"Henceforth, I will ensure the rigorous enforcement of dog vaccinations, and non-compliance with the directive will face consequences. To guarantee the effectiveness of this enforcement, sentimentality towards family, friends, and loved ones will not be a barrier."

This was the warning issued by Nana Agyei Jumah, the Chief of Nsutam in Effiduasi of the Ashanti Region, following the tragic deaths of children due to rabies from dog bites.

Nana Jumah conveyed this caution to his community during a gathering aimed at strategising on addressing the increasing prevalence of Neglected Tropical Diseases (NTDs) in the Sekyere East District. He emphasised that having dogs is not inherently problematic, but his concern lies in the presence of numerous idle dogs in the area.

"Why are there so many dogs causing harm to children and adults when grasscutters, a common prey for dogs, are scarcely found?" he questioned.

He expressed distress over the reported deaths of seven children in the community, some of whom he said might have had promising future. Nana issued a stern warning that soon, every unvaccinated dog would face elimination.

Harrowing story of a woman whose daughter was bitten by a dog

The Chief recounted an incident where a woman shared a harrowing picture of her daughter bitten by a dog belonging to a Methodist Bishop. The severity of the bite resulted in the tearing of the girl's flesh.

"I informed the woman that I would permit the dog to be euthanized, and despite her disagreement, I insisted on it. The next morning, the dog was put down. It was then revealed that the dog had not received vaccinations for the past two years. This raises concerns, as even an educated person neglected such a crucial responsibility. This begs the question of how those who are ignorant and illiterate might handle such matters."

Nana Jumah also pointed out an interesting fact, noting that the primary reason for dogs resorting to biting is the neglect by owners who fail to feed them, even with the meat they have hunted. This deprivation leads to the dogs becoming hungry, wild, and ultimately prone to aggressive behaviour.

"I implore each of you to make a concerted effort to curb the spread of rabies by adhering to the established rules," he emphasised.

Nana Jumah highlighted the existing obligations for dog owners, emphasising that individuals who own dogs are mandated to vaccinate them, failing which they must be held accountable. He expressed disappointment in the inefficacy of these obligations.

Nana Jumah lamented that the responses from dog owners indicate a lack of compliance with vaccination requirements, posing a significant threat to society. He underscored the heightened risk of rabies infection for anyone bitten by an unvaccinated dog.

“Notably, children bear the brunt of these incidents, with a striking ratio of 30:1 in dog bite cases between children and adults. This discrepancy is attributed to the fact that children often engage more frequently with pets, especially the specific pet in question,” Nana Jumah said.

Rabies, categorised as a Neglected Tropical Disease (NTD), is a viral infection that frequently leads to a fatal outcome.

Concern over the escalating number of NTDs

The District Director of Health for Sekyere East, Dr. Justice Ofori-Amoah, expressed concern over the escalating number of Neglected Tropical Diseases (NTDs) in the district and appealed to stakeholders for assistance in combating these illnesses.

Dr. Ofori-Amoah underscored the significance of community engagement as a critical measure to reduce further cases. He also emphasised the importance of patients seeking prompt medical attention by visiting health facilities.

In 2023 alone, the district reported significant instances of NTDs, with 2,471 cases of scabies, 22 cases of lymphatic filariasis, 55 cases of yaws, and 5 cases of leprosy. Regrettably, there were 7 fatalities among children attributed to rabies cases. The alarming statistics highlight the urgent need for collaborative efforts in addressing and preventing the spread of these diseases within the community.

Situation in picture

In Ghana, particularly in the Ashanti and Greater Accra regions, the incidence of dog bite cases has been on the rise over the years, primarily attributed to the increasing population of stray dogs. According to the World Health Organization (WHO), approximately 70,000 individuals succumb to rabies annually on a global scale.

Shockingly, out of the estimated 70,000 annual rabies-related fatalities, 99 percent occur in Africa and Asia, highlighting the disproportionate impact on developing countries, including Ghana. Despite efforts to address this public health concern, the prevalence of rabies persists.

Rabies remains a pervasive threat in over 150 countries and territories, with a notable statistic revealing that approximately 40 percent of those bitten by potentially rabid animals are children aged between five and 15. This underscores the vulnerability of younger age groups to rabies infections, necessitating increased awareness, preventive measures, and intervention strategies to mitigate the risks associated with dog bites and rabies transmission.

MoFA, GHS collaboration

In July 2023, the Ministry of Food and Agriculture, in collaboration with the Ghana Health Service and other development partners, launched the National Rabies Prevention Campaign in Accra under the theme "Prevent the Bite or Scratch! Vaccinate your Dog! Stop Rabies Now!" The initiative aimed to increase awareness about rabies, educate the public on prevention measures, and highlight ways to mitigate the risk of exposure.

During the launch, Dr. Franklin Aseidu Bekoe, Director of the Public Health Division, spoke on behalf of Dr. Patrick Kuma-Aboagye, the Director-General of the Ghana Health Service. Dr. Bekoe emphasised that rabies is a serious and potentially life-threatening issue that demands urgent attention.

He revealed that rabies accounted for 153 reported cases, resulting in 10 deaths in 2023 so far. Dr. Bekoe urged pet owners to prioritise the vaccination of their animals, emphasising the importance of safeguarding both individuals and communities from the risks associated with rabies.

Addressing the audience, Dr. Mickey Aryee, a representative of the Veterinary Services Department, proposed a strategic shift in utilising global financial resources.

He suggested redirecting the funds currently allocated for treating individuals bitten by potentially rabid dogs into a sustained and aggressive free mass vaccination campaign. Dr. Aryee envisioned this approach unfolding progressively over five years, with intensive vaccination efforts concentrated within a two-month time-frame each year.

Control & Solutions

Efforts towards rabies elimination center on dog vaccination and the prevention of dog bites. Numerous countries have achieved rabies-free status through strategic initiatives, endorsed by organizations such as the Centre for Disease Control and Prevention.

The financial implications of treating rabies exposure are substantial, with Post-Exposure Prophylaxis (PEP) costs averaging US$40 in Africa and US$49 in Asia. In the context of Africa and Ghana, these expenses can be financially devastating for affected families.

Irene Efua Acquah, District Veterinary officer for Sekyere East asserted that the most cost-effective approach to prevent rabies in humans is through the vaccination of dogs. Dog vaccination not only reduces rabies-related fatalities but also diminishes the demand for PEP, as an integral component of patient care for dog bite incidents.

She urged parents to promptly seek medical attention at healthcare facilities if their children suffer dog bites, while also advising dog owners to ensure their dogs receive annual vaccinations, which cost only 30 cedis.

Irene emphasised that the PEP to prevent rabies in humans within the district is nearly 700 cedis. She stressed the importance of taking dog bite cases seriously and encouraged residents to seek proper medical treatment at hospitals.

"Cases of dog bites should be treated seriously. It is crucial to visit the hospital and ensure you receive the right treatment before considering any other actions," advised Irene.

The challenge posed by rabies underscores the significance of the Veterinary Services Directorate (VSD) under the Ministry of Food and Agriculture. Currently undergoing retooling, the VSD aims to enhance institutional capacity, fortifying its ability to prevent, detect, and control animal diseases, including rabies.

With robust resources and effective programme management, Ghana is well-positioned to eliminate rabies. Several European countries and select African nations, including Cape Verde, Libya, Mauritius, and Seychelles, have successfully eradicated rabies. Key to preventing rabies infections is the avoidance of dog bites, particularly for both children and adults. Additionally, a comprehensive rabies vaccination programme holds the potential to reduce both human rabies incidence and the financial burden associated with treating dog bites.

Increasing awareness of rabies prevention and control within communities is crucial, especially among pet owners. In cases of suspected rabies exposure, immediate notification to veterinary services is essential.

Irene said the biting animal should be identified and quarantined for observation. Simultaneously, proper wound care, including flushing and washing with appropriate substances, is crucial for at least 15 minutes after contact with a suspected rabid animal.

Dr. Ofori-Amoah Appeal

Dr. Ofori-Amoah is urging collaborative efforts to prevent any rabies cases in the district in 2024 and beyond. Emphasising the importance of community engagement, he stresses the need for residents to vaccinate their dogs and promptly report any incidents of dog bites.

He said, health officials will then take swift action to address suspected cases, mitigating the risk of fatalities. The proactive involvement of the community and timely response from health authorities is crucial in ensuring a rabies-free environment in the district.

Dr. Ofori-Amoah is appealing for logistical support to facilitate the reporting and handling of rabies cases by health officials, volunteers, and teachers. Recognising the importance of streamlined processes, he emphasises the need for efficient mechanisms that enable swift action in addressing potential rabies incidents. This logistical support will enhance the capacity of key stakeholders, ensuring a more effective and coordinated approach to the prevention and management of rabies cases in the district.