RABIES AND DOG BITE IN CHILDREN: A DECADE OF EXPERIENCE IN SOKOTO. NIGERlA.

Abstract

A prospective study of cases of rabies in chi ld rcn in two major hospitals in Sukotu oyer a decade (1980 to 1(98) was complemented with a retrospective analysis of dog hitc injuries in children secn in these hospitals and thc Veter'inary Centre during thc same period. Data on rahics control by the relevant Statc Ministry were also analysed. There were 11 children with rahics (6 males, 5 females, aged 3 to 13 years, mcan = 7 years). All had history of dog hite, but in onl~' 2 cases was postcxposu re antirahics vaccination commenced. The incuhation period nmgcd from 1- 3 months (mcan = 1.7 months). Murtalitv was 100%. SUITiYalafter thc first symptom was short (3 - 6 days). Of the 991 victims of dog hitc sccn in thc vetcrinary centre, 62.t (r.3'!io) WCI'Cagcd < 12 years. Ma.iorit~· ofthc bites occurred in thc dry hot scason (March to .lunc). Ofthc 370 cases of doghite seen in thc hospitals 242 (65%) wcrc children aged 3.5 - II. 75 years (mcan = Sol, SD ± 2.5 years). Injuries were of gradc Il and III severity in 183 (88%) cases. Bitcs on the hcad and neck were commonest in child rcnundcr 5. Post exposure 111'01) hylaxi S was inappropriate or incomplete in the majOl'ity of cases, The majnrity ofthc dogs were stray. Most dogs arc no longcr vaccinated, because the veterinary cnfurcement machinery has collapsed, and the cost of vaccination has escalated. A new stn,teg." to control rabies in Nigeria is urgently needed, and should include efforts to educate health workers on the proper managemcnt of dog hite and thc enforcement of th •.. existing legislatul'c on dog population control and the vaccination of dogs.