Rabies kills about 55 000 people every year and more than 90% of infected humans are considered getting the disease from dog-bites. To control the disease and eventually eliminate human rabies, the most efficient and economic method is to keep the dog population vaccinated. The objective of this thesis was to evaluate the situation of canine rabies in two urban areas in Lilongwe, Malawi, where canine rabies is enzootic. In each area 200 household-interviews were conducted in September and October 2013. Focal points were awareness of the disease, human incidence as well as vaccination coverage in the dog population. Furthermore an animal organization had vaccinated dogs in one of the areas in their community clinic, but not in the other area. A comparison in vaccination coverage was made between the areas to evaluate the impact of the work of the community clinic.
In total 98% had heard of rabies and 88% would seek medical care if bitten by a dog in order to get treatment against rabies. Hereby awareness of rabies must be considered high. The standard treatment regimen to prevent rabies after dog-bite in Lilongwe is five doses of vaccine, which also is the recommendation by the World Health Organization (WHO), but in average bitten people got only 3.7 doses. The reason is likely to be lack of vaccine doses.
Both areas had together vaccination coverage of 59% which is quite high when considering that it was only about a month left to the annual vaccination campaign at the time of the study. The human incidence of rabies in Lilongwe seems to be much higher than the annual officially reported number, which was estimated based on number of dog-bitten persons in the included areas in the study. Other studies have previously shown a correlation between number of dog-bites and number of human deaths in rabies. The vaccination coverage turned out to be higher in the area where the community clinic had not been based. Although the community clinic had not achieved especially high yearly coverage and it might not have contributed enough to make a difference.