had a clinical diagnosis of rabies.
Results: We found a strong trend of declining human rabies cases in Bangladesh from 2006 to 2017 (p<0.001 and tau = -0.85). In Sen’s slope test we found, over the 12 year period the slope changes at the rate of 11.45 (95% CI: -14.00 to -8.00) annually (p<0.001). The declining trend of human rabies cases can be explained by the number of dogs being vaccinated against rabies during 2011 to 2017 (adjusted R2=0.55). Dogs with unknown vaccination status, comprised the majority of exposures (n=380, 90%) followed by cat (n=24, 6%), jackal (n=12, 3%) and mongoose (n=6, 1%). The majority (n=327, 78%) of the victims sought treatment from traditional healers and 12% (n=51) received post-exposure prophylaxis (PEP). There was a difference in incubation times between the sites of bites in which the patients were exposed. The shortest, longest and median reported incubation periods were 11, 1080 and 52 days respectively. Cases with a wound on the head and neck appeared to have a shorter incubation time than those with wounds at other sites. Clinical symptoms included hydrophobia (97%), acrophobia (84%), photophobia (10%), and hypersalivation (7%). The case-fatality rate was 100%.