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The epidemiology of rabies in selected sub-Saharan countries
Thesis (PhD (Microbiology))--University of Pretoria, 2018.
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| Format: | Thesis |
| Language: | English |
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2026
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| _version_ | 1867613470596268032 |
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| access_status_str | Open Access |
| author2 | Nel, Louis Hendrik |
| author_browse | Nel, Louis Hendrik |
| author_facet | Nel, Louis Hendrik |
| collection | Thesis |
| description | Thesis (PhD (Microbiology))--University of Pretoria, 2018. |
| format | Thesis |
| id | oai:repository.up.ac.za:2263/110005 |
| institution | University of Pretoria (South Africa) |
| language | English |
| last_indexed | 2026-06-10T12:36:39.766Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UPSpace — University of Pretoria Institutional Repository |
| publishDate | 2026 |
| publishDateRange | 2026 |
| publishDateSort | 2026 |
| record_format | dspace |
| source_str | UPSpace — University of Pretoria Institutional Repository |
| spelling | oai:repository.up.ac.za:2263/110005 The epidemiology of rabies in selected sub-Saharan countries Nel, Louis Hendrik andre.coetzer@up.ac.za Markotter, Wanda Coetzer, Andre Rabies Diagnosis Africa Surveillance Molecular epidemiology Thesis (PhD (Microbiology))--University of Pretoria, 2018. Canine-mediated rabies is a neglected tropical disease found everywhere on earth except Antarctica and some islands. Although control initiatives across the world have repeatedly proven that canine-mediate rabies can be eliminated, this preventable disease still kills an estimated 59,000 people globally every year. The burden of the disease, however, is heaviest in developing countries where social, economic and political factors limit adequate control. A major reason for this is poor disease surveillance due to the lack of both diagnostic proficiency and molecular epidemiological evidence, especially in resource-limited sub-Saharan African countries. v The work presented here reports on the generation and use of increased and accurate rabies surveillance data in low- and middle-income countries, driven by the direct, rapid immunohistochemical test (DRIT). The DRIT was implemented in selected subSaharan countries to investigate the capacity and versatility of the assay according to three specific goals. The first was diagnostic twinning with the established direct fluorescent antibody (DFA) test in response to local rabies outbreaks (South Africa’s KwaZulu-Natal province and Zimbabwe’s Harare province). The second was the routine implementation of the DRIT as a possible supplement to the DFA test in order to generate accurate surveillance data (Lesotho and Mozambique). The third goal was establishing routine rabies surveillance in a region where no diagnostic capacity previously existed (Tanzania’s Zanzibar island). In addition to bolstering the epidemiological understanding of rabies within the target countries, our investigation identified critical shortcomings in the implementation and interpretation of the DFA assay, while also demonstrating that the DRIT had a diagnostic efficacy equal to, if not better than, the DFA test. The DRIT not only demonstrated high diagnostic efficacy, but also maintained this efficacy on specimens collected, transported and stored in sub-optimal conditions – a reality in many developing countries. Improved data on the extent, origin and movement of rabies within and between developing countries, made possible by a diagnostic assay that is both highly accurate and suited to local conditions, offers great potential for costeffective strategic control initiatives targeting rabies hotspots inside and along the borders of these countries. In addition, molecular epidemiological analysis was used to increase the resolution of the surveillance data by identifying and underpinning unique endemic RABV cycles and multiple instances of cross-border spread. The identification of these endemic cycles helped improve understanding of the transmission of rabies within the target countries, while also exposing the significant risk that the ongoing movement of people and animals - across political and geographical borders - pose to disease elimination programmes and overall disease control in the region as a whole. Microbiology and Plant Pathology PhD (Microbiology) 2026-05-15T17:26:03Z 2026-05-15T17:26:03Z 18/07/12 2018 Thesis http://hdl.handle.net/2263/110005 en application/pdf |
| spellingShingle | Rabies Diagnosis Africa Surveillance Molecular epidemiology The epidemiology of rabies in selected sub-Saharan countries |
| title | The epidemiology of rabies in selected sub-Saharan countries |
| title_full | The epidemiology of rabies in selected sub-Saharan countries |
| title_fullStr | The epidemiology of rabies in selected sub-Saharan countries |
| title_full_unstemmed | The epidemiology of rabies in selected sub-Saharan countries |
| title_short | The epidemiology of rabies in selected sub-Saharan countries |
| title_sort | epidemiology of rabies in selected sub saharan countries |
| topic | Rabies Diagnosis Africa Surveillance Molecular epidemiology |
| url | http://hdl.handle.net/2263/110005 |