The danger of free roaming dogs in urban settings: A report of two suspected rabid dogs on rampage that inflicted 47 bites to people and domestic animals in peri-urban Uganda

Abstract Background Human rabies cases associated with bites from rabid roaming dogs are prevalent in Uganda. Unfortunately, there is limited documentation of the circumstances surrounding those bites. Here, we documented dog attacks to humans and animals in two peri-urban areas in Central Uganda. Methods We responded to alerts of two suspected rabid dogs on rampage. We traced the dogs responsible for the attacks to diagnose the cause of the aggression and we interviewed the victims and community members to determine the circumstances of the bites and health care sought by the victims. We scheduled follow-up visits after 40 days, to assess compliance of the victims to rabies postexposure prophylaxis (PEP) and to document any challenges encountered in the process. Results The two rabid dogs inflicted 47 recorded attacks to 29 humans, mostly children (75.8%) and 18 domestic animals in Matugga and Mawale parishes in Wakiso and Luweero districts, respectively. Two individuals washed the wound with water and 7 individuals reported to the health facility for treatment in accordance with the WHO-guidelines for preclinical management of bites from suspected rabies cases. By contrast, 17 individuals sought treatment from a traditional healer while 5 individuals self-medicated with herbs at home. We advised those individuals to visit health facilities for proper medical care. All the victims started rabies PEP treatment; however, 2 individuals did not complete their prescription. Although rabies PEP at public health facilities was free, regularly the victims paid 3–5 USD to the clinician as an incentive while the cost at private health facilities was 13–15 USD for a single dose. Due to the unprovoked attacks, the victims and local leaders advocated for elimination of roaming dogs, but the roaming dog owners objected. Conclusions Overall, our results demonstrate the outsized impact that a single-rabid dog can have on a community. They also reveal how poverty, knowledge gaps, community trust in traditional healers, and barriers to healthcare access negatively affect medical care given to dog bite victims in this setting. Educational campaigns and control of roaming dogs should help improve the situation in Central Uganda, as well as in other socioeconomically similar settings.