Shimbo Pastory and Victoria Lyimo
This article was published in The Citizen Newspaper, Tanzania on 2nd January, 2024
Rabies disease, (in Kiswahili – kichaa cha mbwa), is a deadly viral disease which has survived over four millennia. It is one of the diseases that can be transferred between humans and animals, experts call these ‘zoonotic diseases.’ At the moment, the World Health Organization (WHO) classifies rabies as a vaccine-preventable viral disease, though it is among the deadliest diseases, with a 99% mortality rate for unvaccinated people.
For humans, rabies infection leads to fever, pain, unusual tingling, pricking or burning feeling at the wound. The patient may later experience hallucinations, abnormal behaviour, agitations, confusion, hydrophobia (fear of water), unusual vocalizations and insomnia (sleep disorder). It is a fatal disease that may irreparably affect the nervous system and cause inflammation of the brain (encephalitis) in all mammals who acquire it.
Wild rabies is often spread by raccoons, skunks, bats and foxes who are its most prominent carriers, while among domestic animals, dogs, cats and cattle are the most prominent rabid carriers. Animals can transfer rabies among themselves as in attacks and fights. At its peak, rabid animals become aggressive and fearless, highly excitable, drool excessively, and they eventually paralyse and become unable to eat.
The government needs active and responsive collaboration from the citizens and organizations to raise awareness, conduct mass vaccinations, and eliminate stray dogs. The slow pace of effectiveness in control has led to rabies being internationally classified as a neglected tropical disease (NTD).
The WHO data establish that globally, dogs are the main source of rabies transmission to humans. 95% of rabies deaths occur in the continents of Asia and Africa. People die in tens of thousands every year.
The cumulative record of 2021 recorded 59,000 deaths, equivalent to 6 people per hour for the entire year. According to WHO the actual figure is much higher, as some cases are not reported.
On the 2023 World Rabies Day, the Director General of the African Centre for Disease Control and Prevention (Africa-CDC), Jean Kaseya said, “In Africa, about 25,000 human deaths are associated with rabies every year, and approximately 40% of these rabies deaths occur in children under 15 years of age.”
The Local Situation
Tanzania has recorded rabies incidences since 1932. Since then the disease has spread widely in the country. According to the Rabies Control Report in Tanzania has resulted in over 1,500 deaths in the year 2021, and even higher figures in the past years. This is equivalent to losing at least 4 people each day of the year, meaning at least one person every 6 hours.
The Tanzanian government has invested a ton of effort to combat this disease, in combined interventional efforts on animals and humans as well. Through the integrated disease surveillance response system, a strong channel for real-time reporting of the incidences of rabies from all levels to the Ministry of Health has been established. Upon reporting response actions are implemented immediately.
Through the integrated disease surveillance response channel, the government has mapped out and established 8 rabies investigating zones covering the entire country. In addition, the government has been performing rabies vaccination campaigns for dogs and cats through the Tanzania Animal Protection Organization. These campaigns appear to bear fruits.
There has also been an increase in vaccination levels against rabies, easier access to vaccines, and a broadened awareness even in interior communities. Through different administrative levels as in regions, councils and wards, the government has created a working channel for the prevention, controlling and reporting of rabies.
According to data by the WHO Rabies Bulletin, which is the Rabies Information System of the WHO, Tanzania is classified as a country where canine rabies (spread by dog species) is an ‘endemic with control.’
Local Challenges
There is a challenge of vulnerability due to exposure to unvaccinated stray dogs in the streets and households. With the difficulty of locating them, vaccination is impeded. There is also a lack of awareness among people, making them less cautious. Many deaths could be prevented if people were informed.
Generally, people do not know much about diseases which can be contracted from animals, what animals to avoid, and not to eat, and in what situations medical help should be sought. Communities need to be taught to keep their animals safely and to get them vaccinated.
Shimbo Pastory is a journalist and student at Ateneo de Manila University, Manila, Philippines. Victoria Lyimo is a nurse, and holds a master’s in public health (MPH) from the University of Dodoma, Tanzania.
