Republic of Sudan Federal Ministry of Animal Resources & Fisheries (FMAR&F) Intercountry Expert Workshop on protecting Humans from Domestic and Wildlife Rabies in Jordan and the Middle East, 23-25 June 2008, Amman, Jordan
Rabies Country Report/Sudan
Dr. Ibrahim Hassan Ahmed Director of Animal Health 7/13/2008
Rabies in Sudan
1
Republic of Sudan
Policies and strategies Development of infrastructures Personnel development and capacity building Technology transfer Improvement of basic services Livestock export promotion and upgrading Encouragement of production of livestock production inputs and establishment of private companies Laws and legislation Encouraging investment in field of animal resources and fisheries through creation of conducive and attractive conditions. 7/13/2008
Rabies in Sudan
2
Republic of Sudan
Animal health and disease control During the last 15 years a lot of efforts were exerted in improving livestock health. Execution of PARC/PACE/LESP projects through regional cooperation. Eradication of rinderpest disease and recognition from OIE as free from rinderpest (certificate). Control of all devastating diseases. Provision of 108 mobile veterinary units for field veterinary services Support from international and regional organizations. Cooperation and coordination with neighboring countries. Legislation and laws. The country practice routine vaccination against infectious diseases.
7/13/2008
Rabies in Sudan
3
Livestock Sector in Sudan
Republic of Sudan
The livestock sector is an important contributor to the over all economy of the Sudan where more than 40%of the population depend socially and economically on livestock, this why the government is doing the best for protection and improvement of these resources. The sector contributes approximately 23% to GDP, 40% to the total agricultural export and provides over 20%of the country foreign exchange earning in addition to securing meat and milk for local consumption and provides seasonable income for their keepers. 7/13/2008
Rabies in Sudan
4
Animal population Distribution
N
NORTHERN SECTOR
#
#
EASTERN SECTOR WESTERN SECTOR
#
CENTRAL SECTOR
#
SOUTHERN SECTOR #
Cattle Shee p G oats C am el
100
0
100
200
300
400
500 Mile s
Republic of Sudan
Veterinary Services System The official veterinary services consists of the Federal Ministry of Animal Resources and Fisheries (FMAR&F), headed by the Federal Minister of Animal Resources, followed by Undersecretary and Director General, Animal Health and Epizootic Disease control at National level. At the state level there are state directors General who are responsible for all veterinary activities in the states. 7/13/2008
Rabies in Sudan
6
Republic of Sudan
At the locality level, there is a veterinary officer responsible for all veterinary activities in the locality. At the administrative unit level (villages), not all villages have a veterinary officer, but animal health technicians and Community Animal Health Workers (CAHWs) who are responsible for all veterinary activities
7/13/2008
Rabies in Sudan
7
Republic of Sudan
The total number of veterinarians officially registered under the Sudan Veterinary Council is 7,000. A total of 2,000 veterinarians are working fulltime in the government veterinary services at the central and state levels. Those vets are assisted by around 1,475 technicians. The private veterinary sector plays a vital role in the delivery of animal health services which are carried out by around 2,000 veterinarians both in the commercial sector and the rural areas. In the far remote and marginalized areas, the community-based animal health workers provide veterinary services to the livestock owners as part of a network linking the community with the public and private sectors. Their current number is around 3,000 active CAHWs. The main operation areas are located in southern, western areas.
7/13/2008
Rabies in Sudan
8
REPUBLIC OF SUDAN
ORGANOGRAM OF THE FEDERAL MINISTRY OF ANIMAL RESOURCES & FISHETRIES (ANIMAL HEALTH AND EPIZOOTIC DISEASES CONTROL) MINISTRY OF
FEDERAL MINISTER OF ANIMAL RESOURCES & FISHERIES
SCIENCE &
VET SUPPLIES ANIMAL RESOURCES UNDERSECRETARY
ANIMAL PRODUCTION DEVELOPMENT
GENERAL AFFAIRS
EXTENSION
ANIM HEALTH & EPIZOOTIC DISEASES CONTROL
VET HOSP &
REGIONAL LABORATORIES
DIAGNOSTIC CENTERS
CHECK POINTS
QUORANTINES & MEAT HYGIENE
LESP
EPIZOOTIC DISEASES CONTROL
ANIMAL HEALTH
DISPENSARIES
PLANNING & ANIMAL RESOURCES ECONOMICS
FISHERIES & AQUARIUM
STATES COORD. UNIT
DIS SURV & INVSTIG
VET DRUGS AND BIOLOGICS
FIELD OPERAT.
VET DRUGS
PRIVATE PRACTICES
VET EQUIP
REGIONAL DIRECTORATES OF ANIMAL RESOURCES
E gy p t ea Red S
Veterinary Services Distribution 7/13/2008
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P A C E -S u d a n , D M E U , Aug ust 200 5 D r . H .Y .M .A .
Rabies in Sudan
U g an d a
K en y a
10
Republic of Sudan
Laboratory Structure 7/13/2008
Rabies in Sudan
11
Mobile Unit Distribution , Used & Required
Y # (4) {x
(8) NORTHERN SECTOR
WESTERN SECTOR
Y # (7) {x (15) EASTERN SECTOR
Y # (37)
Y # (18) {x (20)
{x (30)
CENTRAL SECTOR
SOUTHERN SECTOR Y # (16)
{x (25)
Y #
currently used mobile units
{x
Required Mobile units N W
E S
500
0
500
1000 Mile
slaughterhouses Distribution , Exists & Proposed .
NORTHERN SECTOR Kadaro \ Sabaloga & \ & \ Ghanawa& \ & Jemco
WESTERN SECTOR Z $ Alfashir
CENTRAL SECTOR
\ & AlRadwan EASTERN SECTOR
Z $ Gedarif
Z $ Z $ Elobeid Rabak {x
\& Nyala
Z $ Faloug
SOUTHERN SECTOR
N
\ &
slaughterhouses
Z $
proposed slaughterhouses
W
E S
300
0
300
600
900 Miles
Extension campaigns
N
NORTHERN SECTOR sedon
EASTERN SECTOR
shendi kabkabyia WESTERN SECTOR
CENTRAL SECTOR
Dilling
kotom kondi lake Umdafoug
kosti Z $
Abujebaiha kailk
Butana
Faloug
Abinaama Gessan
Bantiu AlNassir SOUTHERN SOUTHERN SECTOR SECTOR
300
0
300
600
900 Miles
Republic of Sudan
Epidemiology of Rabies in Sudan Rabies is one of the serious zoonotic diseases; it is considered one of the major public health problems worldwide. The disease is endemic in Sudan; it’s first report was in 1904. Entrance of rabies to Sudan suggested being from Eritrea and Abyssinia to the eastern part and from west Africa to Darfur then to the other parts of the country. 7/13/2008
Rabies in Sudan
15
Republic of Sudan
Epidemiology of Rabies in Sudan/ cont. 1531 out of 5375 brain samples tested for rabies were found positive during 1935-1959. During 1904-1970 reported rabies positive cases in Sudan were 2070, 37.3% of them were dogs. An increase rabies incidence in Khartoum state was noticed during 1975-1985, 117 out of 2044 brain samples tested for rabies during 1977-87, were positive where 66.7% of them were dogs. 7/13/2008
Rabies in Sudan
16
Republic of Sudan
Epidemiology of Rabies in Sudan/ cont. During 1988-1991 a total of 55514 human rabies post exposures and 1964 suspected animals rabies had been reported in Sudan. Reported rabies suspected animals in Sudan during 1992-1998, 492 were dogs, 314 goats, 171 donkeys, 69163 human rabies post exposures and 165 deaths had been reported during the same period. 7/13/2008
Rabies in Sudan
17
Republic of Sudan
Epidemiology of Rabies in Sudan/ cont. During the period 1992-2002 the reported animal rabies suspects in Sudan were 2656(1401were in Khartoum) dogs, goats, donkeys, are the main animals involved Laboratory confirmed rabies cases during the period were 243 out of 424. During this period 180959 human rabies postexposures and 253 deaths of the disease had been reported. 7/13/2008
Rabies in Sudan
18
Republic of Sudan
Rabies Laboratory Diagnosis Rabies Laboratory Diagnosis in Sudan is restricted at Central Veterinary Research Laboratory at Khartoum, which is not easily reachable to many states. Fluorescent antibody test (FAT) which is recommended by WHO routinely used for laboratory diagnosis. 19 out of 33 brain samples tested for rabies were found positive during 2003-2007. 7/13/2008
Rabies in Sudan
19
Republic of Sudan
Rabies Laboratory Diagnosis/ cont. The number of laboratory diagnosed samples are low due to difficulty of sample transport from different states to the Central Veterinary Research Laboratory at Khartoum. About 95% of brain samples are usually submitted from Khartoum Veterinary Clinic and 50-60%of the cases had been destructed which explains the relatively low percentage of positive cases (57.6%). Availability of fluorescent microscope at Regional Laboratories as well as facilities of rapid and standard means of sample transport to the central laboratory is highly recommended.
7/13/2008
Rabies in Sudan
20
Results of rabies laboratory diagnosis using FAT (table)
Republic of Sudan
Animals
2003
2004
2005
2006
2007
Total
%+ve
Dog +ve
-
-
1
1
1
3
60%
-ve
-
1
-
1
-
2
+ve
-
-
-
1
-
1
-ve
2
2
-
-
-
4
+ve
-
-
2
-
1
3
-ve
-
2
-
-
1
3
Cat Goat
7/13/2008
Results
Rabies in Sudan
20% 50%
21
Republic of Sudan
Results of rabies laboratory diagnosis using FAT (table) cont. Animal s
Results 2003
2004
2005
2006
2007
Total
%+ve
Equine
+ve -ve +ve -ve +ve -ve +ve -ve
2 2 1 1 3 8
5 1 1 9 1
2 1
2 4 1
7 1 3 3 2 1 19 14
87.5%
Cattle
Camel
total
7/13/2008
1 1 1 3
Rabies in Sudan
50% 66.7%
57.6%
22
Republic of Sudan
Nature of rabies virus in Sudan During 1988-1998 rabies isolates were tested in Sudan using RT/PCR and sequenced in collaboration with WHO rabies reference laboratory at Tubingen , Germany. the results showed the detection of classical rabies virus 1 in all positive samples, no other rabies related viruses had been detected. 7/13/2008
Rabies in Sudan
23
Republic of Sudan
Nature of rabies in Sudan/ cont. Sudanese dog rabies isolates were used to establish a molecular phylogeny based on partial sequence of the viral nucleoprotein. These isolates from a tight cluster of isolates with a single outlier, they were found most closely to isolates from Ethiopia. Sudan rabies isolates belong to the Africa 1a group of viruses that are present throughout most of North Africa 7/13/2008
Rabies in Sudan
24
Republic of Sudan
Nature of rabies virus in Sudan/ cont. More than 95% of rabies isolates tested was from Khartoum State. Further molecular biology work on rabies isolates from different states specially eastern states is highly recommended as Mokola virus had been reported in Ethiopia last decade.
7/13/2008
Rabies in Sudan
25
Structure and composition of rabies virus (longitudinal diagram)
Republic of Sudan
Rabies suspected animals in different states (2003-2007) Continuous rabies with some outbreaks are regularly reported in different states of the Sudan During 2003-2007 a total of 1328 rabies suspected animals had been reported to the veterinary clinics in Sudan. Year
Khartoum
Central
Northern
Eastern
Kordofan
Darfur
Total
2003 2004 2005 2006 2007 Total
38 15 36 35 124
1 4 7 21 33
19 19
9 89 98
180 540 99 119 938
5 103 8 116
252 662 142 35 273 1328
7/13/2008
Rabies in Sudan
28
Republic of Sudan
Species of reported rabies suspected animals in Sudan (2003-2007)
Dogs are the main animals involved in rabies epidemiology in Sudan (52%). Goats and donkeys are also playing significant role in rabies incidence. Year
Dog
Cat
Monkey
Goat
Sheep
Donkey
Horse
Cattle
Camel
Total
2003
175
7
3
16
4
39
-
4
4
252
2004
323
76
8
71
41
73
-
18
52
662
2005
65
4
1
20
8
31
3
8
2
142
2006
9
3
2
9
2
10
-
-
-
35
2007
117
1
1
11
26
58
1
17
-
232
Total
689
91
15
127
81
211
4
47
58
1323
7/13/2008
Rabies in Sudan
29
Republic of Sudan
Human rabies post-exposure treatment and deaths of the disease
City Khartoum
Central
Eastern
Kordofan
7/13/2008
2003
2004
2005
2006
Total
Post-exposure
5062
4948
5378
5323
20711
Death
-
-
1
-
1
Post-exposure
1148
1410
1645
922
5125
Death
2
5
4
2
13
Post-exposure
406
377
739
798
2320
Death
2
-
-
-
2
Post-exposure
794
1322
2000
1259
2375
Death
-
1
1
-
2
Rabies in Sudan
30
uman rabies post-exposure treatments and deaths from the disease in Sudan/ Cont.
City
Northern
Darfur
outhern Southern
otal
2003
2004
2005
2006
Total
Post-expoure
141
228
117
66
552
Death
-
-
-
-
-
Post-exposure
1445
1413
2630
2224
7712
Death
-
-
-
-
-
Post-exposure
188
195
418
361
1162
Death
-
-
-
-
-
Post-exposure
9184
9893
12922
10953
42952
Death
4
6
6
2
18
Human Rabies
Human rabies diagnosis in Sudan depends mainly on clinical bases and history of animal bite, laboratory confirmation is rarely applied. Eighteen human rabies deaths had been reported during 2003-2006 meanwhile 42952 humans had received rabies post-exposure treatment in Sudan. It was noticed that there is slight decrease in number of reported human rabies post-exposure treatment in 2006 compared to 2005 which is mainly due to increase in number of vaccinated animals in 2005-2006. Khartoum state is usually showing the highest number of human rabies post-exposure. The highest figures of human rabies deaths is noticed in the central state.
Dog bite transmit rabies
Rabies in human
Hospitalized human rabies victim who was restrained while bedridden
Penned dog affected with dumb rabies
Rabies control measures in Sudan(2003-2007)
2003
2004
2005
2006
2007
Total
Vac. Vac. Dest. Dest.
Khartoum
Central
Northern
Eastern
Kordofan
Darfur
Total
Vac.
234
37
7751
205
966
2676
11869
Dest.
45
11
20
13
43
10
142
Vac.
780
-
1482
-
-
27
2289
Dest.
4144
-
500
-
-
159
4803
Vac.
1859
366
38
-
398
413
3074
Dest.
-
-
-
-
7
-
7
Vac.
5190
384
1785
-
693
547
8599
Dest.
-
-
-
-
-
-
-
Vac.
1346
4680
-
125
-
-
6151
Dest.
5331
21
-
260
6
11
5629
Vac.
9409
5467
11056
330
2057
3663
31982
Dest.
9520
32
520
273
56
180
10581
Vaccination Destruction
Rabies control (animal vaccination and destruction )
Rabies incidence is inversely proportional to good control measures; it is known the recommended annual rabies vaccination coverage is 70-80% of dog population. It was clearly obvious that rabies vaccination coverage in Sudan is very low and fluctuated which explains the continuous outbreak of the disease. The routinely applied rabies control policy in Sudan is vaccination of susceptible animals and destruction of stray dogs.
Rabies control (animal vaccination and destruction)
During 2003-2007 a total of 31982 animals had been vaccinated while 10581 were destroyed. The routinely used vaccine for animals is an imported tissue culture vaccine which is distributed free of charges. Local production of anti rabies vaccine for animals as well as adoption of animal intensive vaccination and destruction of stray and un-vaccinated animals in Sudan is highly recommended.
Locally produced and imported human rabies vaccine in Sudan (2003-2007)
pe of ccine doses)
2003
2004
2005
2006
2007
Total
at brain cally duced)
47310
38740
47280
37780
-
171110
5000
-
-
-
-
5000
sue culture ported)
25000
25000
15000
10000
11,721
86,721
tal
77310
63740
62280
47,780 11,721
ck embryo mported)
262,831
Pre-exposure prophylaxis
