Haematophagous bat bites in Ecuadorian Amazon: characterisation and implications for sylvatic rabies prevention

Objective: To characterise the risk factors of haematophagous bat bites and to provide information to contribute to the prevention of rabies in Ecuador.

Design: Cross-sectional study based on interviews with 3518 individuals, from which two sets of variables were generated: characteristics of haematophagous bat attacks in the previous year among humans and risk factors for being bitten.

Methods: Data were analysed using multivariate logistic regression models, taking history of bat bites in the previous year as the response variable.

Results: In the previous year 723 (20.6%, 95% CI 19.321.9) of the participants declared having received haematophagous bat bites and 50.4% in the previous month, giving an incidence rate of 10.4% (95% CI 9.611.6) per month. Sleeping on the floor or in a hammock (adjusted odds ratio [aOR] 1.58, 95% CI 1.21-2.06), not using a protective bed net (aOR 1.25, 95% CI 1.03-1.50) and living in a dwelling with permanent openings in the structure (aOR 1.49, 95% CI 1.12-1.95) were associated with a higher probability of bat bites. Those most affected were the group aged. 12 years (age 13-19 years, aOR 0.39, 95% CI 0.32-0.48; age. 20 years, aOR 0.67, 95% CI 0.50-0.90).

Conclusion: Primary prevention based on pre-exposure vaccination would be justifiable given the high dispersion of the population and the high incidence of bat bites. As a secondary protective measure, communities should work towards increasing the use of protective measures and putting barriers in permanent openings in their dwellings.