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Bonaparte SC, Moodie J, Undurraga EA, Wallace RM. Evaluation of country infrastructure as an indirect measure of dog-mediated human rabies deaths. Front Vet Sci 2023; 10:1147543. [PMID: 37228840 PMCID: PMC10203152 DOI: 10.3389/fvets.2023.1147543] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/17/2023] [Indexed: 05/27/2023] Open
Abstract
Background Rabies is a neglected disease, primarily due to poor detection stemming from limited surveillance and diagnostic capabilities in most countries. As a result, there is limited ability to monitor and evaluate country, regional, and global progress towards the WHO goal of eliminating human rabies deaths by 2030. There is a need for a low-cost, readily reproducible method of estimating rabies burden and elimination capacity in endemic countries. Methods Publicly available economic, environmental, political, social, public health, and One Health indicators were evaluated to identify variables with strong correlation to country-level rabies burden estimates. A novel index was developed to estimate infrastructural rabies elimination capacity and annual case-burden for dog-mediated rabies virus variant (DMRVV) endemic countries. Findings Five country-level indicators with superior explanatory value represent the novel "STOP-R index:" (1) literacy rate, (2) infant mortality rate, (3) electricity access, (4) political stability, and (5) presence/severity of natural hazards. Based on the STOP-R index, 40,111 (95% CI 25,854-74,344) global human rabies deaths are estimated to occur in 2022 among DMRVV-endemic countries and are projected to decrease to 32,349 (95% CI 21,110-57,019) in 2030. Interpretation The STOP-R index offers a unique means of addressing the data gap and monitoring progress towards eliminating dog-mediated human rabies deaths. Results presented here suggest that factors external to rabies programs influence the successes of rabies elimination, and it is now possible to identify countries exceeding or lagging in expected rabies control and elimination progress based on country infrastructure.
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Affiliation(s)
- Sarah C. Bonaparte
- Poxvirus and Rabies Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Janae Moodie
- New York University College of Global Public Health, New York, NY, United States
- James A. Ferguson Emerging Infectious Diseases RISE Fellow, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Eduardo A. Undurraga
- Escuela de Gobierno, Pontificia Universidad Católica de Chile, Santiago, Chile
- Millennium Initiative for Collaborative Research in Bacterial Resistance (MICROB-R), Santiago, Chile
- Research Center for Integrated Disaster Risk Management (CIGIDEN), Santiago, Chile
| | - Ryan M. Wallace
- Poxvirus and Rabies Branch, Division of High Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States
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Ghai RR, Wallace RM, Kile JC, Shoemaker TR, Vieira AR, Negron ME, Shadomy SV, Sinclair JR, Goryoka GW, Salyer SJ, Barton Behravesh C. A generalizable one health framework for the control of zoonotic diseases. Sci Rep 2022; 12:8588. [PMID: 35597789 PMCID: PMC9124177 DOI: 10.1038/s41598-022-12619-1] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 04/13/2022] [Indexed: 11/08/2022] Open
Abstract
Effectively preventing and controlling zoonotic diseases requires a One Health approach that involves collaboration across sectors responsible for human health, animal health (both domestic and wildlife), and the environment, as well as other partners. Here we describe the Generalizable One Health Framework (GOHF), a five-step framework that provides structure for using a One Health approach in zoonotic disease programs being implemented at the local, sub-national, national, regional, or international level. Part of the framework is a toolkit that compiles existing resources and presents them following a stepwise schematic, allowing users to identify relevant resources as they are required. Coupled with recommendations for implementing a One Health approach for zoonotic disease prevention and control in technical domains including laboratory, surveillance, preparedness and response, this framework can mobilize One Health and thereby enhance and guide capacity building to combat zoonotic disease threats at the human-animal-environment interface.
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Affiliation(s)
- Ria R Ghai
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, USA.
| | - Ryan M Wallace
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, USA
| | - James C Kile
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, USA
| | - Trevor R Shoemaker
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, USA
| | - Antonio R Vieira
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, USA
| | - Maria E Negron
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, USA
| | - Sean V Shadomy
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, USA
- Food and Agriculture Organization of the United Nations (FAO), Rome, Italy
| | - Julie R Sinclair
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, USA
| | - Grace W Goryoka
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, USA
| | - Stephanie J Salyer
- Center for Global Health, Centers for Disease Control and Prevention, Atlanta, USA
| | - Casey Barton Behravesh
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, USA
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Léchenne M, Traore A, Hattendorf J, Kallo V, Oussiguere A, Tetchi M, Moyengar R, Traore AK, Moto DD, Ngandolo R, Bonfoh B, Zinsstag J. Increasing rabies data availability: The example of a One Health research project in Chad, Côte d'Ivoire and Mali. Acta Trop 2021; 215:105808. [PMID: 33385360 DOI: 10.1016/j.actatropica.2020.105808] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 11/21/2020] [Accepted: 12/23/2020] [Indexed: 11/25/2022]
Abstract
Rabies is a fatal but preventable disease that remains notoriously underreported. Weak data availability hampers advocacy, constitutes a barrier to resource allocation and inhibits effective prevention and control. To gain better insight into the global rabies burden and human vaccine demand several studies were funded through the Vaccine Alliance (GAVI) learning agenda. With the help of this funding, Swiss TPH and local in country partner organizations implemented a One Health research project in Chad, Côte d'Ivoire and Mali to collect data at household, public health facility and veterinary level. This paper describes the implementation of this research project and evaluates its success on amount of information gained, achieved capacity building, impact on knowledge creation and influence on national and international policies. The project was based on the One Health concept and guided by the principles of transboundary research partnerships formulated by the Swiss Academy of Sciences. Data was collected on bite incidents and health seeking from over 24'000 households, on access to treatment of over 8'800 bite cases registered in public health facilities and on the status of over 1'800 rabies suspect animals. Selected country specific datasets have contributed to more than 10 scientific articles so far. On the international level, the multi-level data collection provided a unique set of indicators to inform, along with results from other studies, new WHO rabies immunization recommendations and a vaccine investment case scenario to prevent human rabies. New rabies burden estimates based on the data gathered are published for Mali and will be modelled for the whole West and Central African region. On the national level, the project facilitated communication between animal health and human health workers catalyzing creation of local and national committees and formulation of national action plans for Mali and Côte D'Ivoire. Major challenges arose from lack of data collection and documentation experience of human health and veterinary workers and weak infrastructural capacities of the veterinary and human health systems of the project countries. Through adherence to the principles of transboundary research partnerships, project team members acquired valuable research and networking skills despite language barriers, enabling them to play key roles in the future agenda towards national, regional and global canine rabies elimination. Project external collaborations with local public institutions was facilitated through long-term local partnerships. Both factors enabled success in project implementation and outcomes by identifying and mitigating risks in advance, resolving challenges amiably and enabling mutual knowledge creation as a fructuous ground for sustained commitment. Lack of immediate follow-up funding did not allow to maintain activities beyond the project timeframe. However, the national and international policy changes triggered, as well as the strengthened local disease control and research capacities provides sustainable basis for the elimination of dog transmitted human rabies.
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Galière M, Peyre M, Muñoz F, Poupaud M, Dehove A, Roger F, Dieuzy-Labaye I. Typological analysis of public-private partnerships in the veterinary domain. PLoS One 2019; 14:e0224079. [PMID: 31671123 PMCID: PMC6822735 DOI: 10.1371/journal.pone.0224079] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 10/05/2019] [Indexed: 01/09/2023] Open
Abstract
Public-Private Partnerships (PPPs) are defined as a collaborative approach in which the public and private sector share resources, responsibilities and risks to achieve common objectives and mutual benefits in a sustainable manner. PPPs are identified as a key solution to reinforce Veterinary Services. However only limited information is available on the scope, added value and enabling factors of PPPs in this sector. The aims of this study were to develop a typology of PPPs in the veterinary field and to identify key success factors and obstacles to their implementation. A structured questionnaire was sent to all 181 World Organisation for Animal Health (OIE) Member Countries and to 47 private contacts. 36 different variables characterizing PPP initiatives were collected. 97 examples of PPPs were retrieved from 76 countries. Dimensionality reduction techniques were combined with clustering and discrimination methods to establish a typology of PPPs and to derive a set of simple rules to classify new instances of PPPs. Three clusters were identified, separated according to two main variables: the type of private partners and the type of interaction. Cluster 1, transactional PPPs, represented the traditional understanding of PPPs by Veterinary Services, initiated and funded by the public sector, giving service delivery accreditation to mostly private veterinarians; cluster 2, collaborative PPPs, included partnerships between producer associations and public Veterinary Services, driven by trade interests; cluster 3, transformational PPPs, represented joint programs initiated and funded by private companies and initially driven by business development objectives. Specific success factors and key obstacles affecting the performances and sustainability of these initiatives were identified for each cluster. This study represents the first practical attempt to develop a meaningful typology of PPPs in the field of animal health and to identify fundamental obstacles currently inhibiting the development of PPPs, and suggests ways to support national Veterinary Services in overcoming these obstacles.
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Affiliation(s)
- Margot Galière
- World Organisation for Animal Health (OIE), Paris, France
| | - Marisa Peyre
- CIRAD, UMR ASTRE, Montpellier, France, ASTRE, CIRAD, INRA, Univ Montpellier, Montpellier, France
- * E-mail: (MP); (IDL)
| | - Facundo Muñoz
- CIRAD, UMR ASTRE, Montpellier, France, ASTRE, CIRAD, INRA, Univ Montpellier, Montpellier, France
| | - Mariline Poupaud
- CIRAD, UMR ASTRE, Montpellier, France, ASTRE, CIRAD, INRA, Univ Montpellier, Montpellier, France
| | - Alain Dehove
- World Organisation for Animal Health (OIE), Paris, France
| | - François Roger
- CIRAD, UMR ASTRE, Montpellier, France, ASTRE, CIRAD, INRA, Univ Montpellier, Montpellier, France
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Yahiaoui F, Kardjadj M, Laidoudi Y, Medkour H, Ben-Mahdi MH. The epidemiology of dog rabies in Algeria: Retrospective national study of dog rabies cases, determination of vaccination coverage and immune response evaluation of three commercial used vaccines. Prev Vet Med 2018; 158:65-70. [PMID: 30220397 DOI: 10.1016/j.prevetmed.2018.07.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 06/26/2018] [Accepted: 07/22/2018] [Indexed: 12/24/2022]
Abstract
Rabies is a neglected zoonotic disease. Several animal species can transmit rabies, but domestic dogs are the main reservoir implicated in rabies transmission to human and other susceptible animals. There is a scarcity of data regarding canine rabies in Algeria. Hence, this report is the first study that attempts to understand the epidemiology of dog rabies through a retrospective national study of rabies cases between 2010 and 2016, determination of canine vaccination coverage and evaluation of immune response of three rabies commercial vaccines used in Algeria. Our results revealed the persistent nature of dog rabies in Algeria; with a mean of 131 positive cases per year. The vaccination coverage findings indicated that 30.81% (126/409) of the reported vaccinated dog and 47.98% (261/544) of all studied dogs presented low level of rabies antibodies titres (less than 0.5 IU), and were therefore considered not immune to rabies. Additionally, our vaccine evaluation findigs showed a weak immune response of inactivated vaccine without adjuvant. Even with adjuvanted inactivated and attenuated live vaccines, several vaccinated dogs did not develop vaccine protection. Therefore, our results recommend further studies to test the efficiency of adding a booster vaccine shot, especially in primo-vaccinated dogs to optimize the vaccination protocol; rabies is potentially fatal zoonosis, tolerating no vaccine failure. Moreover, the present study establish the necessity to re-examine the national rabies control program, implemented in 1996, particularly concerning population education, vaccination strategy, surveillance and campaigns monitoring.
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Affiliation(s)
- Fatima Yahiaoui
- Laboratoire de Recherche "Santé et Productions Animales", Ecole Nationale Supérieure Vétérinaire (ENSV) d'Alger, El Harrach, Algiers, Algeria
| | - Moustafa Kardjadj
- Laboratoire de Recherche "Santé et Productions Animales", Ecole Nationale Supérieure Vétérinaire (ENSV) d'Alger, El Harrach, Algiers, Algeria; Ecole Supérieure en Sciences de l'Aliment et des Industries Agro-alimentaires, ESSAIA (Ex EPSNV) El-Harrach, Algiers, Algeria.
| | - Younes Laidoudi
- Laboratoire de Recherche "Santé et Productions Animales", Ecole Nationale Supérieure Vétérinaire (ENSV) d'Alger, El Harrach, Algiers, Algeria
| | - Hacène Medkour
- Laboratoire de Recherche "Santé et Productions Animales", Ecole Nationale Supérieure Vétérinaire (ENSV) d'Alger, El Harrach, Algiers, Algeria
| | - Meriem Hind Ben-Mahdi
- Laboratoire de Recherche "Santé et Productions Animales", Ecole Nationale Supérieure Vétérinaire (ENSV) d'Alger, El Harrach, Algiers, Algeria; Ecole Supérieure en Sciences de l'Aliment et des Industries Agro-alimentaires, ESSAIA (Ex EPSNV) El-Harrach, Algiers, Algeria
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Beyene TJ, Mindaye B, Leta S, Cernicchiaro N, Revie CW. Understanding Factors Influencing Dog Owners' Intention to Vaccinate Against Rabies Evaluated Using Health Belief Model Constructs. Front Vet Sci 2018; 5:159. [PMID: 30050912 PMCID: PMC6050386 DOI: 10.3389/fvets.2018.00159] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 06/22/2018] [Indexed: 12/25/2022] Open
Abstract
Ethiopia has one of the highest incidence levels of human rabies in Africa, with 3-7 deaths per 100,000 people annually. The country has no official rabies control programme, despite the availability of an effective canine vaccine to control rabies. To support effective rabies control, an understanding of the factors affecting dog owners' voluntary intentions to vaccinate their dogs is important. As such, this study examined factors influencing dog owners' intentions to vaccinate their dogs using the constructs of health belief theory. In this cross-sectional study, a questionnaire, designed based on the Health Belief Model constructs was completed by 249 dog owners in 9 randomly selected wards of Bishoftu town in central Ethiopia between October and December 2016. An ordinal regression model was then fitted to explore factors which best predict the likelihood of a dog owner's intention. A classification and regression tree (CART) model was then used for recursive partitioning of the Likert scale in the significant variables to distinctively classify ordinal categories of vaccination intention. Participants' preventive intention was associated with the six constructs of the Health Belief Model: perceived susceptibility, readiness to action, self-efficacy, perceived threat, benefits, and barriers. Dog owner's knowledge about rabies was found to be positively associated with intention to vaccinate, whereas distance from vaccination centers and difficulty of dog transportation were found to be negatively associated to intention to vaccinate. Distance from vaccination center was found to be the best predictor for the intention to vaccinate. The results of this study have policy implications for controlling rabies including increasing dog owners' knowledge about rabies, locating vaccination centers at shorter distances from dog populations and providing suitable means to transport dogs to vaccination centers.
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Affiliation(s)
- Tariku Jibat Beyene
- College of Veterinary Medicine and Agriculture, Addis Ababa University, Bishoftu, Ethiopia
- Department of Diagnostic Medicine and Pathobiology, College of Veterinary Medicine, Center for Outcomes Research and Epidemiology, Kansas State University, Manhattan, KS, United States
| | - Beakal Mindaye
- College of Veterinary Medicine and Agriculture, Addis Ababa University, Bishoftu, Ethiopia
| | - Samson Leta
- College of Veterinary Medicine and Agriculture, Addis Ababa University, Bishoftu, Ethiopia
| | - Natalia Cernicchiaro
- Department of Diagnostic Medicine and Pathobiology, College of Veterinary Medicine, Center for Outcomes Research and Epidemiology, Kansas State University, Manhattan, KS, United States
| | - Crawford W. Revie
- Centre for Veterinary Epidemiological Research, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, PE, Canada
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Mpolya EA, Lembo T, Lushasi K, Mancy R, Mbunda EM, Makungu S, Maziku M, Sikana L, Jaswant G, Townsend S, Meslin FX, Abela-Ridder B, Ngeleja C, Changalucha J, Mtema Z, Sambo M, Mchau G, Rysava K, Nanai A, Kazwala R, Cleaveland S, Hampson K. Toward Elimination of Dog-Mediated Human Rabies: Experiences from Implementing a Large-scale Demonstration Project in Southern Tanzania. Front Vet Sci 2017; 4:21. [PMID: 28321400 PMCID: PMC5337520 DOI: 10.3389/fvets.2017.00021] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 02/08/2017] [Indexed: 12/25/2022] Open
Abstract
A Rabies Elimination Demonstration Project was implemented in Tanzania from 2010 through to 2015, bringing together government ministries from the health and veterinary sectors, the World Health Organization, and national and international research institutions. Detailed data on mass dog vaccination campaigns, bite exposures, use of post-exposure prophylaxis (PEP), and human rabies deaths were collected throughout the project duration and project areas. Despite no previous experience in dog vaccination within the project areas, district veterinary officers were able to implement district-wide vaccination campaigns that, for most part, progressively increased the numbers of dogs vaccinated with each phase of the project. Bite exposures declined, particularly in the southernmost districts with the smallest dog populations, and health workers successfully transitioned from primarily intramuscular administration of PEP to intradermal administration, resulting in major cost savings. However, even with improved PEP provision, vaccine shortages still occurred in some districts. In laboratory diagnosis, there were several logistical challenges in sample handling and submission but compared to the situation before the project started, there was a moderate increase in the number of laboratory samples submitted and tested for rabies in the project areas with a decrease in the proportion of rabies-positive samples over time. The project had a major impact on public health policy and practice with the formation of a One Health Coordination Unit at the Prime Minister's Office and development of the Tanzania National Rabies Control Strategy, which lays a roadmap for elimination of rabies in Tanzania by 2030 by following the Stepwise Approach towards Rabies Elimination (SARE). Overall, the project generated many important lessons relevant to rabies prevention and control in particular and disease surveillance in general. Lessons include the need for (1) a specific unit in the government for managing disease surveillance; (2) application of innovative data collection and management approaches such as the use of mobile phones; (3) close cooperation and effective communication among all key sectors and stakeholders; and (4) flexible and adaptive programs that can incorporate new information to improve their delivery, and overcome challenges of logistics and procurement.
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Affiliation(s)
- Emmanuel Abraham Mpolya
- Global Health and Biomedical Sciences, School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA, USA
| | - Tiziana Lembo
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - Kennedy Lushasi
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
- Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Rebecca Mancy
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - Eberhard M. Mbunda
- Department of Epidemiology, Ministry of Agriculture, Livestock and Fisheries, Dar es Salaam, Tanzania
| | - Selemani Makungu
- Department of Epidemiology, Ministry of Agriculture, Livestock and Fisheries, Dar es Salaam, Tanzania
| | - Matthew Maziku
- Department of Epidemiology, Ministry of Agriculture, Livestock and Fisheries, Dar es Salaam, Tanzania
| | | | - Gurdeep Jaswant
- Preventive Veterinary Medicine, Sokoine University of Agriculture (SUA), Morogoro, Tanzania
| | - Sunny Townsend
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - François-Xavier Meslin
- Food Safety Zoonoses and Food-Borne Diseases, World Health Organization (former WO staff), Geneva, Switzerland
| | | | - Chanasa Ngeleja
- Tanzania Veterinary Laboratory Agency (TVLA), Ministry of Agriculture, Livestock and Fisheries, Dar es Salaam, Tanzania
| | - Joel Changalucha
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
- Ifakara Health Institute, Dar es Salaam, Tanzania
| | | | - Maganga Sambo
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
- Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Geofrey Mchau
- Department of Epidemiology, Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC), Dar es Salaam, Tanzania
| | - Kristyna Rysava
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - Alphoncina Nanai
- Department of Neglected Tropical Diseases, World Health Organization – Country Office of Tanzania, Dar es Salaam, Tanzania
| | - Rudovick Kazwala
- Preventive Veterinary Medicine, Sokoine University of Agriculture (SUA), Morogoro, Tanzania
| | - Sarah Cleaveland
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - Katie Hampson
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
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Wallace RM, Undurraga EA, Blanton JD, Cleaton J, Franka R. Elimination of Dog-Mediated Human Rabies Deaths by 2030: Needs Assessment and Alternatives for Progress Based on Dog Vaccination. Front Vet Sci 2017; 4:9. [PMID: 28239608 PMCID: PMC5300989 DOI: 10.3389/fvets.2017.00009] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 01/24/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Rabies imposes a substantial burden to about half of the world population. The World Health Organization (WHO), World Organization for Animal Health, and the Food and Agriculture Organization have set the goal of eliminating dog-mediated human rabies deaths by 2030. This could be achieved largely by massive administration of post-exposure prophylaxis-in perpetuity-, through elimination of dog rabies, or combining both. Here, we focused on the resources needed for the elimination of dog rabies virus by 2030. MATERIALS AND METHODS Drawing from multiple datasets, including national dog vaccination campaigns, rabies literature, and expert opinion, we developed a model considering country-specific current dog vaccination capacity to estimate the years and resources required to achieve dog rabies elimination by 2030. Resources were determined based on four factors: (a) country development status, (b) dog vaccination costs, (c) dog rabies vaccine availability, and (d) existing animal health workers. Our calculations were based on the WHO's estimate that vaccinating 70% of the dog population for seven consecutive years would eliminate rabies. FINDINGS If dog rabies vaccine production remains at 2015 levels, we estimate that there will be a cumulative shortage of about 7.5 billion doses to meet expected demand to achieve dog rabies elimination. We estimated a present cost of $6,300 million to eliminate dog rabies in all endemic countries, equivalent to a $3,900 million gap compared to current spending. To eliminate dog rabies, the vaccination workforce may suffice if all public health veterinarians in endemic countries were to dedicate 3 months each year to dog rabies vaccination. We discuss implications of potential technology improvements, including population management, vaccine price reduction, and increases in dog-vaccinating capacities. CONCLUSION Our results highlight the resources needed to achieve elimination of dog-mediated human rabies deaths by 2030. As exemplified by multiple successful disease elimination efforts, one size does not fit all. We suggest pragmatic and feasible options toward global dog rabies elimination by 2030, while identifying several benefits and drawbacks of specific approaches. We hope that these results help stimulate and inform a necessary discussion on global and regional strategic planning, resource mobilization, and continuous execution of rabies virus elimination.
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Affiliation(s)
- Ryan M. Wallace
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Eduardo A. Undurraga
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jesse D. Blanton
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Julie Cleaton
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Richard Franka
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Medina DJO, Jayme SI, Amparo ACB, Cresencio RO, Lopez EL, Baquilod MS, Hernandez LM, Villalon EES, Nel LD. World Rabies Day campaign in the Philippines. Trop Dis Travel Med Vaccines 2016; 2:22. [PMID: 28883966 PMCID: PMC5531103 DOI: 10.1186/s40794-016-0036-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 09/17/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rabies is a fatal disease, claiming the lives of around 59,000 people annually worldwide. It is considered a neglected and underreported disease leading to inadequate support from governments. Apart from dog vaccination and proper animal bite management, an integral part of a successful rabies control program is community education. The Philippine government conducts an extensive nationwide annual World Rabies Day (WRD) celebration as part of its community education. METHODS Strong inter-sectoral collaboration at the national level is a key factor for the success of WRD, capitalizing on the partners' strengths to mobilize various sectors. Strategies include the National WRD Celebration and releasing national government memorandums. An invitation letter campaign was initiated, encouraging stakeholders to register their activities. Banners were given as an incentive for those who registered. Mass and social media were also utilized to promote WRD. RESULTS Registered WRD events held in the Philippines rose from 10 events in 2012, to 37 events in 2013, to 66 events in 2014 and 76 events in 2015. The individual activities involved veterinary services and information, communication, and education (IEC) activities. Nine unique WRD IEC activities are highlighted in this paper. Promotion of WRD through social media was also utilized in recent years. More news items were published online than those printed in newspapers and aired on television. CONCLUSION The campaign's success underlines the value of a national government-led program. The national rabies program sets the agenda for priority activities including the WRD campaign. Its capacity to allocate funds for the program also denotes stability which is beneficial for local program implementers. Different segments of society were tapped through various strategies. The campaign's flexibility allowed for a large range of activities and presented opportunities for expanding partnerships and integration with others interventions for its sustainability. With appropriate tools and government support, the extensive WRD campaign in the Philippines can be replicated in other countries. The strategies discussed prove that since different localities celebrate WRD in their own way, other countries can also organize activities adapted to their culture and contribute to the global campaign against rabies.
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Affiliation(s)
- Danellie Joy O. Medina
- Global Alliance for Rabies Control, Unit 313, 3rd Floor, Humana Building, Balibago-Tagaytay Road, Sta. Rosa City, Laguna Philippines
| | - Sarah I. Jayme
- Global Alliance for Rabies Control, Unit 313, 3rd Floor, Humana Building, Balibago-Tagaytay Road, Sta. Rosa City, Laguna Philippines
| | - Anna Charinna B. Amparo
- Global Alliance for Rabies Control, Unit 313, 3rd Floor, Humana Building, Balibago-Tagaytay Road, Sta. Rosa City, Laguna Philippines
| | - Rubina O. Cresencio
- Department of Agriculture—Bureau of Animal Industry, Visayas Avenue, Quezon City, Metro Manila Philippines
| | - Emelinda L. Lopez
- Department of Agriculture—Bureau of Animal Industry, Visayas Avenue, Quezon City, Metro Manila Philippines
| | - Mario S. Baquilod
- Department of Health—Disease Prevention and Control Bureau, San Lazaro Compound, Tayuman, Sta. Cruz, Manila, Philippines
| | - Leda M. Hernandez
- Department of Health—Disease Prevention and Control Bureau, San Lazaro Compound, Tayuman, Sta. Cruz, Manila, Philippines
| | - Ernesto E. S. Villalon
- Department of Health—Disease Prevention and Control Bureau, San Lazaro Compound, Tayuman, Sta. Cruz, Manila, Philippines
| | - Louis D. Nel
- Global Alliance for Rabies Control, Unit 313, 3rd Floor, Humana Building, Balibago-Tagaytay Road, Sta. Rosa City, Laguna Philippines
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