Dog population structure in Kumasi, Ghana: a missing link towards rabies control

Introduction Dog-mediated human rabies remains a major public health threat in Ghana. Dog population structure surveys are pre-requisites for appropriate planning for rabies vaccination; however, this information is unavailable in Ghana. This study describes dog population structure in Kumasi, Ghana. Methods A household cross sectional survey was conducted from January through April 2016 in Ayeduase and Kwame Nkrumah University of Science and Technology (KNUST) campus using a structured questionnaire. Results A total of 1319 households were surveyed out of which 35.1% (463/1319) kept dogs. We recorded 816 dogs from 463 households, giving dog to household ratio of 1.8:1. Respondents acquired 71% (579/816) of dogs through purchase. Of 2065 persons in Ayeduase, 406 owned dogs, resulting in man to dog ratio of 5.1:1. Male dogs represented 62.9% (513/816) while those aged a year and above recorded 70%. Most of the dogs were not restricted (80.3%) and 49.9% were allowed to enter neighbors' households. Dog rabies vaccination coverage was 28.1% and 64.9% in Ayeduase and KNUST campus respectively. Respondents (87.8%) from Ayeduase knew dog bite was the main means of rabies transmission, however, about 65% believed in traditional ways of treatment such as concoction, herbs and consumption of offending dogs' organs. Conclusion The high dog to household-human ratio, increased roaming dog population and low vaccination coverage is of concern to rabies. Respondents' knowledge on their dogs is an indication of accessibility for vaccination. Obtained results can be useful for rabies vaccination planning in Kumasi and other comparable settings in Ghana.


Introduction
Rabies is among the deadliest zoonotic diseases in the world, with an estimated case fatality rate of almost 100%. Human rabies can be controlled through elimination of the disease in animals. Rabies deaths in human are in the range of 70,000s each year. Rabies tops annual human deaths from all zoonoses and is likely number 1 vaccine preventable disease that kills most [1]. The disease affects poor-rural communities across most parts of Africa and Asia [2]. Rabies in the domestic dog has been on the increase in most parts of sub-Saharan Africa due to low vaccination coverage [3]. Thousands of lives are lost each year due to rabies mostly in children. Reported data on rabies is considered under-reported. This appears to be one of the reasons for low priority in commitment and resource allocation for control and elimination of rabies [4]. In Ghana, rabies incidence has been on the increase since the government stopped funding free mass vaccination in 1997 [5]. Afakye further noted human rabies cases are clinically diagnosed in terminal stages without laboratory confirmation while reported animal rabies to the veterinary services is mostly low. Even when these cases are reported, little or no investigation is often conducted. Ghana has three zonal veterinary and five regional laboratories which are not well equipped. According to the World Organisation for Animal Health (OIE) performance veterinary services gap report [6], there is the need to strengthen passive surveillance for zoonotic diseases such as rabies, tuberculosis, brucellosis and cisticercosis. Same report indicated a yearly target of 15,000 dogs and cats to be vaccinated against rabies in main cities of Ghana as advised by the public health division of veterinary services. It is obvious this number may not curtail the menace of rabies which is known to affect dogs and humans mainly in the rural areas of developing countries like Ghana. Knowledge and understanding of population density, structure and ownership of dogs is vital to the planning and execution of mass vaccination against rabies in dogs in a given area [7,8]. Cultural practices determine the level of supervision of the social interactions of dogs and access to resources (food, water, shelter and mates). It is assumed that high-density dog populations permit the occurrence of enzootic canine rabies; but this is not very well documented [9]. Studies have shown positive correlation between dog and human population [10] as represented in a 30% increase in Ghana's human population from 2000 to 2010 [11]. Dog ecology studies are directly linked to the epidemiology of dog, thus a better understanding of this linkage is crucial to the design and planning of effective rabies control measures [12].
Knowledge about the size and turnover of the dog population concerned, degree of supervision, owned and unowned population, accessibility and socio-cultural attitudes of community members are all crucial and dependent on the success of rabies control measures.
Where the number of dogs is not registered by licensing, questionnaire surveys can fill this gap through street dog counts and household interviews [13]. High numbers are reported of the domestic dog and it is estimated to be over 700 million [14]. In Chile there was high proportion of households owning dogs in rural areas (89%) than in towns (63%) or cities (49%). Population growth was as high as 20% in cities, 19% in towns and 9% in rural areas.

Results
A total of 1319 households were surveyed out of which an average of 35% owned dogs.  (Table 4).

Discussion
The aim of this study was to determine dog population structure and knowledge gaps that may favor dog-mediated human rabies in parts

Conclusion
There was high dog to household and dog to human ratio in the study sites. The close interaction of dogs and humans is of concern to rabies and other dog related zoonoses. Dog ownership may be considered as a business venture in view of the high purchase and sale yet low attention is given to these dogs in Ayeduase and KNUST campus. What is known about this topic  Rabies is a major public health threat in Africa;  The domestic dog is the main source of rabies transmission in developing countries;  Dog population studies offer requisite information for vaccination programs.

What this study adds
 Dog to household ratio is high in the study area;  Coverage of dog antirabies vaccination was low;  Dog owners still believe in superstition for rabies treatment.
contributed equally in analysis, mapping and review of the manuscript. All authors read and approved the final manuscript.