Genetic diversity, transmission dynamics, spatiotemporal distribution, adherence to treatment, exposure outcomes and associated factors of human rabies viruses in Amhara region, Ethiopia

PhD Candidate: Taye Abuhay
Institution: Bahir Dar University, College of Medicine and Health Sciences
Supervisors: Professor Essey Kebede, Dr. Alemtsehay Mekonnon, Professor Tesfaye Mersha, and Professor Wondemagegn Enbiale

This PhD project investigates rabies in the Amhara Region of Ethiopia, focusing on the genetic diversity of circulating rabies viruses, transmission dynamics, spatial and temporal distribution of cases, treatment adherence, adverse exposure outcomes and associated factors. Rabies, caused by Rabies, remains a fatal zoonotic disease with persistent dog-mediated transmission in many low-resource settings.

The study is conducted in the Amhara Region, one of the most rabies-affected regions in the country. It addresses critical gaps in surveillance, post-exposure prophylaxis (PEP) adherence, patient outcomes and understanding of circulating viral strains and transmission patterns.

A mixed-methods design will be applied, combining secondary surveillance data (2015–2025) with primary data from rabies treatment centers. Dog bite victims will be systematically followed to assess exposure classification, PEP uptake and completion, and clinical outcomes.

Spatial and temporal analyses using GIS and time-series models (including ARIMA and Join point regression) will be applied to identify hotspots areas and to predict trends. Bayesian Hierarchical spatiotemporal model will be fitted to see the combined effects of space and time on human rabies distribution. In addition, both deterministic and spatiotemporal stochastic SEIR models will be utilized to see the transmission dynamics of rabies virus between dogs and from dogs to humans under various rabies control strategies. Key metrics, such as peak infection time, population sizes of exposed, infected, deceased, and recovered individuals, as well as disease fadeout timing, will be estimated.  Logistic regression will identify determinants of adherence to PEP and adverse exposure outcomes. Finally, laboratory and genomic analyses (DFAT, RT-PCR, and whole genome sequencing) will characterize circulating rabies virus strains and transmission pathways.

The study aims to generate integrated epidemiological and genomic evidence to support targeted rabies control, strengthen One Health surveillance, and contribute to elimination efforts in northern Ethiopia.