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Official websites use. Share sensitive information only on official, secure websites. Correspondence: louis. Rabies is widespread throughout Africa and Asia, despite the fact that the control and elimination of this disease has been proven to be feasible. Lesotho, a small landlocked country surrounded by South Africa, has been known to be endemic for rabies since the s but the epidemiology of the disease remains poorly understood due to limited sample submission, constrained diagnostic capabilities, and a lack of molecular epidemiological data.

Considering the existing challenges experienced in Lesotho, we aimed to evaluate the direct, rapid immunohistochemical test DRIT as an alternative to the direct fluorescent antibody DFA test for rabies diagnosis in Lesotho. Towards this aim, extensive training on the implementation and interpretation of the DRIT was hosted in Lesotho in April before both tests were applied to all samples subjected to routine rabies diagnosis at the Central Veterinary Laboratory CVL.

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Molecular epidemiological analyses, which included viruses from neighbouring provinces in South Africa, suggested that at least three independent rabies cycles within Lesotho were implicated in instances of cross-border transmission. This study has evaluated alternative methods for diagnosing and improving rabies surveillance in Lesotho, as well as providing new information that would be of importance in the planning of future disease intervention campaigns, not only in Lesotho, but also in neighbouring South Africa.

Canine-mediated rabies, caused by rabies virus RABV , is a neglected tropical disease that has the highest case-fatality rate of any known infectious disease, accounting for an estimated 59, human deaths every year globally [ 1 ]. The burden associated with the disease is highest in developing countries and is typically a scourge on the poorest people in low and middle income countries LMICs [ 1 , 2 , 3 ]. While the availability of post-exposure prophylaxis PEP prevents the onset of human rabies after an exposure, the most cost-effective control measure is the routine vaccination of the domestic dog populations [ 3 ].

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Unfortunately, various social, economic, and political factors contribute to the inadequate control of canine-mediated rabies in endemic areas, with human rabies cases occurring as a result thereof [ 1 , 3 , 4 ]. Rabies was first recorded in Lesotho in the s when the disease was introduced into the northeastern part of the country from the KwaZulu-Natal KZN province of South Africa [ 5 ].

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