A new study led by DBEI faculty member Dr. Ricardo Castillo, and recently highlighted in a Penn Medicine News article by Frank Otto, examines how socioeconomic inequality shapes rabies risk in urban Peru.
Rabies is a preventable yet deadly disease that kills tens of thousands of people every year, mostly in resource-limited countries. The virus, transmitted primarily through dog bites, continues to circulate where poverty limits access to vaccination and surveillance. While the global burden of dog-mediated rabies is well recognized, few studies have examined how socioeconomic inequality influences risk within cities.
Using a uniquely detailed surveillance database from Arequipa, Peru—one of the few urban centers in the Americas where canine rabies persists—researchers analyzed data from 2015 to 2022 to explore how neighborhood-level socioeconomic status (SES) affects disease risk. Rabies cases were overwhelmingly concentrated in socioeconomically disadvantaged areas. Diagnostic samples from these neighborhoods were more likely to test positive, indicating that surveillance and control were weaker relative to the true burden of disease. Spatial models were able to identify coldspots with low surveillance and guide search efforts. When health teams conducted spatially-targeted surveillance (“active surveillance”)—proactively seeking cases rather than waiting for reports—these disparities decreased. These findings reveal that the global inequities shaping rabies transmission also exist at the local level. Targeted, data-driven vaccination and surveillance programs in disadvantaged neighborhoods could help accelerate the global elimination of dog-mediated human rabies.