Prevalence of Dog-Mediated Rabies in Ethiopia: A Systematic Review and Meta-Analysis From 2010-2020

Abstract Background: Rabies is a lethal zoonotic viral disease mostly transmitted by dog-bite. Ethiopia accommodates the second largest number of human rabies deaths in Africa. The total number of animal rabies cases in Ethiopia is not known. This systematic review and meta-analysis aimed to summarize and pool estimates of dog-mediated rabies' status in Ethiopia. Methods: Published researches between the years 2010 to 2020 were comprehensively searched and the required information was extracted. The prevalence was estimated using the random-effects meta-analysis because higher heterogeneity between studies was expected. Results: The pooled estimate of rabies was 32% (95% CI: 19% - 46%), with individual study prevalence estimates ranged from 1% - 78%. Studies were approximately weighted equally with individual weight ranging from 5.19% - 5.28%. Subgroup analysis indicated that the random pooled prevalence of rabies based upon hosts affected was 28% (95% CI: 0% – 81%) in animals and 33% (95% CI: 20% - 47%) in humans. Furthermore, a subgroup analysis across regions indicated that the pooled prevalence in Amhara and Tigray regional states was 5% (CI: 3% - 8%) and 55% (CI: 21% - 86%), respectively. No single study was reported from the country's Eastern and Southern parts which might be due to the religious aspect that most Muslims do not keep dogs in this region. Thus, the regional differences in data availability may have led to an overestimation of some regions' estimates. Conclusion: The estimated pooled rabies prevalence was found high and showed varying among study regions. Therefore, focusing on mass dog vaccination campaigns and public awareness should be implemented to control the disease.