Risk Mapping of Risk Factors Associated with Human Rabies Cases in Bali Province, Indonesia

Abstract

─ Since the emergence of rabies cases in human in 2008, there have been 174 humans affected by the disease in Bali. Eradication program implementing dog vaccination has seemed to decrease the incidence of rabies cases in human, however the human cases were still found. A lot of resources from local and national government as well as the international organisation has been spent on this program. There need to be a review on rabies control implementation in Bali in order to have an effective dan efficient control program. Our study investigated data on rabies in humans and dogs and vaccination program in Bali from 2016 to 2018. In this study we analysed the association between number of human cases and three factors that include number of dog cases, dog vaccination coverages and number of poor households using a zero inflated Poisson regression. A risk map was also built by mapping the unexplained spatial risk (residual) using R. From this study we found that dog rabies and social economy status have positive association with human cases. As expected, the higher the vaccination coverage in dogs the lower the human rabies. However, none of these factors were significantly associated with the human cases. In the risk maps we found that Kintamani has the largest residual. This could mean this area has a unique risk factors compare to other subdistricts. Investigation in the areas with relatively high residual e.g. Kintamani is needed to uncover the unique risk factors contributing to human cases. Keywords─ risk maps, rabies, human, Bali, Indonesia