Beginning January 2012, a humane method of dog population management using a Catch-Neuter-Vaccinate-Release (CNVR) program was implemented in Dhaka City, Bangladesh as part of the national rabies control program. To enable this program, the size and distribution of the free-roaming dog population needed to be estimated. We present the results of a dog population survey and a pilot assessment of the CNVR program coverage in Dhaka City. Free-roaming dog population surveys were undertaken in 18 wards of Dhaka City on consecutive days using mark-resight methods. Data was analyzed using Lincoln-Petersen index-Chapman correction methods. The CNVR program was assessed over the two years (2012–2013) whilst the coverage of the CNVR program was assessed by estimating the proportion of dogs that were ear-notched (processed dogs) via dog population surveys. The free-roaming dog population was estimated to be 1,242 (95 % CI: 1205–1278) in the 18 sampled wards and 18,585 dogs in Dhaka City (52 dogs/km²) with an estimated human-to-free-roaming dog ratio of 828:1. During the two year CNVR program, a total of 6,665 dogs (3,357 male and 3,308 female) were neutered and vaccinated against rabies in 29 of the 92 city wards. A pilot population survey indicated a mean CNVR coverage of 60.6% (range 19.2–79.3%) with only eight wards achieving > 70% coverage. Given that the coverage in many neighborhoods was below the WHO-recommended threshold level of 70% for rabies eradications and since the CNVR program takes considerable time to implement throughout the entire Dhaka City area, a mass dog vaccination program in the non-CNVR coverage area is recommended to create herd immunity. The findings from this study are expected to guide dog population management and the rabies control program in Dhaka City and elsewhere in Bangladesh. Rabies is a public health problem in Bangladesh. A CNVR program was commenced in Dhaka City in January 2012 as part of the Bangladesh national rabies control program. We describe the findings of a dog population survey that was conducted to estimate the free-roaming dog population using a mark-resight framework and the progress of the CNVR program. The free-roaming dog population in the 18 sampled wards was estimated to be 1,242 dogs, and 18,585 dogs in Dhaka City (52 dogs/km²). The estimated human-to-free-roaming dog ratio was 828:1. Between 2012 and 2013, 6,665 dogs (3,357 male, 3,308 female) were neutered and vaccinated against rabies in 29 of the 92 city wards. A pilot survey conducted in 18 wards indicated a CNVR coverage of 60.6% (range 19.2–79.5%). We recommend conducting an annual mass dog vaccination in the non-CNVR coverage area during the intervening period of the CNVR program to create herd immunity against rabies and break the cycle of rabies transmission.

Understanding the demography of domestic dogs is essential to plan the dog population management and rabies control program. In this study, we estimated the owned and stray dog population and the proportion of owned dogs that are free-roaming in Bhutan. For this, a cross-sectional household surveys were conducted in six districts (both urban and rural areas) and two border towns in southern Bhutan. The population estimation was done by extrapolation of the mean number of dogs per household and dogs per person, whilst mark-resight survey was conducted to estimate the proportion of owned dogs that were free-roaming. A total of 1,301 (rural:585; urban:716) respondents (one per household) were interviewed of which 173 households (24.4%) in urban areas owned 237 dogs whilst 238 households (40.8%) in rural areas owned 353 dogs. The mean number of dogs per dog owning household was estimated to be 1.44 (urban:1.37 dogs; rural:1.48 dogs) and dogs per household was estimated to be 0.45 (urban:0.33; rural:0.60). The dog: human ratio was 1:16.30 (0.06 dogs per person) in urban areas and 1:8.43 (0.12 dogs per person) in rural areas. The total owned dog population based on the mean number of dogs per household and dogs per person were estimated to be 65,312 and 71,245 in the country, respectively. The male: female ratio of the owned dog was 1.31:1 in urban areas and 2.05:1 in rural areas. Majority of the dogs were local non-descript breeds in both urban (60.8%) and rural (78%) areas, and the most common source was acquisition from friends or family (44.7%). The stray dog population in Bhutan was estimated to be 48,379 (urban:22,772; rural:25,607). Of the total estimated owned dog population in the two border towns, the proportion that were found free-roaming was estimated to be 31%. The different dog population estimation methods were compared and discussed in this paper. This study generated baseline data on the demographic patterns of the owned and stray dogs in Bhutan which will be useful for planning and monitoring dog population management and rabies control program in the country.

Dog bites are the main source of rabies infection and death in humans, contributing up to 99% of all cases. We conducted a contact-tracing study to evaluate the health seeking and treatment compliance behaviors of people following potential exposure to rabies in rabies endemic south Bhutan. Using information from the rabies post exposure prophylaxis (PEP) register, animal-exposed victims who had visited five hospitals in south Bhutan between January and March 2017 were traced and further data were collected from them using a structured questionnaire. A snowballing technique was used to identify victims who did not seek PEP.The survey was conducted between April and June 2017. Logistic regression was performed to assess factors associated with PEP-seeking and compliance behavior by the victims. Amongst 630 who reported to hospitals, 70% (444) of people could be traced and additional 8% (39) who did not seek PEP was identified through contact tracing. Therefore, a total of 483 people were interviewed. Seventy one percent (344/483) of exposure were due to animal bites of which 80% (365/455) were considered to be provoked incidents. Common reasons for not seeking health care included assumptions that risks of infection were minor if bitten by an owned or vaccinated dog. The victims who are male (OR: 0.36; 95% CI: 0.16–0.77) and educated (OR: 0.41; 95% CI: 0.17–0.96) were less likely to seek PEP, while those that experienced unprovoked bite (OR: 5.10; 95% CI: 1.20–21.77) were more likely to seek PEP in the hospitals. Overall, 82% of the victims sought PEP from the hospitals within 24 h after exposure. Eighty three percent completed the PEP course prescribed by the physician. The respondents living in urban areas (OR: 2.67; 95% CI: 1.34–5.30) were more likely to complete the prescribed PEP course than rural dwellers. There is high risk of rabies infection in southern Bhutan. It is critical to bridge knowledge gaps and dispel existing myths which will help to improve PEP seeking and compliance behavior of people exposed to rabies infection from animals. A risk-based advocacy program is necessary to prevent dog-mediated human rabies deaths.

Human rabies cases today are predominantly associated with infection from rabid domestic dogs. Unlike dogs, a common global reservoir species that perpetuates rabies viruses (RABV) within their populations, domestic cats are much less frequently reported or vaccinated. Epidemiologically, cats are important vectors of lyssaviruses but are not viral reservoirs. Typically, cats are incidental hosts only, infected with the predominant lyssavirus in their geographic locale. Human cases associated with rabid cats have occurred in Africa, Asia, Europe and throughout the Americas. As adept, solitary hunters, wild and domestic felids are at risk of lyssavirus infection based upon interactions with infected prey, such as bats, or from transmission by other mesocarnivores, such as rabid dogs, foxes, jackals, raccoons, and skunks. Current veterinary vaccines provide safe and effective immunity in cats against phylogroup I lyssaviruses, such as RABV, but not against divergent lyssaviruses in phylogroups II-IV. With the focus upon the global elimination of canine rabies, the emergence of rabies in cats represents a concerning trend. Clearly, education about the occurrence of rabies in cats needs to be improved, as well as the routine vaccination of cats to reduce the associated risks to public health, agriculture, and conservation biology from a One Health perspective.