Incidence and prevalence of rabies virus infections in tested humans and animals in Asia: A systematic review and meta-analysis study.

Abstract

<h4>Introduction</h4>Rabies is a fatal neurological zoonotic disease affecting warm-blooded animals, causing nearly 60,000 human deaths annually, primarily in developing Asian and African countries (95 % of cases). This review examines the prevalence and incidence of rabies in tested humans and animals across Asia.<h4>Methods</h4>We searched for scientific articles published in peer-reviewed journals between 2010 and 2024 in electronic databases. Ninety-seven publications were selected for the assessment of the rabies prevalence and nine for the assessment of the rabies incidence.<h4>Results</h4>Overall, the prevalence of rabies based on the random-effects meta-analysis was 23 % (95 % CI 22.7-23.4) in tested animals and 52 % (95 % CI 40.2-63.8) in tested humans. Among animals, foxes had the highest test prevalence of 78.3 % (95 % CI 70.4 %-86.2 %) followed by dogs (38.1 %, 95 % CI 31.2 %-45 %). The incidence in tested animals was 0.5 % (95 % CI 0.4 %-0.6 %) and 0 % (95 % CI 0 %-0 %) in tested humans. Among animals, dogs have the highest incidence at 0.7 % (95 % CI 0.5 %-0.8 %).<h4>Conclusion</h4>Many Asian countries have eradicated rabies by implementing control measures such as animal registration, quarantine, isolation, and mandatory mass vaccination. However, rising fox populations now pose a potential risk for rabies spread in the region.