Rabies is a life-threatening, zoonotic viral disease that can cause fatal encephalomyelitis (Jibat, Mourits, & Hogeveen, 2016). According to WHO (WHO, 2013), canine rabies causes an estimated 61,000 deaths per year within the wider international community, of which 56% and 44% of the deaths occurred in Asia and Africa, respectively (Deribe et al., 2012). This disease is mostly transmitted by dog-bite and causes significant morbidity and mortality among humans and animals, with high incidence in rural areas each year (WHO, 2013).
As Yimer et al. (Yimer et al., 2002) reported and Deressa et al. (H. A. Deressa et al., 2010), dogs are the primary cause for fatal human rabies cases and responsible for maintaining and disseminating rabies in Ethiopia. The country accommodates the second largest number of rabies deaths of all African countries (Coetzer et al., 2016). The first rabies epidemic in Ethiopia was recorded in the capital city of Addis Ababa in 1903 (Pankhurst, 1970). A retrospective study done between 2001 and 2009 by the Ethiopian Public Health Institute (EPHI) showed that approximately 1000 to1600 patients were exposed each year in Addis Ababa (H. A. Deressa et al., 2010; Reta, T., Teshale, S., Deresa, A., Ali, A., Mengistu, F., Sifer, D. and Freuling, 2014). The total number of animal rabies cases in Ethiopia is unknown, but with a rural and farming population of more than 80%, annual livestock losses caused by rabies place a large societal and economic burden (Pieracci et al., 2016).
In recent data reported by Beyene et al. (Beyene, Mourits, Kidane, & Hogeveen, 2018), more than 2.9 thousand human rabies deaths occurred every year. The annual rabid dog exposures in some selected urban and rural districts were estimated to be 135,101 and 86 bites per 100,000 inhabitants, respectively (Beyene, Mourits, & Hogeveen, 2017). Quiet, the virus has long been a significant public health threat in Ethiopia (A. Deressa et al., 2010). This is considering with limited information on the true Ethiopian dog populations (i.e., owned dog and free-roaming dog populations (Ali, 2012; A. Deressa et al., 2010; Jemberu, Molla, Almaw, & Alemu, 2013; Yimer et al., 2002).
Dog-derived rabies in rural seating has also been reported as a potential problem for animal production sectors as dogs are kept in close contact with them for safeguarding purposes, which might provide an opportunity to transmit the virus (Jibat et al., 2016; Yizengaw et al., 2018). Researchers like Coetzer et al. (Coetzer et al., 2016) raise the question why the control and elimination of rabies is a daunting undertaking and why it is going as further challenged in Ethiopia. Every case of rabies in the country is confirmed by the only one National Rabies Laboratory (EPHI's), poor surveillance, irregular reporting and discrepancies in official data are the contributing factors for the underestimated burden of rabies Ethiopia (Coetzer et al., 2016; Reta, T., Teshale, S., Deresa, A., Ali, A., Mengistu, F., Sifer, D. and Freuling, 2014). Most importantly, limited vaccine availability in the regions is an extra headache where vaccine production is truncated. Thus, an increasing stray dog population, lack of rabies vaccines, poor rabies surveillance, low level of public awareness, poor attention and resource allocation by the government are major significant problems that hinder the control of rabies in Ethiopia (Coetzer et al., 2016).
Rabies has been reported as a significant public health threat in Ethiopia (A. Deressa et al., 2010) and the control and elimination of rabies is a daunting undertaking and going as further challenged in Ethiopia. Due to an increasing stray dog population, lack of rabies vaccines, poor rabies surveillance, low level of public awareness, poor attention and resource allocation by the government are major important problems facing forward (Coetzer et al., 2016). Scientific researches based on observational studies on viral isolation and identification is limited, except survey studies focused on knowledge assessment using questionnaire data. Furthermore, no data on systematic review and meta-analysis was done on rabies in Ethiopia. Hence, this systematic review and meta-analysis summarize and pool estimates of rabies' status in Ethiopia, which indicates necessary practical measures for the government and policymakers for appropriate control strategies at the national level.