Fig 1.
Official territorial division of El Salvador.
A) Administrative department division; B) Townships; C) Epidemiological region: metropolitan area (red; San Salvador), Western region (green; Santa Ana, Ahuachapan, and Sonsonate), Central region (orange; Chalatenango, Cuscatlan, and La Libertad), Paracentral region (yellow; Cabañas, San Vicente and La Paz) and Eastern region (Blue; Usulutan, San Miguel, Morazan, and La Union) [17]. Use of data authorized by Geoportal-CNR under a CC BY license, with permission from Geoportal-CNR, original copyright 2014.
Fig 2.
Laboratory-confirmed positive canine rabies cases, 2005–2014, and Kernel Density analysis in El Salvador.
The highest number of positive canine rabies cases was reported in the Eastern region. Hot spots were identified in all five epidemiological regions. Source: Ministry of Health, El Salvador. Use of data authorized by Geoportal-CNR under a CC BY license, with permission from Geoportal-CNR, original copyright 2014.
Table 1.
Annual number and percentage of positive canine rabies cases from five epidemiological regions in El Salvador in 2005–2014.
Fig 3.
Canine rabies cases in 2005–2014 (points) and social factors indicated in maps.
A) Violence classification (low, mid-low, mid-high, high) [25, 56]; B) Poverty classification (low, mid-low, mid-high, high) [24]. Source: Ministry of Health, El Salvador. Use of data authorized by Geoportal-CNR under a CC BY license, with permission from Geoportal-CNR, original copyright 2014.
Table 2.
Factors associated with canine rabies, relative risks, and 95% confidence intervals estimated with a Poisson-regression model adjusted for overdispersion in 262 townships, El Salvador, 2005–2014.
Fig 4.
Canine rabies clusters unadjusted for covariates in El Salvador, 2005–2014.
Statistically significant clusters (p < 0.05) were identified in the Eastern, Central, Paracentral, and Metropolitan areas; no clusters were detected in 2013, and no positive rabies cases were reported in 2014. Use of data authorized by Geoportal-CNR under a CC BY license, with permission from Geoportal-CNR, original copyright 2014.
Table 3.
Significant cluster location (p < 0.05) of canine rabies, El Salvador, 2005–2014.
Clusters are shown for adjusted and unadjusted models for covariates.
Fig 5.
Canine rabies clusters adjusted for covariates in El Salvador 2005–2014.
Adjustments were made using several variables (violence, poverty, illiteracy, canine population density, human population density, number of public health centers, and vaccination coverage). Statistically significant clusters (p < 0.05) were found in all five epidemiological regions; no clusters were detected in 2013, and no positive rabies cases were reported in 2014. Use of data authorized by Geoportal-CNR under a CC BY license, with permission from Geoportal-CNR, original copyright 2014.
Fig 6.
Canine rabies risk assessment.
Expected canine rabies cases per km2 were estimated with Poisson-regression analysis including the variables violence, poverty, illiteracy, canine population density, human population density, number of public health centers, and vaccination coverage. Use of data authorized by Geoportal-CNR under a CC BY license, with permission from Geoportal-CNR, original copyright 2014.