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Epidemiology, clinical features and risk factors for human rabies and animal bites during an outbreak of rabies in Maputo and Matola cities, Mozambique, 2014: Implications for public health interventions for rabies control.

Abstract In Mozambique, the majority of rabies outbreaks are unreported and data on the epidemiological features of human rabies and animal bites are scarce. An outbreak of human rabies in adjacent Maputo and Matola cities in 2014 prompted us to investigate the epidemiology, clinical features and risk factors of human rabies and animal bites in the two cities.
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Authors

Mayor MeshTerms
Keywords
Journal Title plos neglected tropical diseases
Publication Year Start




PMID- 28742094
OWN - NLM
STAT- MEDLINE
DA  - 20170725
DCOM- 20170810
LR  - 20170813
IS  - 1935-2735 (Electronic)
IS  - 1935-2727 (Linking)
VI  - 11
IP  - 7
DP  - 2017 Jul
TI  - Epidemiology, clinical features and risk factors for human rabies and animal
      bites during an outbreak of rabies in Maputo and Matola cities, Mozambique, 2014:
      Implications for public health interventions for rabies control.
PG  - e0005787
LID - 10.1371/journal.pntd.0005787 [doi]
AB  - BACKGROUND: In Mozambique, the majority of rabies outbreaks are unreported and
      data on the epidemiological features of human rabies and animal bites are scarce.
      An outbreak of human rabies in adjacent Maputo and Matola cities in 2014 prompted
      us to investigate the epidemiology, clinical features and risk factors of human
      rabies and animal bites in the two cities. METHODOLOGY/PRINCIPAL FINDINGS: We
      reviewed cases of human rabies and animal bites from April to July 2014, and
      carried out a community investigation in July and August in the neighborhoods
      where cases of human rabies resided. This investigation included collection of
      clinical, demographic and epidemiological information and a case control study to
      investigate the risk factors associated with human rabies. Fourteen cases of
      human rabies were detected in Maputo (n = 10) and Matola (n = 3) cities and
      neighbouring Boane district (n = 1) between April and August 2014, all of whom
      had been admitted to hospital. All had a recent history of dog bite. Of the 14
      rabid dogs, only one had been immunized. 819 cases of animal bites were
      registered, of which 64.6% (529/819) were from Maputo City. Dogs were responsible
      for 97.8% (801/819) of all animal bites, but only 27.0% (126/467) were immunized.
      Factors significantly associated with human rabies were: age <15 years (p =
      0.05), bite by stray dog (p = 0.002), deep wound (p = 0.02), bite in the head (p 
      = 0.001), bite by unimmunized dog (p = 0.01), no use of soap and water (p =
      0.001), and no post-exposure prophylaxis (p = 0.01). CONCLUSIONS/SIGNIFICANCE:
      Implementation of control measures for rabies is poor in Maputo and Matola
      cities, where cases of human rabies were strongly associated with bites by stray 
      and unvaccinated dogs and irregular implementation of post-exposure measures.
FAU - Salomao, Cristolde
AU  - Salomao C
AD  - Department of Surveillance, National Institute of Health, Maputo, Mozambique.
FAU - Nacima, Amilcar
AU  - Nacima A
AD  - Field Epidemiology and Laboratory Training Program, National Institute of Health,
      Maputo, Mozambique.
FAU - Cuamba, Lutero
AU  - Cuamba L
AD  - Maputo City Health Directorate, Ministry of Health, Maputo, Mozambique.
FAU - Gujral, Lorna
AU  - Gujral L
AD  - Department of Epidemiology, National Directorate of Public Health, Ministry of
      Health, Maputo, Mozambique.
FAU - Amiel, Olga
AU  - Amiel O
AD  - Department of Neglected Tropical Diseases Program, National Directorate of Public
      Health, Maputo, Mozambique.
FAU - Baltazar, Cynthia
AU  - Baltazar C
AD  - Department of Surveillance, National Institute of Health, Maputo, Mozambique.
FAU - Cliff, Julie
AU  - Cliff J
AD  - Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique.
FAU - Gudo, Eduardo Samo
AU  - Gudo ES
AUID- ORCID: http://orcid.org/0000-0002-8686-7873
AD  - Department of Surveillance, National Institute of Health, Maputo, Mozambique.
LA  - eng
PT  - Journal Article
DEP - 20170724
PL  - United States
TA  - PLoS Negl Trop Dis
JT  - PLoS neglected tropical diseases
JID - 101291488
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Animals
MH  - Bites and Stings/*epidemiology
MH  - Case-Control Studies
MH  - Child
MH  - Child, Preschool
MH  - Demography
MH  - Disease Outbreaks/*prevention & control
MH  - Dog Diseases/*prevention & control/virology
MH  - Dogs
MH  - Female
MH  - Humans
MH  - Infant
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Mozambique
MH  - Post-Exposure Prophylaxis/*methods
MH  - Public Health
MH  - Rabies/*mortality/*prevention & control
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Surveys and Questionnaires
MH  - Vaccination
MH  - Young Adult
PMC - PMC5542695
EDAT- 2017/07/26 06:00
MHDA- 2017/08/11 06:00
CRDT- 2017/07/26 06:00
PHST- 2017/01/12 [received]
PHST- 2017/07/06 [accepted]
PHST- 2017/08/03 [revised]
AID - 10.1371/journal.pntd.0005787 [doi]
AID - PNTD-D-17-00026 [pii]
PST - epublish
SO  - PLoS Negl Trop Dis. 2017 Jul 24;11(7):e0005787. doi:
      10.1371/journal.pntd.0005787. eCollection 2017 Jul.