1 Review of Rabies cases in the Paediatric Infectious Disease Unit, Mulago Hospital Dr Edison Mworozi Arwanire & Joseph Rujumba Department of Mulago Hospital and Presented at the Uganda Medical Association & Uganda Veterinary Association 1 st International ONE Health Conference February 2015 at Hotel Africana, Kampala

2 Overview Background Objectives Methods Results Conclusion

3 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)

4 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.

5 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

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

7 Methods Conducted a records review of Rabies cases admitted to the pediatric infectious diseases unit of Mulago National Referral Hospital from 1st January st December 2012 documenting – address, – age – sex – duration of hospitalization and – outcome of the cases.

8 Results From 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.

9 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.

10 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.

11 Thank you for your attention