One Health research program rolls out rabies management training for health workers in Machakos, Kenya

Dog bites are a serious health problem in parts of Kenya because of the risk of spreading the rabies to humans. The proper management of dog bite victims can be the difference between life and death. The One Health Research, Education and Outreach Centre in Africa (OHRECA) organized a series of four, two-day training sessions from 28 March to 7 April 2022 that aimed to equip healthcare workers in Machakos County with practical skills to assess and manage dog bites.

The World Health Organization (WHO) estimates that dog bites account for 76-94% of animal bite injuries in low- and middle-income countries. Dogs are responsible for rabies virus transmission to humans and once clinical symptoms appear; rabies is 100% fatal. An estimated 2,000 people in Kenya die annually from rabies with Machakos among the top five counties with the highest reported cases of dog bites on humans. Thus, this training was timely to ensure the proper management of dog bite victims to drastically reduce fatal cases.

Judith Kimuyu, Machakos County director of preventive and promotive health services, officially opened the sessions by highlighting that the right rabies management and preventive measures will empower not only the health workers but the entire community at large. She added that ‘effective upward and downward communication is key to reach the target groups and the empowerment of health workers will go a long way in reaching the community.’

The interactive training brought together 80 health workers who were refreshed their knowledge and skills on the history of rabies, rabies epidemiology, clinical management of dog bite victims, clinical presentation and management of human rabies, and human and animal rabies surveillance. An introduction to the concept of One Health and the importance of working with the veterinary sector to combat this important yet often neglected disease was also presented. Participants took part in practical scenarios of rabies case to assess how they would apply the knowledge they had acquired.

Lilian Mutungi, assistant deputy director of veterinary services, Machakos County, said the training ‘will help healthcare workers make informed decisions when handling dog bite victims and use pre-exposure prophylaxis (PEP) after bite assessment. They will promote rabies prevention in the communities and share information on bite victims with the veterinarians. This will improve collaboration between the two sectors through the One Health approach.’

Sharon Mweni, the director of medical services in Machakos County, closed the training by saying that as a result of the training ‘clinical management of rabies cases in Machakos county health facilities will improve leading to a reduction in the burden of rabies and morbidity and mortality from the disease.’

This training was part of OHRECA and University of Liverpool multisectoral and interdisciplinary efforts to support Machakos County to eliminate rabies by 2030 through vaccination campaigns, better public awareness and improved access to human rabies vaccines. ILRI graduate fellow Maurice Karani is concurrently conducting research to quantify the cost effectiveness of rabies control in Machakos County to aid the current healthcare delivery approaches and enhance investment for future control.

This work is funded by the German Federal Ministry of Economic Cooperation and Development (BMZ) through OHRECA.

The first cohort of Machakos County health workers trained on dog bite management (photo credit: ILRI/Geoffrey Njenga).