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Review of Rabies cases in the Paediatric Infectious Disease Unit,

Mulago Hospital

Dr Edison Mworozi Arwanire & Joseph RujumbaDepartment of Mulago Hospital

Email: arwanire@yahoo.com and emworozi@gmail.com

Presented at the Uganda Medical Association & Uganda Veterinary Association 1st International ONE Health Conference 14-16 February

2015 at Hotel Africana, Kampala

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Overview

• Background• Objectives• Methods• Results• Conclusion

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Background • The Decade of Vaccines Collaboration commits

to improving the health and lives of women and children (WHO, UNICEF, NIAID, GAVI Alliance, and Bill & Melinda Gates Foundation 8 October 2012)

• Decade of Vaccines Collaboration is a vision to reach all people with the vaccines they need”” (WHO 2013)

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Background - Rabies• A zoonotic disease caused by the Rabies Virus

leading to Rabies encephalitis which is almost always fatal in humans.

• Despite being a preventable disease by vaccinating primarily animals and susceptible humans, Rabies affects about 55,000 people globally the majority being in Asia and Africa.

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Background to Rabies ct’d• It remains a relatively common problem in

developing countries including Uganda especially in children.

• Is associated with a high case fatality rate. • Mainly due to lack of immunization of domestic

animals particularly dogs and humans especially children bitten by such animals due to limited awareness and access to Rabies Vaccine.

• Inadequate/lack of PEP

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Objective

To document and highlight the fact that Rabies is a disease of public health importance in children in Uganda.

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Methods• Conducted a records review of Rabies cases

admitted to the pediatric infectious diseases unit of Mulago National Referral Hospital from 1st January 2010- 31st December 2012 documenting– address, – age – sex– duration of hospitalization and – outcome of the cases.

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Results• From 2010-2012 a total of 13 Children with

Rabies were admitted • Majority, 8/13(61.5%) were from Kampala

District. • Age range was 1yr and 4 months to 12yrs with an

average age of 7.6 yrs . • Almost all of the cases had been bitted by un

immunized domestic dogs.

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Results ct’d• By age category 8/13(61.5%) were aged ≥

7years, while 4/13(30.8 %) were aged 5-6 years • By gender, 11/13(85%) were males. • All the 13 children (100%) died. • The average duration of stay in hospital was 3.8

days (range 1-13 days) • The majority 7/12(58%) died within 1-3 days of

admission.

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Conclusion• Rabies infection in humans especially children is

a public health problem in Uganda with high mortality calling for a concerted effort by veterinary & health professionals to vaccinate all susceptible domestic animals especially dogs and human beings particulary children bitten by such animals.

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Thank you for your attention