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Survey of animal bite injuries and their management for an estimate of human rabies deaths in N’Djamena, Chad

J. Frey1, R. Mindekem2, H. Kessely2, D. Doumagoum Moto2, S. Na€ıssengar3, J. Zinsstag1,4 and E. Schelling1,4
1 Swiss Tropical and Public Health Institute, Basel, Switzerland
2 Centre de Support en Sante Internationale, N’Djamena, Chad
3 Laboratoire de Recherches Veterinaires et Zootechniques de Farcha, N’Djamena, Chad
4 Faculty of Science, University of Basel, Basel, Switzerland

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Abstract

OBJECTIVE To estimate the annual human rabies incidence as a baseline prior to mass dog
vaccination campaigns in N’Djamena, Chad.

METHODS Survey of animal bites, involving 50% of all healthcare providers in N’Djamena, from
September 2008 to April 2009. Of 86 people exposed to a suspected rabid animal, 50% received
post-exposure vaccination and a further 8% had their wound cleaned. We estimated annual incidence
of bites from suspected rabid animals of 12.9/100 000 and an incidence of 0.7 human rabies deaths/
100 000, resulting in 7 estimated deaths (95% confidence interval 4–10 deaths) per year in N’Djamena. 14% of bite victims sought help from veterinarians.

CONCLUSIONS Closer cooperation between physicians and veterinarians warrants more effective rabies control. The high proportion (42%) of potentially exposed people without post-exposure vaccination or wound treatment necessitates urgent attention.

keywords rabies, N’Djamena, animal bites, post-exposure prophylaxis, wound management, human
rabies incidence, human deaths