Spatial-Temporal Distribution and Some Associated Factors of Rabies in Dhamar Governorate, Yemen: A Retrospective Study 2011–2017

Abstract

Rabies is a fatal zoonotic disease of mammals, including humans. It remains a public health problem in many Asian and African countries, including Yemen. This study aimed to describe the spatial-temporal distributions and associated risk factors of rabies in Dhamar governorate, Yemen. Data on reported rabies cases for the years 2011 to 2017 was obtained from the National Rabies Control Program (NRCP)-Unit of Dhamar Governorate. Three rabies indicators were analyzed, including total bites, positive bites, and the number of deaths. The association of rabies indicators with reporting year, month/season, district, as well as the age and gender of the victims, was assessed. A total of 13,706 bites, 2,555 positive bites, and 49 deaths due to rabies were reported in Dhamar governorate between 2011 and 2017. The annual incidence was averaged at 111.64 bites, 20.80 positive bites, and 0.402 deaths per 100,000 capita. Incidence in some rural areas was as high as in urban areas, and it was significantly higher in the eastern districts than in the western districts. The highest exposure occurred in winter (December–February) while the lowest exposure occurred in summer (June–August). The incidence was significantly higher in males (OR ≥ 2.36) and in age strata 5-14 years (OR ≥ 2.42). Rabies is still endemic in Dhamar governorate, and several factors affect exposure to the disease. Factors associated with higher exposure in some districts need to be clarified, in particular the determination of the local wildlife reservoir(s) and its distribution/mobility. Study the incidence of rabies in animals, like bovine and equine species, and their role in transmission of the disease is also encouraged.