Incidence of Category II and III Dog Bites among 5-14 year old children in El Nido estimated from passive and active surveillance, 2011 to 2012

Active surveillance

At enrollment, a questionnaire was completed in order to collect the history of potential rabies exposures (animal bites and scratches) over the past 6 months in the cohort children. Information about a child’s possible rabies exposures was collected retrospectively through home visits, mobile phone contact, and through consultations with midwives and village health workers, teachers and neighbors. During the 18 months of follow-up beginning July 2011, active detection of rabies exposures was conducted every three months until December 2012 and included the interview of the exposed patient’s parent regarding incidents of contact with a suspected rabid animal. Parents were contacted and asked whether their child had experienced contact with a suspect rabid animal since the previous interview and follow-up forms were completed. All patients that had experienced a potential exposure during the previous three months were visited at home and standardized rabies exposure forms (REF) were completed. All follow-up questionnaires administered during the study were similar except the questionnaire provided in March 2012, in which questions regarding the PrEP were added. Also in 2012, a small survey was carried out of the parents of 328 randomly chosen children who were not vaccinated, to determine the reasons for this.

During the follow-up period, the ABTC data were collected on all children with a reported contact with a suspect rabid animal. Every three months thereafter, an ABTC data retrieval form was completed for every rabies exposure consultation for a child included in the study cohort.

Passive surveillance

Data on animal bite consultations of children in the same age group as the study cohort at the ABTC were collected retrospectively for the period from January 2011 to December 2012 in order to establish a temporal trend of exposures. Bite incidence was calculated from the number of bites amongst children divided by the total number of children aged 5-14 years old based on the 2007 Population Census.