Deaths from Symptomatically Identifiable Furious Rabies in India: A Nationally Representative Mortality Survey
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{"title"=>"Deaths from Symptomatically Identifiable Furious Rabies in India: A Nationally Representative Mortality Survey", "type"=>"journal", "authors"=>[{"first_name"=>"Wilson", "last_name"=>"Suraweera", "scopus_author_id"=>"35732644300"}, {"first_name"=>"Shaun K.", "last_name"=>"Morris", "scopus_author_id"=>"7403325715"}, {"first_name"=>"Rajesh", "last_name"=>"Kumar", "scopus_author_id"=>"35334397200"}, {"first_name"=>"David A.", "last_name"=>"Warrell", "scopus_author_id"=>"7102334232"}, {"first_name"=>"Mary J.", "last_name"=>"Warrell", "scopus_author_id"=>"57201282188"}, {"first_name"=>"Prabhat", "last_name"=>"Jha", "scopus_author_id"=>"7102630216"}], "year"=>2012, "source"=>"PLoS Neglected Tropical Diseases", "identifiers"=>{"scopus"=>"2-s2.0-84869014211", "sgr"=>"84869014211", "issn"=>"19352727", "pmid"=>"23056661", "doi"=>"10.1371/journal.pntd.0001847", "pui"=>"366040834"}, "id"=>"aef805f3-470e-3676-af12-1afdf1aedba9", "abstract"=>"BACKGROUND: It is estimated that India has more deaths from rabies than any other country. However, existing estimates are indirect and rely on non-representative studies.\\n\\nMETHODS AND PRINCIPAL FINDINGS: We examined rabies deaths in the ongoing Million Death Study (MDS), a representative survey of over 122,000 deaths in India that uses enhanced types of verbal autopsy. We estimated the age-specific mortality rates of symptomatically identifiable furious rabies and its geographic and demographic distributions. A total of 140 deaths in our sample were caused by rabies, suggesting that in 2005 there were 12,700 (99% CI 10,000 to 15,500) symptomatically identifiable furious rabies deaths in India. Most rabies deaths were in males (62%), in rural areas (91%), and in children below the age of 15 years (50%). The overall rabies mortality rate was 1.1 deaths per 100,000 population (99%CI 0.9 to 1.4). One third of the national rabies deaths were found in Uttar Pradesh (4,300) and nearly three quarters (8,900) were in 7 central and south-eastern states: Chhattisgarh, Uttar Pradesh, Odisha, Andhra Pradesh, Bihar, Assam, and Madhya Pradesh.\\n\\nCONCLUSIONS AND SIGNIFICANCE: Rabies remains an avoidable cause of death in India. As verbal autopsy is not likely to identify atypical or paralytic forms of rabies, our figure of 12,700 deaths due to classic and clinically identifiable furious rabies underestimates the total number of deaths due to this virus. The concentrated geographic distribution of rabies in India suggests that a significant reduction in the number of deaths or potentially even elimination of rabies deaths is possible.", "link"=>"http://www.mendeley.com/research/deaths-symptomatically-identifiable-furious-rabies-india-nationally-representative-mortality-survey", "reader_count"=>62, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Professor > Associate Professor"=>4, "Student > Doctoral Student"=>3, "Researcher"=>16, "Student > Ph. D. Student"=>9, "Student > Postgraduate"=>6, "Student > Master"=>10, "Other"=>5, "Student > Bachelor"=>6, "Lecturer"=>1, "Professor"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Professor > Associate Professor"=>4, "Student > Doctoral Student"=>3, "Researcher"=>16, "Student > Ph. D. Student"=>9, "Student > Postgraduate"=>6, "Student > Master"=>10, "Other"=>5, "Student > Bachelor"=>6, "Lecturer"=>1, "Professor"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>2, "Engineering"=>1, "Environmental Science"=>1, "Biochemistry, Genetics and Molecular Biology"=>1, "Nursing and Health Professions"=>3, "Medicine and Dentistry"=>25, "Agricultural and Biological Sciences"=>15, "Arts and Humanities"=>1, "Veterinary Science and Veterinary Medicine"=>7, "Social Sciences"=>4, "Immunology and Microbiology"=>2}, "reader_count_by_subdiscipline"=>{"Engineering"=>{"Engineering"=>1}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>25}, "Social Sciences"=>{"Social Sciences"=>4}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>2}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>15}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>3}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>1}, "Unspecified"=>{"Unspecified"=>2}, "Environmental Science"=>{"Environmental Science"=>1}, "Arts and Humanities"=>{"Arts and Humanities"=>1}, "Veterinary Science and Veterinary Medicine"=>{"Veterinary Science and Veterinary Medicine"=>7}}, "reader_count_by_country"=>{"Sri Lanka"=>1, "United States"=>1, "United Kingdom"=>2, "India"=>3}, "group_count"=>7}

Scopus | Further Information

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  • {"files"=>["https://ndownloader.figshare.com/files/299277", "https://ndownloader.figshare.com/files/299333"], "description"=>"<div><h3>Background</h3><p>It is estimated that India has more deaths from rabies than any other country. However, existing estimates are indirect and rely on non-representative studies.</p> <h3>Methods and Principal Findings</h3><p>We examined rabies deaths in the ongoing Million Death Study (MDS), a representative survey of over 122,000 deaths in India that uses enhanced types of verbal autopsy. We estimated the age-specific mortality rates of symptomatically identifiable furious rabies and its geographic and demographic distributions. A total of 140 deaths in our sample were caused by rabies, suggesting that in 2005 there were 12,700 (99% CI 10,000 to 15,500) symptomatically identifiable furious rabies deaths in India. Most rabies deaths were in males (62%), in rural areas (91%), and in children below the age of 15 years (50%). The overall rabies mortality rate was 1.1 deaths per 100,000 population (99%CI 0.9 to 1.4). One third of the national rabies deaths were found in Uttar Pradesh (4,300) and nearly three quarters (8,900) were in 7 central and south-eastern states: Chhattisgarh, Uttar Pradesh, Odisha, Andhra Pradesh, Bihar, Assam, and Madhya Pradesh.</p> <h3>Conclusions and Significance</h3><p>Rabies remains an avoidable cause of death in India. As verbal autopsy is not likely to identify atypical or paralytic forms of rabies, our figure of 12,700 deaths due to classic and clinically identifiable furious rabies underestimates the total number of deaths due to this virus. The concentrated geographic distribution of rabies in India suggests that a significant reduction in the number of deaths or potentially even elimination of rabies deaths is possible.</p> </div>", "links"=>[], "tags"=>["deaths", "symptomatically", "identifiable", "furious", "rabies", "nationally"], "article_id"=>119005, "categories"=>["Science Policy"], "users"=>["Wilson Suraweera", "Shaun K. Morris", "Rajesh Kumar", "David A. Warrell", "Mary J. Warrell", "Prabhat Jha"], "doi"=>["https://dx.doi.org/10.1371/journal.pntd.0001847.s001", "https://dx.doi.org/10.1371/journal.pntd.0001847.s002"], "stats"=>{"downloads"=>0, "page_views"=>13, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Deaths_from_Symptomatically_Identifiable_Furious_Rabies_in_India_A_Nationally_Representative_Mortality_Survey/119005", "title"=>"Deaths from Symptomatically Identifiable Furious Rabies in India: A Nationally Representative Mortality Survey", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2012-10-04 02:30:05"}
  • {"files"=>["https://ndownloader.figshare.com/files/563763"], "description"=>"<p>Notes:</p><p>1. Overall study deaths totaling 122,429 excludes stillbirths. Unspecified or ill defined deaths (n = 10,647) that accounts for 8.7% of all deaths were not assigned to any specific disease categories. Of these unspecified deaths, 3,828 were below age 70 and 6,819 above age 70.</p><p>2. Proportional rabies mortality per 1000 is estimated after applying sample weights to adjust for urban-rural probability of selection.</p><p>3. ± Minimum reported age was 2 years.</p><p>4. † United Nations 2005 estimates for India <a href=\"http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0001847#pntd.0001847-UN1\" target=\"_blank\">[27]</a>.</p>", "links"=>[], "tags"=>["rabies", "deaths"], "article_id"=>234255, "categories"=>["Science Policy"], "users"=>["Wilson Suraweera", "Shaun K. Morris", "Rajesh Kumar", "David A. Warrell", "Mary J. Warrell", "Prabhat Jha"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0001847.t002", "stats"=>{"downloads"=>0, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Estimated_annual_rabies_deaths_2001_8211_2003_and_national_estimated_deaths_2005_by_age_/234255", "title"=>"Estimated annual rabies deaths (2001–2003) and national estimated deaths (2005), by age.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-10-04 01:10:55"}
  • {"files"=>["https://ndownloader.figshare.com/files/563795"], "description"=>"<p>Notes</p><p>(1) ** In the partially vaccinated group, 5 people received 4–10 vaccine doses and the remainder received 1–3 injections. Most cases sought treatment after symptoms of rabies had already appeared and the remainder abandoned the treatment after only a few injections.</p><p>(2) During the period 2001–03, the most commonly used rabies vaccine in rural India was SEMPLE (sheep brain homogenate), for which the full course is 14 daily doses by injection. The alternative modern cell culture vaccine was expensive and was largely introduced to government hospitals in 2005 <a href=\"http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0001847#pntd.0001847-Directorate1\" target=\"_blank\">[30]</a>.</p><p>(3) * Reported animal exposures other than dogs: cat (1), jackal (1), unspecified wild animals (2).</p><p>(4) † Mostly students and house wives. ‡ - Traditional local therapy centers.</p>", "links"=>[], "tags"=>["rabies", "deaths"], "article_id"=>234290, "categories"=>["Science Policy"], "users"=>["Wilson Suraweera", "Shaun K. Morris", "Rajesh Kumar", "David A. Warrell", "Mary J. Warrell", "Prabhat Jha"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0001847.t001", "stats"=>{"downloads"=>0, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Variables_related_to_rabies_deaths_in_India_/234290", "title"=>"Variables related to rabies deaths in India.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2012-10-04 01:11:30"}
  • {"files"=>["https://ndownloader.figshare.com/files/563612"], "description"=>"<p>State wise death rates are standardized to 2005 UN population estimates <a href=\"http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0001847#pntd.0001847-UN1\" target=\"_blank\">[27]</a> for India. Total estimated rabies deaths for India in the present study is 12,700, 99% CI (10,000, 15,500). Areas where no rabies deaths captured by this study represent 7% of the total India population. <a href=\"http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0001847#pntd.0001847.s001\" target=\"_blank\">Figure S1</a> shows a comparison of state level rabies deaths reporting from present study and other mortality studies available. Abbreviations: <b><u>Larger states</u></b>U: AP-Andhra Pradesh, AS-Assam, BR-Bihar, CG-Chhattisgarh, DL-Delhi, GJ-Gujarat, HR-Haryana, JK-Jammu & Kashmir, JH-Jharkhand, KA-Karnataka, KL-Kerala, MP-Madhya Pradesh, MH-Maharashtra, OR-Odisha, PB-Punjab, RJ- Rajasthan, TN-Tamil Nadu, UP-Uttar Pradesh, WB-West Bengal, <b><u>Smaller states</u></b>U: AN-A & N Islands, AR-Arunachal Pradesh, CH-Chandigarh, DN-Dadra & Nagar Haveli, DD-Daman & Diu, GA-Goa, HP-Himachal Pradesh, LD-Lakshadweep, ML-Meghalaya, MN-Manipur, MZ-Mizoram, NL-Nagaland, PY-Puducherry, SK-Sikkim, TR-Tripura, UK-Uttarakhand.</p>", "links"=>[], "tags"=>["rabies", "deaths"], "article_id"=>234106, "categories"=>["Science Policy"], "users"=>["Wilson Suraweera", "Shaun K. Morris", "Rajesh Kumar", "David A. Warrell", "Mary J. Warrell", "Prabhat Jha"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0001847.g001", "stats"=>{"downloads"=>0, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Regional_variation_of_estimated_rabies_deaths_and_death_rates_India_2005_/234106", "title"=>"Regional variation of estimated rabies deaths and death rates: India, 2005.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-10-04 01:08:26"}
  • {"files"=>["https://ndownloader.figshare.com/files/563704"], "description"=>"<p>We collected rabies deaths as reported from 6 different sources in India from 1991 to 2005 in order to compare our estimates with all other estimates available. (1) Medically Certified Causes of Death (MCCD) <a href=\"http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0001847#pntd.0001847-Registrar3\" target=\"_blank\">[28]</a> data for 1991–2004 are mostly urban deaths collected from selected urban hospitals mainly from the 10 biggest states. (2) Survey of Cause of Death (SCD) <a href=\"http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0001847#pntd.0001847-Registrar4\" target=\"_blank\">[29]</a> data are rural deaths between 1991–98 and were collected from about 1900 selected rural Primary Health Centers (PHC) in 23 states and 3 union territories. (3) Causes of Death Survey (Form 12) (RGI, 1998–2002) data are from the Registrar General of India. It shares the same sample framework (Sample Registration System) as our Million Death Study (MDS; 2001–2003) and includes both urban and rural deaths. (4) Sudarshan's study (January 2002 to March 2003) <a href=\"http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0001847#pntd.0001847-Sudarshan2\" target=\"_blank\">[9]</a> was a multi-centre community survey conducted by 23 university/research institutions in their territorial areas. (5) Government hospital data from the routine data collection of the Union Ministry of Health and Family Welfare <a href=\"http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0001847#pntd.0001847-Government1\" target=\"_blank\">[6]</a>. These data were significantly under reported and produced very inconsistent and sporadic results. Therefore, to calculate proportional deaths, our denominator was all causes of deaths from the states where at least one rabies death had been reported. (6) Knobel et. al. <a href=\"http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0001847#pntd.0001847-Knobel1\" target=\"_blank\">[4]</a> rabies deaths were calculated independently from a predictive probabilistic model based on hypothetical human-canine density, post-exposure treatment, and regional demographic features. The model does not consider any mortality statistics from India.</p>", "links"=>[], "tags"=>["rabies", "reported", "sources", "india"], "article_id"=>234197, "categories"=>["Science Policy"], "users"=>["Wilson Suraweera", "Shaun K. Morris", "Rajesh Kumar", "David A. Warrell", "Mary J. Warrell", "Prabhat Jha"], "doi"=>"https://dx.doi.org/10.1371/journal.pntd.0001847.g002", "stats"=>{"downloads"=>0, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Proportional_rabies_mortality_reported_from_various_sources_in_India_1991_8211_2005_/234197", "title"=>"Proportional rabies mortality reported from various sources in India 1991–2005.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2012-10-04 01:09:57"}

PMC Usage Stats | Further Information

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Relative Metric

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