title: Survey of animal bite injuries and their management for an estimate of human rabies deaths in N'Djaména, Chad.
abstract: OBJECTIVE
  To estimate the annual human rabies incidence as a baseline prior to mass dog vaccination campaigns in N'Djaména, Chad.
  
  
  METHODS
  Survey of animal bites, involving 50% of all healthcare providers in N'Djaména, from September 2008 to April 2009. Of 86 people exposed to a suspected rabid animal, 50% received post-exposure vaccination and a further 8% had their wound cleaned. We estimated annual incidence of bites from suspected rabid animals of 12.9/100,000 and an incidence of 0.7 human rabies deaths/100,000, resulting in 7 estimated deaths (95% confidence interval 4-10 deaths) per year in N'Djaména. 14% of bite victims sought help from veterinarians.
  
  
  CONCLUSIONS
  Closer cooperation between physicians and veterinarians warrants more effective rabies control. The high proportion (42%) of potentially exposed people without post-exposure vaccination or wound treatment necessitates urgent attention.
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Frey
authors.forename: R
authors.initials: R
authors.lastname: Mindekem
authors.forename: H
authors.initials: H
authors.lastname: Kessely
authors.forename: D
authors.initials: D
authors.lastname: Doumagoum Moto
authors.forename: S
authors.initials: S
authors.lastname: Naïssengar
authors.forename: J
authors.initials: J
authors.lastname: Zinsstag
authors.forename: E
authors.initials: E
authors.lastname: Schelling
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D001733:Bites and Stings / Q000150:complications / Q000453:epidemiology* / Q000628:therapy; D002415:Cats; D002596:Chad / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004283:Dog Diseases / Q000517:prevention & control; D004285:Dogs; D018397:Equidae; D005260:Female; D000882:Haplorhini; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D032541:Mass Vaccination / Q000662:veterinary; D008875:Middle Aged; D011818:Rabies / Q000209:etiology / Q000401:mortality* / Q000662:veterinary; D055815:Young Adult
keywords: N'Djaména; animal bites; human deaths; human rabies incidence; post-exposure prophylaxis; rabies; wound management