Lack of surveillance data on the number of people bitten by dogs, the number of rabid dogs, or confirmed human deaths from rabies is making it difficult to prioritise the provision of the lifesaving vaccines.
Though the disease can be prevented by vaccinating dogs at a cost of less than Sh150, testing and vaccination of animals has lagged far behind the number of bites reported, leaving Kenyans ignorant of the true risk they face from the disease.
Effective vaccines against dog rabies are available in Kenya, but cost and the fact that they are not always available when needed have left Kenyans vulnerable to rabies, which is almost impossible to cure without immediate treatment.
The cost of administering post-exposure prophylaxis (PEP) after being bitten by a dog is at least Sh9,000 per person, without which the bite victim dies if the dog was rabid.
According to the National Rabies Elimination Strategy of 2014 which aims to eliminate the disease by 2030, rabies is endemic with Machakos, Makueni, Kitui, Siaya and Kisumu counties having particularly high prevalence.
Researchers from the Kenya Medical Research Institute (Kemri) are conducting a census dubbed Dog Cohort Study to identify the number of dogs in Siaya County, where only 15 per cent of bite victims have access to lifesaving treatment.
Through the study, they hope to understand the factors that underline rabies transmission.
The study will also ensure that people bitten by dogs are promptly provided with post-exposure prophylaxis and vaccines and create awareness through public education campaigns.
The World Health Organisation, which classified rabies as a neglected disease and made elimination a global goal, recommends that at least 70 per cent of the dogs in the country be vaccinated and the level of vaccination maintained for three years to prevent rabies transmission.
However, veterinarian and study coordinator Emmah Kwoba says that lack of data on the population of dogs in the country has been a major obstacle in implementing the national rabies elimination strategy, something that the Kemri study hopes to change.
Dr Kwoba notes that not knowing the dog population and rabies risk has led to unavailability of vaccines in counties as the devolved units have no idea how much to purchase or whether to buy any at all.
As part of the Dog Cohort Study, each dog and household has a unique ID and the canines are identified using the unique ID, their name, age, sex and coat colour.
The researchers collect information on the number of dogs per household, their origin, how they are fed and whether any dog got lost or died during the study period.
The dogs are reviewed once a month to track any changes in their health and veterinarians on the ground give advice to the owners and treat any sick dogs.
There is also a hotline which anyone can call to get prompt treatment if bitten by a dog. The study will conclude in August.
According to Thumbi Mwangi, a veterinary epidemiologist, lack of public awareness about the need to vaccinate dogs and failure to seek treatment following dog bites have been major drawbacks in the quest to eliminate rabies.
“Ensuring that all dogs are vaccinated is cheaper than waiting to treat the disease after a bite.
“But if bitten, one should seek medical treatment without delay instead of waiting for clinical symptoms to appear, because then it will be too late,” says Dr Mwangi, noting that there is also a challenge of lack of vaccines and treatments in some health facilities.