Human Rabies Control – A Challenge to Public Health in Sri Lanka

A study done on effectiveness of rabies control strategies on reducing incidence of human rabies deaths in Sri Lanka by Dr. Vindya Kumarapeli of the Ministry of Health reveals that the rate of mass dog vaccination had increased from 3.2% to 49.3% during the period 1975 – 2007. However this coverage varies among districts.

During the period from 1975 -2005 the rate of dog elimination was reported to be less than 10%. The study also reveals that there was a significant inverse correlation between death rates from human rabies and dog vaccination rates and dog elimination rates.

Sri Lanka is among the ten leading countries in the world that report highest death rates from human rabies and animal bites requiring post-exposure treatment. Dogs are the main reservoir and transmitters of rabies in Sri Lanka. Mass dog vaccination, control of dog population and provision of post-exposure treatment to animal bite victims at risk are the main control strategies.

This study has been carried out using data from the Public Health Veterinary Services of the Ministry of Health to evaluate the effectiveness of rabies control strategies that had been implemented, on reducing incidence of human rabies.

The study had estimated dog populations based on mean human: dog ratio published for Asia to determine the denominator to calculate annual coverage of control strategies. Correlations were calculated between the rates of human rabies deaths and dog rabies control strategies. Geographic information system was used to illustrate district distributions of human rabies deaths with the estimated dog population densities aiming to identify areas at risk.

This study had recognized mass dog vaccination as the most effective strategy implemented so far and recommended that mass dog vaccination should continue to be the main dog rabies control strategy, yet the coverage needs to be improved. Optimum coverage and frequencies for dog vaccination and dog population control should be explored giving special emphasis on high risk areas as opposed to applying a blanket strategy to the entire country.

It also emphasizes the need to have better understanding of the dog ecology (population density, population structure such as age & sex distribution, confinement status etc) of stray and owned dogs in the context of the human environment and culture. It is also imperative to promote ‘responsible dog ownership’ through health education, advocacy, social mobilization and legislation: paying emphasis on dog registration, vaccination, birth control and movement restriction of dogs within premises. Coordination among regional Public Health and Veterinary services is imperative to strategize the control strategies, the study determines.

- Asian Tribune -