An assessment of the operationality and factors influencing the effectiveness of rabies surveillance in Gombe State, Nigeria.

Rabies remains a burden in Africa, disproportionately affecting the most vulnerable despite the availability of effective vaccines. Nigeria, the most populous African country, needs rapid disease control actions and commitments to achieve the goal of eliminating dog-mediated rabies by 2030. Surveillance is an essential element of effective disease control strategies. This study examined the current state of operationality of the rabies surveillance system for early case detection and management in Gombe state, Nigeria, through a One Health lens. It further examined the barriers impeding the effectiveness of the surveillance based on the perception of surveillance workers. Qualitative and quantitative methods were used to assess the structure of the system and its functioning. Data on dog bite and rabid cases obtained from the veterinary services in Gombe state were analysed descriptively. A total of 13 key informants were interviewed using a semi-structured interview guide. Qualitative data were analysed using thematic analysis to explore in depth the factors that influenced the operationality of the system. A total of 157 potential human exposures to rabies were identified in this study, out of which two people reportedly died at the health facility after showing symptoms highly suggestive of rabies. In terms of rabies surveillance and control, cross-sectoral collaboration was found between the human health and veterinary sectors for risk assessment of potential rabies exposures and its management. Some identified factors affecting the operations of the surveillance were inadequate funding, lack of infrastructure, lack of feedback from higher authorities and insufficient knowledge of rabies prevention and management. To improve the capacity for case detection and management within the state, the appropriate authorities may focus on increasing awareness about the disease to the populace to increase the number of cases identified by the system, employ more workers and strengthen the surveillance capability of existing workers.

Prospects for dog rabies elimination in Nigeria by 2030.

The attainment of the global target of zero dog-mediated human rabies by 2030 depends on functional rabies programmes. Nigeria, a rabies-endemic country, and the most populous country in Africa has a very poor rabies control strategy with a score of 1.5 out of 5 based on the Stepwise Approach towards Rabies Elimination (SARE). In this article, we report a scoping review that we conducted to highlight the strengths, weaknesses, opportunities and threats as well as situational analysis of rabies control in Nigeria and suggest a timeline for key activities that are needed to ensure zero by 30. Our findings reveal that rabies is grossly under-reported as only 998 human and 273 dog-suspected rabies cases were reported across Nigeria between 2017 and 2022. Our literature review also demonstrates a paucity of information on rabies in both human and animal health sectors. A total of 49 studies on dog rabies in Nigeria, with a predominance of reports from the North Central geopolitical region (48%, n = 23) were therefore included in this study. Currently, only 16.2% (n = 6/37) of Nigerian states have available data related to the estimated dog populations, the dog ownership rates, the vaccination status of dogs or the incidence of dog bites. Based on a dog-to-human ratio of 1:16.3, we estimated that the dog population in Nigeria was 12,969,368 (95% CI: 12,320,900-13,617,836). Thus, to attain herd immunity and dog rabies control in Nigeria, at least 9.1 million dogs must be vaccinated annually. Our review reveals that, despite the strengths and available opportunities to achieve rabies control in Nigeria by 2030, the weaknesses and challenges will make the attainment of zero by 30 very difficult or impossible. Nigeria's best-case scenario by the year 2030 is SARE stage 3-4 (control-elimination) out of 5. Otherwise, the rabies control programme might not surpass SARE stages 2-3. To attain zero by 30, Nigeria must re-strategize its current rabies control programme by funding and implementing the national strategic plan for rabies control, creating a rabies desk office in the 37 states (FCT inclusive), rigorously conducting mass vaccination campaigns, providing post-exposure prophylaxis, prioritizing mass enlightenment with a focus on responsible pet ownership and conduct baseline national rabies surveillance in the animal and human health sectors.

Molecular study of rabies virus in slaughtered dogs in Billiri and Kaltungo local government areas of Gombe state, Nigeria.

Rabies is one of the most dreadful diseases and a major viral zoonosis which has been shown to cause an almost 100% fatality rate in infected victims. It is characterized by acute progressive encephalitis in mammals. This study determined the genotypic characteristics of rabies virus in dogs slaughtered for human consumption based on sequence of a fragment of nucleoprotein gene. Brain tissues were collected from 50 dogs slaughtered in Billiri and Kaltungo Local Government Areas of Gombe State, Nigeria. Direct fluorescent antibody test (DFAT) was used to screen for the presence of rabies virus antigen. Viral RNA isolated from DFAT positive brain tissues were subjected to the reverse transcription polymerase chain reaction (RT-PCR) followed by sequencing of the amplicons. Maximum Likelihood (ML) was used to construct a phylogenetic tree for sequences obtained with 1000 bootstrap replicates. The DFAT detected rabies antigen in 3 (6%) of the 50 dog brain tissues, from which 1 (2%) was positive by RT-PCR. ML phylogeny approach of the nucleotide sequences inferred members as originating lyssavirus genus and dog species. Essentially, MK234794 in this study displayed 99.3% sequence similarity with other related rabies viruses in the Africa 2 cluster (Nigeria, Cameroon, Chad and Niger). Interestingly, MK234794 showed no cluster relation with the Africa 1a, 1b, 3 and Africa 4 clades, respectively. This indicates there is in-country and trans-boundary circulation of the rabies viruses with no co-circulation between the Africa lineages, especially as dogs are continuously being traded due to consumption of dog meat in West Africa. This finding has given additional insight into the molecular epidemiology of rabies virus in Nigeria, therefore providing more baseline information for future design of rabies control programs in the country.