Discrepancies in Data Reporting for Rabies, Africa

Louis H. Nel

Author affiliation: University of Pretoria, Pretoria, South Africa

Abstract

Human rabies is an ancient disease but in modern times has primarily been associated with dog rabies–endemic countries of Asia and Africa. From an African perspective, the inevitable and tragic consequences of rabies require serious reflection of the factors that continue to drive its neglect. Established as a major disease only after multiple introductions during the colonial era, rabies continues to spread into new reservoirs and territories in Africa. However, analysis of reported data identified major discrepancies that are indicators of poor surveillance, reporting, and cooperation among national, international, and global authorities. Ultimately, the absence of reliable and sustained data compromises the priority given to the control of rabies. Appropriate actions and changes, in accordance to the One Health philosophy and including aspects such as synchronized, shared, and unified global rabies data reporting, will not only be necessary, but also should be feasible.

Rabies, despite its high case-fatality rate and preventability (through efficacious preexposure and postexposure prophylaxis), has in recent years progressively become established as a neglected disease, and most human cases are associated with dog rabies endemic to countries in Africa and Asia. However, there are numerous other serious infectious diseases that, like rabies, are underreported and linked with poverty in the developing world. How then should these diseases be prioritized?
This report presents considerations that influence the priority status of rabies, as well as issues that could differentiate rabies and should play a role in establishing the relative role of this disease in Africa and other parts of the developing world. It also discusses 1 key area that needs to be addressed before a bona fide demonstration of rabies incidence and progress toward effective dog rabies control will be feasible. This area is the need for true cooperation and synergy between global organizations and national authorities with respect to responsibilities related to effective and thorough surveillance with synchronized and responsible data reporting. Analyses of examples from Africa indicate that the above aspects are seriously compromised.