Epidemiology of Rabies in Botswana
Notifications of animal rabies have shown an upward trend in Botswana during the recent years and the number of notified human exposures to rabies is disturbingly high.
The number of human cases/deaths from rabies in Botswana (by 1982 5), however, is comparatively low for the developing world, although any number of rabies fatalities obviously must be considered too high regarding the existing possibilities for effective post-exposure treatment in Botswana.
On the basis of existing information on the epidemiology of human rabies in Botswana it is not possible to define any high risk age group, season or geographical region in the country.
Certain occupational groups have — on the basis of international experience — been defined as high risk groups and receive pre-exposure anti-rabies prophylaxis.
Although the health information system in Botswana still has problems in terms of its validity and specificity regarding human rabies, it seems to be possible to conclude on the basis of existing material that post-exposure anti-rabies prophylaxis has proven its effectiveness. The high costs for the treatment are motivated by this effectiveness.
In the short term perspective the rabies control programme in Botswana will continue to be based on its present three components: veterinary precautions, standardized treatment of animal bites in all health facilities and pre-exposure vaccination of high-risk groups.
All of the components will be reinforced through the establishment of an inter-ministerial committee with a central responsibility for rabies surveillance and control.
In the long term perspective — regarding the endemicity of rabies in Botswana, the high costs for post-exposure anti-rabies prophylaxis (for 1982 the equivalent of approximately US $ 40,000) and the present number of cases/deaths from rabies in spite of the availability of this treatment — prophylactic (pre-exposure) vaccinations of all children in Botswana might be considered at a later stage. The Ministry of Health is following the scientific development in this field with particular interest. Rabies is endemic in Botswana, affecting mainly animals such as dogs, jackals and cats. The main reservoir of the infection is probably the wild, carnivorous animals such as jackals, while domestic animals like dogs in most cases are responsible for the transmission to man.
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