Rabies burden in Côte d'Ivoire.

BACKGROUND: In Côte d'Ivoire, just as in the majority of developing countries, rabies cases are underestimated. The official data are based on passive surveillance studies which cannot provide true estimates. Therefore, the economic and health burden of rabies is underestimated. To be able to better estimate the true burden of rabies, this study looked at surveillance data of bite records and household survey. METHODOLOGY: The data was collected from a cross-sectional survey of 8004 households, of which 4002 were in the Department of Bouaké and 4002 in the Department of San Pedro. Further data was collected from Human Rabies control centres and from the respective veterinary services. We estimate the burden of rabies through data from the bites surveillance records. Human deaths from rabies were estimated using a series of probability steps to determine the likelihood of clinical rabies in a person after being bitten by a suspected rabid dog. Monte Carlo simulations of a series of interconnected probabilities were used to estimate the rabies burden in the country. RESULTS: The number of deaths from rabies was estimated at 637deaths per year [95% CI 442-849] and human mortality from rabies was estimated at 2.61 per 100'000 [95% CI 1.81-3.56], which represents 24-47 times more cases than the official data. Deaths due to rabies are responsible for 23,252 Disability Adjusted Life Years (DALY) lost each year [95% CI 16,122-30,969]. The estimated annual cost of rabies is 40.15 million USD [95% CI 27.8-53.4]. Overall, 99% of the cost was due to premature deaths. The cost of post-exposure prophylaxis was estimated at 1.6 million USD and represented 1% of the overall cost of rabies. CONCLUSION: This study highlights the underreporting of rabies cases by the official health information system in Côte d'Ivoire and the annual financial losses related to rabies are equivalent to the estimated cost of the elimination of rabies by 2030. Thus, investing in the fight against in Côte d'Ivoire will be cost effective.

Estimation of dog population and dog bite risk factors in departments of San Pedro and Bouake in Côte d'Ivoire.

Rabies is endemic in Côte d'Ivoire and was identified in January 2017 as a priority zoonosis by all stakeholders in public health. A well-designed integrated national rabies control is essential to attain the objective of zero human deaths from dog rabies by 2030. The current study describes the complementary elements of dog bite risk factors and the dog population estimate that are relevant for planning sustainable interventions. We conducted a transverse survey in 8'004 households in the departments of San Pedro (4'002) and Bouaké (4'002), covering both rural and urban areas. The dog-household ratio was estimated at one dog for three households (0.33) or one dog for 20 people (0.05). The owned canine population on a national level was estimated at 1'400'654 dogs (range 1'276'331 to 1'535'681). The main dog bite risk factors were dog ownership, being male, and living in urban San Pedro Department. The results lay a foundation for public engagement and further steps for mass vaccination of the household dog population to reach vaccination coverage of at least 80%. Stakeholders further recommend raising awareness of dog owners, reinforcing knowledge in school children and young boys, and behavior changes towards domestic animals.

Taenia solium cysticercosis in West Africa: status update.

Cysticercosis is caused by the larvae of the cestode Taenia solium. Few data are available on the prevalence of this disease in pigs and humans in West African countries. The aim of this study was to provide an overview of existing data concerning the spread of this parasitosis in the countries of the Economic Community of West African States (ECOWAS) on the basis of the literature published over the last five decades. Systematic searches for publications were carried out on PubMed and Google Scholar, as well as in certain regional and local journals. From a total of 501 articles initially retrieved concerning T. solium cysticercosis in West African countries, only 120 articles were relevant for this review and therefore finally retained. For pigs, only eight out of sixteen countries of the region have reported porcine cysticercosis. Post-mortem examination of carcasses at slaughterhouses, meat inspection at butcheries or tongue inspection in herds have been the main source of data, but may not entirely reflect actual parasite distribution. For humans, only five out of sixteen countries reported epidemiological data on neurocysticercosis. Most data referred to neurocysticercosis prevalence among epileptic patients or isolated clinical cases. Furthermore, existing data are often old. Overall, T. solium cysticercosis remains largely neglected in West Africa, and its prevalence appears not to be affected by any religion in particular. There is an urgent need to promote and implement health partnerships and programs on this disease in order to collect more data and identify sensitive populations in the countries of the ECOWAS area.

TITLE: La cysticercose à Taenia solium en Afrique de l'Ouest : état des lieux. ABSTRACT: La cysticercose est causée par les larves du cestode Taenia solium. Peu de données sont disponibles sur la prévalence de cette maladie chez les porcs et les humains dans les pays d'Afrique de l'Ouest. Le but de cette étude est de fournir un aperçu des données existantes concernant la propagation de cette parasitose dans les pays de la Communauté économique des États de l'Afrique de l'Ouest (CEDEAO) sur la base de la littérature publiée au cours des cinq dernières décennies. Des recherches systématiques de publications ont été effectuées sur PubMed, Google Scholar, ainsi que sur certaines revues régionales et locales. Sur un total de 501 articles initialement récupérés et concernant la cysticercose à T. solium dans les pays d'Afrique de l'Ouest, seuls 120 articles étaient pertinents pour cet examen et ont donc finalement été retenus. Pour les porcs, seulement huit des seize pays de la région ont signalé une cysticercose porcine. L'examen post mortem des carcasses dans les abattoirs, l'inspection de la viande dans les boucheries ou l'inspection de la langue dans le troupeau ont été la principale source de données, mais peuvent ne pas refléter entièrement la répartition réelle des parasites. Pour l'homme, seuls cinq pays sur seize ont rapporté des données épidémiologiques sur la neurocysticercose. La plupart des données se référaient à la prévalence de la neurocysticercose chez les épileptiques ou les cas cliniques isolés. De plus, les données existantes sont souvent anciennes. Dans l'ensemble, la cysticercose à T. solium reste largement négligée en Afrique de l'Ouest et sa prévalence ne semble être affectée par aucune religion en particulier. Il est urgent de promouvoir et de mettre en œuvre des partenariats et des programmes de santé sur cette maladie afin de collecter davantage de données et d'identifier les populations sensibles dans les pays de la zone CEDEAO.