A descriptive study of urban rabies during the civil war in Sierra Leone: 1995-2001.

A study was conducted to assess the effects of the breakdown in internal infrastructure on the incidence of canine-transmitted human rabies in urban areas of Sierra Leone during the course of the civil war between 1995 and 2001. Data from provincial hospitals in the Western Area and Southern Province indicated that there was a significant increase in the incidence of canine-transmitted urban human rabies chi2 = 39.63, p < 0.0001, particularly among children chi2 = 23.73, p < 0.0001, over the course of the war. In the Western Area in 2001, towards the end of the war, there was a significant increase in adult cases, which was reflected in the observed versus the expected chi2 ratio (70 versus 53). Interview-based questionnaire surveys in Freetown administered between 2001 and 2002 indicated that dogs were commonly kept for security reasons, and were largely unrestrained and unlicensed, regardless of the socioeconomic status of the owner. Virtually all dogs were unvaccinated and were mainly living in close proximity with humans. This study indicated that there is an urgent requirement for appropriate mass rabies vaccination campaigns for pet dogs and for campaigns to manipulate the urban habitat to control free-roaming and wandering but owned dog populations in Freetown and other urban areas in the provinces of Sierra Leone. Interview-based questionnaires administered in three districts of Freetown indicated a relatively high degree of uniformity in dog husbandry and veterinary care habits across a wide range of socioeconomic status categories in dog owners.