Animal exposures and Rabies in the Eastern central Region of Tunisia (Monastir 2004- 2022)

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Published Jul 12, 2026
https://doi.org/10.62438/tunismed.v104i07.6294
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Vol. 104 No. 07 (2026): Tunis Med Jul 2026

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Cyrine Bennasrallah
Department of Epidemiology and Preventive medicine, Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06,Fattouma Bourguiba University Hospital, Monastir, Faculty of Medecine of Monastir, University of Monastir, Tunisia
Malek Ghoul
Department of Epidemiology and Preventive medicine, Fattouma Bourguiba University Hospital, Monastir, Faculty of Medecine of Monastir, University of Monastir, Tunisia
Syrine Doghri
Department of Epidemiology and Preventive medicine, Fattouma Bourguiba University Hospital, Monastir, Faculty of Medecine of Monastir, University of Monastir, Tunisia
Mariem Kacem
Department of Epidemiology and Preventive medicine, Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06,Fattouma Bourguiba University Hospital, Monastir, Faculty of Medecine of Monastir, University of Monastir, Tunisia
Samia Said Grira
The Regional Direction of Primary Health of Monastir, Monastir, Tunisia
Amani Maatouk
Department of Epidemiology and Preventive medicine, Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06,Fattouma Bourguiba University Hospital, Monastir, Faculty of Medecine of Monastir, University of Monastir, Tunisia
Wafa Dhouib
Department of Epidemiology and Preventive medicine, Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06,Fattouma Bourguiba University Hospital, Monastir, Faculty of Medecine of Monastir, University of Monastir, Tunisia
Manel Ben Fredj
Department of Epidemiology and Preventive medicine, Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06,Fattouma Bourguiba University Hospital, Monastir, Faculty of Medecine of Monastir, University of Monastir, Tunisia
Issam Maalel
The Regional Direction of Primary Health of Monastir, Monastir, Tunisia
Ines Bouanène
Department of Epidemiology and Preventive medicine, Fattouma Bourguiba University Hospital, Monastir, Faculty of Medecine of Monastir, University of Monastir, Tunisia
Hela Abroug
Department of Epidemiology and Preventive medicine, Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06,Fattouma Bourguiba University Hospital, Monastir, Faculty of Medecine of Monastir, University of Monastir, Tunisia
Imen Zemni
Department of Epidemiology and Preventive medicine, Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06,Fattouma Bourguiba University Hospital, Monastir, Faculty of Medecine of Monastir, University of Monastir, Tunisia
Asma Belguith Sriha
Department of Epidemiology and Preventive medicine, Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06,Fattouma Bourguiba University Hospital, Monastir, Faculty of Medecine of Monastir, University of Monastir, Tunisia

Abstract

Introduction-aim: Rabies is a neglected zoonosis; it is a fatal but preventable disease. Despite eradication efforts, it remains a major health problem in many developing countries, including Tunisia. We aimed to describe the epidemiological pattern of human exposures to infected animals from 2004 to 2022 and to assess the impact of COVID-19 pandemic on rabies control in the governorate of Monastir (center of Tunisia).
Methods: We conducted a descriptive study using surveillance data from 2004 to 2022 in Monastir Governorate. All suspected exposures in Monastir that were notified to the Regional Directorate of Primary Healthcare during our study were included.
Results: A total of 35 056 human suspected rabies exposures were reported with an average of 1872.32 ±221.4 cases per year. The incidence rate of suspected rabid exposures was 320.7 per 100,000 inhabitants with a significant annual percentage change (APC) of 1.35 (95% CI: 0.28; 2.49). Dogs represented the main source of suspected exposures (64.58%). From 2004 to 2022, there was an increase in vaccinated and stray dog bites and a decrease in bites from unvaccinated dogs. Comparing the pre- and post-COVID-19 period, we found a significant increase in the average annual number of animal exposures after COVID-19 (1860.3±217 vs 1933.96±231.9) (p < 0.001). The animal rabies positivity rate increased significantly with an APC of 3.74 (CI 95% 0.67-6.89). During the study period, rabies was confirmed in 185 animals and three fatal human cases were reported.
Conclusion: Our study highlights the import (abstract truncated at 250 words).

Keywords:

COVID-19, Epidemiology, Post-Exposure Prophylaxis, Rabies, vaccination

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