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Keshavamurthy R, Boutelle C, Nakazawa Y, Joseph H, Joseph DW, Dilius P, Gibson AD, Wallace RM. Machine learning to improve the understanding of rabies epidemiology in low surveillance settings. Sci Rep 2024; 14:25851. [PMID: 39468157 PMCID: PMC11519585 DOI: 10.1038/s41598-024-76089-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Accepted: 10/10/2024] [Indexed: 10/30/2024] Open
Abstract
In low and middle-income countries, a large proportion of animal rabies investigations end without a conclusive diagnosis leading to epidemiologic interpretations informed by clinical, rather than laboratory data. We compared Extreme Gradient Boosting (XGB) with Logistic Regression (LR) for their ability to estimate the probability of rabies in animals investigated as part of an Integrated Bite Case Management program (IBCM). To balance our training data, we used Random Oversampling (ROS) and Synthetic Minority Oversampling Technique. We developed a risk stratification framework based on predicted rabies probabilities. XGB performed better at predicting rabies cases than LR. Oversampling strategies enhanced the model sensitivity making them the preferred technique to predict rare events like rabies in a biting animal. XGB-ROS classified most of the confirmed rabies cases and only a small proportion of non-cases as either high (confirmed cases = 85.2%, non-cases = 0.01%) or moderate (confirmed cases = 8.4%, non-cases = 4.0%) risk. Model-based risk stratification led to a 3.2-fold increase in epidemiologically useful data compared to a routine surveillance strategy using IBCM case definitions. Our study demonstrates the application of machine learning to strengthen zoonotic disease surveillance under resource-limited settings.
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Affiliation(s)
- Ravikiran Keshavamurthy
- 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, USA.
| | - Cassandra Boutelle
- 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, USA
| | - Yoshinori Nakazawa
- 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, USA
| | - Haim Joseph
- Ministère de l'Agriculture, des Ressources Naturelles et du Développement Rural, Port au Prince, Haiti
| | - Dady W Joseph
- Ministère de l'Agriculture, des Ressources Naturelles et du Développement Rural, Port au Prince, Haiti
| | - Pierre Dilius
- Ministère de l'Agriculture, des Ressources Naturelles et du Développement Rural, Port au Prince, Haiti
| | | | - 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, USA
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Emikpe BO, Asare DA, Tasiame W, Segbaya S, Takyi PN, Allegye-Cudjoe E. Rabies control in Ghana: Stakeholders interventions, challenges and opportunities. Health Sci Rep 2024; 7:e70112. [PMID: 39323463 PMCID: PMC11422661 DOI: 10.1002/hsr2.70112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Revised: 09/07/2024] [Accepted: 09/11/2024] [Indexed: 09/27/2024] Open
Abstract
Background Rabies remains a significant public health issue in Ghana, predominantly affecting rural communities with limited access to health care and veterinary services. The disease is primarily transmitted through bites from infected domestic dogs and leads to many deaths worldwide each year. Despite various interventions, Ghana continues to struggle with rabies control and prevention. This narrative paper focuses on rabies control in Ghana, examining stakeholders' interventions, challenges faced, and opportunities available. Methods The paper reviews existing rabies control measures in Ghana, including dog vaccination efforts and One Health strategies. It also discusses the limitations of these interventions, such as minimal vaccination coverage, weak surveillance, and inadequate intersectoral coordination. Results Ghana has implemented dog vaccination campaigns, but coverage remains minimal. Additionally, weak disease surveillance, cultural perceptions, and inadequate coordination across sectors have hampered the country's ability to control rabies effectively. Conclusion Adopting One Health principles, which integrate human, animal, and environmental health efforts, is emphasized as a critical strategy to eliminate rabies in Ghana by 2030. By addressing these challenges and leveraging available opportunities, Ghana can strengthen its rabies control programs and work toward a rabies-free future.
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Affiliation(s)
- Benjamin Obukowho Emikpe
- Department of Pathobiology, School of Veterinary Medicine Kwame Nkrumah University of Science and Technology (KNUST) Kumasi Ghana
| | - Derrick Adu Asare
- Department of Pathobiology, School of Veterinary Medicine Kwame Nkrumah University of Science and Technology (KNUST) Kumasi Ghana
| | - William Tasiame
- Department of Public Health, School of Veterinary Medicine Kwame Nkrumah University of Science and Technology (KNUST) Kumasi Ghana
| | | | - Prince Nana Takyi
- Department of Pathobiology, School of Veterinary Medicine Kwame Nkrumah University of Science and Technology (KNUST) Kumasi Ghana
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Konishi K, Kusakabe S, Kawaguchi N, Shishido T, Ito N, Harada M, Inoue S, Maeda K, Hall WW, Orba Y, Sawa H, Sasaki M, Sato A. β-d-N 4-hydroxycytidine, a metabolite of molnupiravir, exhibits in vitro antiviral activity against rabies virus. Antiviral Res 2024; 229:105977. [PMID: 39089332 DOI: 10.1016/j.antiviral.2024.105977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Revised: 07/08/2024] [Accepted: 07/30/2024] [Indexed: 08/03/2024]
Abstract
Rabies is a fatal neurological disorder caused by rabies virus (RABV) infection. Approximately 60,000 patients die from rabies annually, and there are no effective treatments for this disease. Nucleoside analogs are employed as antiviral drugs based on their broad antiviral spectrum, and certain nucleoside analogs have been reported to exhibit anti-RABV activity. The nucleoside analog β-d-N4-hydroxycytidine (NHC) has antiviral effects against a range of RNA viruses. Molnupiravir (MPV), a prodrug of NHC, is clinically used as an oral antiviral drug for coronavirus infections. Despite its broad-spectrum activity, the antiviral activity of NHC against RABV remains unclear. In this study, we reveal that NHC exhibits comparable in vitro anti-RABV activity as ribavirin and favipiravir (also known as T-705) with a 90% effective concentration of 6 μM in mouse neuroblastoma cells. NHC reduced viral loads in neuronal and nonneuronal cells in a dose-dependent manner. Both laboratory and field RABVs (fixed and street strains, respectively) were susceptible to NHC. However, no increase in survival or reduction in viral titers in the brain was observed in RABV-infected mice treated prophylactically with MPV. These findings highlight the potential and challenges of NHC in the treatment of RABV infection.
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Affiliation(s)
- Kei Konishi
- Laboratory for Drug Discovery & Disease Research, Shionogi & Co., Ltd., Osaka, Japan; Division of Anti-Virus Drug Research, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan
| | - Shinji Kusakabe
- Laboratory for Drug Discovery & Disease Research, Shionogi & Co., Ltd., Osaka, Japan; Division of Anti-Virus Drug Research, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan
| | - Nijiho Kawaguchi
- Division of Molecular Pathobiology, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan
| | - Takao Shishido
- Laboratory for Drug Discovery & Disease Research, Shionogi & Co., Ltd., Osaka, Japan
| | - Naoto Ito
- Laboratory of Zoonotic Diseases, Faculty of Applied Biological Sciences, Gifu University, Gifu, Japan
| | - Michiko Harada
- Department of Veterinary Science, National Institute of Infectious Diseases (NIID), Tokyo, Japan
| | - Satoshi Inoue
- Department of Veterinary Science, National Institute of Infectious Diseases (NIID), Tokyo, Japan
| | - Ken Maeda
- Department of Veterinary Science, National Institute of Infectious Diseases (NIID), Tokyo, Japan
| | - William W Hall
- International Collaboration Unit, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan; National Virus Reference Laboratory, School of Medicine, University College of Dublin, Ireland; Global Virus Network, Baltimore, MD, USA; Institute for Vaccine Research and Development (HU-IVReD), Hokkaido University, Sapporo, Japan
| | - Yasuko Orba
- Division of Anti-Virus Drug Research, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan; Division of Molecular Pathobiology, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan; International Collaboration Unit, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan; Institute for Vaccine Research and Development (HU-IVReD), Hokkaido University, Sapporo, Japan; One Health Research Center, Hokkaido University, Sapporo, Japan
| | - Hirofumi Sawa
- Division of Anti-Virus Drug Research, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan; International Collaboration Unit, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan; Global Virus Network, Baltimore, MD, USA; Institute for Vaccine Research and Development (HU-IVReD), Hokkaido University, Sapporo, Japan; One Health Research Center, Hokkaido University, Sapporo, Japan
| | - Michihito Sasaki
- Division of Molecular Pathobiology, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan; Institute for Vaccine Research and Development (HU-IVReD), Hokkaido University, Sapporo, Japan.
| | - Akihiko Sato
- Laboratory for Drug Discovery & Disease Research, Shionogi & Co., Ltd., Osaka, Japan; Division of Anti-Virus Drug Research, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan; Institute for Vaccine Research and Development (HU-IVReD), Hokkaido University, Sapporo, Japan.
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Najam A, Abid R, Ali H, Hafeez H, Arif A, Ahmed S, Di Cerbo A, Ghazanfar S. Comparing Intradermal (ID) Rabies Vaccination with Conventional IM Regimen on Humoral Response of New Zealand White Rabbits for the Production of Animal-Derived Polyclonal Antibodies. Vet Med Int 2024; 2024:4451881. [PMID: 38798740 PMCID: PMC11127759 DOI: 10.1155/2024/4451881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 03/04/2024] [Accepted: 04/29/2024] [Indexed: 05/29/2024] Open
Abstract
In developing countries, it is imperative to implement cost-effective strategies for animal humoral response development in the production of antiserum. This study compared the effect of immunization regimens on the humoral immune response of New Zealand White (NZW) rabbits (N = 24) using cell culture rabies vaccine (CCRV) through intradermal (ID) and traditional intramuscular (IM) routes. The rabbits were divided into three experimental groups: (a) IPC-R2 with a two-site one-week regimen; (b) TRC-R3 with a two-site twenty-eight-day regimen; and (c) Alternate-R4 with a four-site one-week regimen. These regimens were then compared to the standard IM schedule of five doses of rabies vaccine administered at days 0, 3, 7, 14, and 28 in control group R-1. The results were evaluated at days 14 and 35 postvaccination using rabies-specific Platelia II™ ELISA kit method. The results showed a better response to the ID regimen than the IM route regarding immunogenicity and volume consumption of the vaccine. The three selected ID regimes showed significantly higher mean titer values than the control IM regimen group R-1 (p < 0.001). The study aims to explore simple immunization strategies to enhance the RV-specific antibody titers for immunization donor animals. This method would produce polyclonal antibodies and strengthen local production of polyclonal antibodies in Pakistan to deal with vaccine and rabies immunoglobulin (RIG) shortage, thus providing effective postexposure prophylaxis (PEP) for better control of rabies in developing countries.
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Affiliation(s)
- Amina Najam
- Biological Production Division, National Institute of Health, Islamabad 45500, Pakistan
| | - Rameesha Abid
- Department of Microbiology, Quaid-I-Azam University, Islamabad 44100, Pakistan
- National Institute for Genomics and Advanced Biotechnology (NIGAB), National Agricultural Research Centre, Park Road, Islamabad 45500, Pakistan
| | - Hussain Ali
- Biological Production Division, National Institute of Health, Islamabad 45500, Pakistan
| | - Hamza Hafeez
- Department of Biological Sciences, University of Sialkot, Sialkot 51310, Pakistan
| | - Amna Arif
- Department of Applied Microbiology, University of Veterinary and Animal Sciences, Lahore 05499, Pakistan
| | - Safia Ahmed
- Department of Microbiology, Quaid-I-Azam University, Islamabad 44100, Pakistan
| | - Alessandro Di Cerbo
- School of Biosciences and Veterinary Medicine, University of Camerino, Matelica 62024, Italy
| | - Shakira Ghazanfar
- National Institute for Genomics and Advanced Biotechnology (NIGAB), National Agricultural Research Centre, Park Road, Islamabad 45500, Pakistan
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Leblanc C, Kassié D, Ranaivoharimina M, Rakotomanana EFN, Mangahasimbola RT, Randrianarijaona A, Ramiandrasoa R, Nely AJ, Razafindraibe NP, Andriamandimby SF, Ranoaritiana DB, Rajaonarivony V, Randrianasolo L, Baril L, Mattern C, Ratovoson R, Guis H. Mixed methods to evaluate knowledge, attitudes and practices (KAP) towards rabies in central and remote communities of Moramanga district, Madagascar. PLoS Negl Trop Dis 2024; 18:e0012064. [PMID: 38551968 PMCID: PMC11006160 DOI: 10.1371/journal.pntd.0012064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 04/10/2024] [Accepted: 03/12/2024] [Indexed: 04/11/2024] Open
Abstract
Control of dog-mediated rabies relies on raising awareness, access to post-exposure prophylaxis (PEP) and mass dog vaccination. To assess rabies awareness in Moramanga district, Madagascar, where rabies is endemic, two complementary quantitative and qualitative approaches were carried out in 2018. In the quantitative approach, a standardized questionnaire was administered to 334 randomized participants living in 170 households located less than 5 km from the anti-rabies treatment center (ARTC) located in Moramanga city (thereafter called the central area), and in 164 households located more than 15 km away from the ARTC in two rural communes (thereafter called the remote area). Logistic regression models were fitted to identify factors influencing knowledge and practice scores. The qualitative approach consisted in semi-structured interviews conducted with 28 bite victims who had consulted the ARTC, three owners of biting dogs, three ARTC staff and two local authorities. Overall, 15.6% (52/334) of households owned at least one dog. The dog-to-human ratio was 1:17.6. The central area had a significantly higher dog bite incidence (0.53 per 100 person-years, 95% CI: 0.31-0.85) compared to the remote area (0.22 per 100 person-years, 95% CI: 0.09-0.43) (p = 0.03). The care pathway following a bite depended on wound severity, how the dog was perceived and its owner's willingness to cover costs. Rabies vaccination coverage in dogs in the remote area was extremely low (2.4%). Respondents knew that vaccination prevented animal rabies but owners considered that their own dogs were harmless and cited access and cost of vaccine as main barriers. Most respondents were not aware of the existence of the ARTC (85.3%), did not know the importance of timely access to PEP (92.2%) or that biting dogs should be isolated (89.5%) and monitored. Good knowledge scores were significantly associated with having a higher socio-economic status (OR = 2.08, CI = 1.33-3.26) and living in central area (OR = 1.91, CI = 1.22-3.00). Good practice scores were significantly associated with living in central area (OR = 4.78, CI = 2.98-7.77) and being aware of the ARTC's existence (OR = 2.29, CI = 1.14-4.80). In Madagascar, knowledge on rabies was disparate with important gaps on PEP and animal management. Awareness campaigns should inform communities (i) on the importance of seeking PEP as soon as possible after an exposure, whatever the severity of the wound and the type of biting dog who caused it, and (ii) on the existence and location of ARTCs where free-of-charge PEP is available. They should also encourage owners to isolate and monitor the health of biting dogs. Above all, awareness and dog vaccination campaigns should be designed so as to reach the more vulnerable remote rural populations as knowledge, good practices and vaccination coverage were lower in these areas. They should also target households with a lower socio-economic status. If awareness campaigns are likely to succeed in improving access to ARTCs in Madagascar, their impact on prompting dog owners to vaccinate their own dogs seems more uncertain given the financial and access barriers. Therefore, to reach the 70% dog vaccination coverage goal targeted in rabies elimination programs, awareness campaigns must be combined with free-of-charge mass dog vaccination.
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Affiliation(s)
- Claire Leblanc
- Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
- General Paediatrics and Paediatric Infectious Disease Unit, Nantes University Hospital, Nantes, France
| | - Daouda Kassié
- Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
- CIRAD, UMR ASTRE, Antananarivo, Madagascar
- ASTRE, Univ Montpellier, CIRAD, INRAE, Montpellier, France
| | - Mendrika Ranaivoharimina
- Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | | | | | - Anjasoa Randrianarijaona
- Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Ravo Ramiandrasoa
- Vaccination Center, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Alphonse José Nely
- Service for the Fight against Plague, Emerging and Re-emerging Diseases and Neglected Tropical Endemo-Epidemic Diseases, Ministry of Public Health, Antananarivo, Madagascar
- WHO Madagascar, Antananarivo 101, Madagascar
| | | | - Soa Fy Andriamandimby
- National Laboratory of Rabies, Virology Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Dany Bakoly Ranoaritiana
- Direction of Health Monitoring, Epidemiological Surveillance and Response (DVSSER), Ministry of Public Health, Antananarivo, Madagascar
| | - Virginie Rajaonarivony
- Service for the Fight against Plague, Emerging and Re-emerging Diseases and Neglected Tropical Endemo-Epidemic Diseases, Ministry of Public Health, Antananarivo, Madagascar
| | - Laurence Randrianasolo
- Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Laurence Baril
- Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
- Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Chiarella Mattern
- Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
- Ceped (Institut de Recherche pour le Développement, Université de Paris, INSERM), Paris, France
| | - Rila Ratovoson
- Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Hélène Guis
- Epidemiology and Clinical Research Unit, Institut Pasteur de Madagascar, Antananarivo, Madagascar
- CIRAD, UMR ASTRE, Antananarivo, Madagascar
- ASTRE, Univ Montpellier, CIRAD, INRAE, Montpellier, France
- Institut Pasteur du Cambodge, Phnom Penh, Cambodia
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Dreyfus A, Volasoa MH, Guis H, Razafindraibe NP, Razafindramparany MH, Arivony NL, Rakotondrabe N, Andriamananjara MA, Dussart P, Kassie D, Lacoste V, Andriamandimby SF. Challenges of rabies surveillance in Madagascar based on a mixed method survey amongst veterinary health officers. Front Vet Sci 2024; 11:1270547. [PMID: 38487708 PMCID: PMC10938849 DOI: 10.3389/fvets.2024.1270547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 02/08/2024] [Indexed: 03/17/2024] Open
Abstract
IntroductionIn Madagascar, rabies is endemic and a notifiable disease. The objective of this mixed study was to understand the challenges faced by the Veterinary Health Officers (VHOs) in the current rabies surveillance system in Madagascar.MethodsA survey was conducted from mid-April to the end of July 2021 during which all officially-listed VHOs (N = 150) were contacted by phone at least twice. Participants, representative of the 22 regions of Madagascar, were interviewed by phone based on a semi-structured questionnaire on (1) their knowledge of rabies epidemiology in their area of activities, (2) the occurrence of human and animal rabies and the species affected in the region where they work, (3) the factors that might influence rabies surveillance depending on (a) their activities and area of operation, (b) the socio-cultural aspects of local communities, and (c) the general organization of animal rabies surveillance.ResultsThe majority (80/90) of VHOs declared having been informed of at least one suspected or confirmed case of human and/or animal rabies in their area of activity during their work as VHOs: at least once a month for 11 of them, at least once a year for 40 and with undetermined frequency for 29. Several obstacles hinder the surveillance of rabies resulting in under-reporting. The lack of funds to access suspect animals, collect, pack and ship samples in compliance with biosecurity measures and the cold chain, was mentioned as a major obstacle to surveillance. The second barrier is socio-cultural: in many large coastal regions, dogs are taboo and VHOs fear rejection by the community if they treat dogs.Discussion and conclusionWhile the general population requires information on the rabies situation in Madagascar and on how to proceed in the event of a bite, veterinarians and decision-makers need to be fully aware of an evidence-based approach to rabies surveillance, prevention and control. Communication between the human and animal health sectors should be improved. Politicians need to be persuaded of the importance of funding to eliminate rabies in Madagascar. The adoption, in early 2023, of a national strategic plan for rabies control is a first step in this direction.
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Affiliation(s)
- Anou Dreyfus
- Unité d’Epidémiologie et de Recherche Clinique, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Marie Hermelienne Volasoa
- Unité de Virologie, Institut Pasteur de Madagascar, Antananarivo, Madagascar
- Département des Enseignements des Sciences et de Médecine Vétérinaire, Université d’Antananarivo, Antananarivo, Madagascar
| | - Hélène Guis
- Unité d’Epidémiologie et de Recherche Clinique, Institut Pasteur de Madagascar, Antananarivo, Madagascar
- CIRAD, UMR ASTRE, Antananarivo, Madagascar
- Astre, Université de Montpellier, CIRAD, INRAE, Montpellier, France
- Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | | | | | | | - Naltiana Rakotondrabe
- Directorate of Veterinary Services, Ministry of Agriculture and Livestock, Antananarivo, Madagascar
| | | | - Philippe Dussart
- Unité de Virologie, Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Daouda Kassie
- Unité d’Epidémiologie et de Recherche Clinique, Institut Pasteur de Madagascar, Antananarivo, Madagascar
- CIRAD, UMR ASTRE, Antananarivo, Madagascar
- Astre, Université de Montpellier, CIRAD, INRAE, Montpellier, France
| | - Vincent Lacoste
- Unité de Virologie, Institut Pasteur de Madagascar, Antananarivo, Madagascar
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Neves JMM, Belo VS, Catita CMS, de Oliveira BFA, Horta MAP. Modeling of Human Rabies Cases in Brazil in Different Future Global Warming Scenarios. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:212. [PMID: 38397701 PMCID: PMC10888213 DOI: 10.3390/ijerph21020212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/22/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024]
Abstract
Bat species have been observed to have the potential to expand their distribution in response to climate change, thereby influencing shifts in the spatial distribution and population dynamics of human rabies cases. In this study, we applied an ensemble niche modeling approach to project climatic suitability under different future global warming scenarios for human rabies cases in Brazil, and assessed the impact on the probability of emergence of new cases. We obtained notification records of human rabies cases in all Brazilian cities from January 2001 to August 2023, as reported by the State and Municipal Health Departments. The current and future climate data were sourced from a digital repository on the WorldClim website. The future bioclimatic variables provided were downscaled climate projections from CMIP6 (a global model ensemble) and extracted from the regionalized climate model HadGEM3-GC31-LL for three future socioeconomic scenarios over four periods (2021-2100). Seven statistical algorithms (MAXENT, MARS, RF, FDA, CTA, GAM, and GLM) were selected for modeling human rabies. Temperature seasonality was the bioclimatic variable with the highest relative contribution to both current and future consensus models. Future scenario modeling for human rabies indicated a trend of changes in the areas of occurrence, maintaining the current pace of global warming, population growth, socioeconomic instability, and the loss of natural areas. In Brazil, there are areas with a higher likelihood of climatic factors contributing to the emergence of cases. When assessing future scenarios, a change in the local climatic suitability is observed that may lead to a reduction or increase in cases, depending on the region.
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Affiliation(s)
| | - Vinicius Silva Belo
- Laboratory of Parasitology, Federal University of São João del-Rei, Divinopolis 36307-352, Brazil;
| | - Cristina Maria Souza Catita
- Department of Geographic Engineering, Geophysics and Energy, University of Lisbon, Lisbon 1649-004, Portugal;
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Abubakar AT, Al-Mustapha AI, Oyewo M, Ibrahim A, Abdulrahim I, Yakub JM, Elelu N, Nguku P, Balogun MS, Awosanya EJ, Kia GSN, Kwaga JKP, Okoli I, Bolajoko MB, Alimi Y, Mbilo C, Dacheux L. Prospects for dog rabies elimination in Nigeria by 2030. Zoonoses Public Health 2024; 71:1-17. [PMID: 37933425 DOI: 10.1111/zph.13084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 10/03/2023] [Accepted: 10/09/2023] [Indexed: 11/08/2023]
Abstract
The attainment of the global target of zero dog-mediated human rabies by 2030 depends on functional rabies programmes. Nigeria, a rabies-endemic country, and the most populous country in Africa has a very poor rabies control strategy with a score of 1.5 out of 5 based on the Stepwise Approach towards Rabies Elimination (SARE). In this article, we report a scoping review that we conducted to highlight the strengths, weaknesses, opportunities and threats as well as situational analysis of rabies control in Nigeria and suggest a timeline for key activities that are needed to ensure zero by 30. Our findings reveal that rabies is grossly under-reported as only 998 human and 273 dog-suspected rabies cases were reported across Nigeria between 2017 and 2022. Our literature review also demonstrates a paucity of information on rabies in both human and animal health sectors. A total of 49 studies on dog rabies in Nigeria, with a predominance of reports from the North Central geopolitical region (48%, n = 23) were therefore included in this study. Currently, only 16.2% (n = 6/37) of Nigerian states have available data related to the estimated dog populations, the dog ownership rates, the vaccination status of dogs or the incidence of dog bites. Based on a dog-to-human ratio of 1:16.3, we estimated that the dog population in Nigeria was 12,969,368 (95% CI: 12,320,900-13,617,836). Thus, to attain herd immunity and dog rabies control in Nigeria, at least 9.1 million dogs must be vaccinated annually. Our review reveals that, despite the strengths and available opportunities to achieve rabies control in Nigeria by 2030, the weaknesses and challenges will make the attainment of zero by 30 very difficult or impossible. Nigeria's best-case scenario by the year 2030 is SARE stage 3-4 (control-elimination) out of 5. Otherwise, the rabies control programme might not surpass SARE stages 2-3. To attain zero by 30, Nigeria must re-strategize its current rabies control programme by funding and implementing the national strategic plan for rabies control, creating a rabies desk office in the 37 states (FCT inclusive), rigorously conducting mass vaccination campaigns, providing post-exposure prophylaxis, prioritizing mass enlightenment with a focus on responsible pet ownership and conduct baseline national rabies surveillance in the animal and human health sectors.
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Affiliation(s)
- Ahmed Tijani Abubakar
- Africa Centers for Disease Control and Prevention, Addis Ababa, Ethiopia
- Department of Veterinary Services, Kwara State Ministry of Agriculture and Rural Development, Ilorin, Nigeria
| | - Ahmad Ibrahim Al-Mustapha
- Department of Veterinary Services, Kwara State Ministry of Agriculture and Rural Development, Ilorin, Nigeria
- Department of Food Hygiene and Environmental Health, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria
| | - Muftau Oyewo
- Department of Veterinary Services, Kwara State Ministry of Agriculture and Rural Development, Ilorin, Nigeria
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
| | - Ahmed Ibrahim
- Department of Veterinary Services, Kwara State Ministry of Agriculture and Rural Development, Ilorin, Nigeria
| | - Ibrahim Abdulrahim
- Department of Veterinary Services, Kwara State Ministry of Agriculture and Rural Development, Ilorin, Nigeria
| | - Jimoh Muhammad Yakub
- Department of Veterinary Services, Kwara State Ministry of Agriculture and Rural Development, Ilorin, Nigeria
| | - Nusirat Elelu
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Ilorin, Ilorin, Nigeria
| | - Patrick Nguku
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
| | | | - Emmanuel Jolaoluwa Awosanya
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria
| | - Grace Sabo Nok Kia
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, Ahmadu Bello University, Zaria, Nigeria
- Africa Center for Excellence for Neglected Tropical Diseases and Forensic Biotechnology, Ahmadu Bello University, Zaria, Nigeria
| | - Jacob K P Kwaga
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, Ahmadu Bello University, Zaria, Nigeria
- Africa Center for Excellence for Neglected Tropical Diseases and Forensic Biotechnology, Ahmadu Bello University, Zaria, Nigeria
| | - Ihekerenma Okoli
- Department of Veterinary and Pest Control Services, Federal Ministry of Agriculture and Rural Development, Abuja, Nigeria
| | | | - Yewande Alimi
- Africa Centers for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Celine Mbilo
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Laurent Dacheux
- National Reference Center for Rabies, Institut Pasteur, Paris, France
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9
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Nadal D, Bote K, Masthi R, Narayana A, Ross Y, Wallace R, Abela B. Rabies post-exposure prophylaxis delivery to ensure treatment efficacy and increase compliance. IJID ONE HEALTH 2023; 1:100006. [PMID: 38152594 PMCID: PMC10752235 DOI: 10.1016/j.ijidoh.2023.100006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/10/2023] [Accepted: 09/05/2023] [Indexed: 12/29/2023]
Abstract
Objectives Since rabies is lethal once symptoms appear, its prevention including community awareness, mass dog vaccination and post-exposure prophylaxis (PEP) is crucial. Although safe and potent rabies vaccines have long been available, the global rabies burden is still high and access to adequately-delivered PEP remains challenging. Here we offer healthcare providers up-to-date, simple, exhaustive, visual guidance on how to perform PEP steps correctly. Protocol PEP consists of 1) washing the wound with water and soap for 15 min, 2) assessing the need for rabies biologicals based on specific criteria; 3) administering, if required, rabies immunoglobulin or monoclonal antibodies deep in and around all wounds; 4) starting, if necessary, the WHO-recommended intradermal 1-week vaccination regimen; 5) informing patients adequately throughout the PEP process to increase compliance and avoid dangerous misconceptions about animal bite treatment and rabies risk. Discussion The intradermal 1-week vaccination regimen recommended by WHO is as safe as other regimens but carries important cost-, dose- and time-sparing benefits. As fundamental as the correct administration of rabies biologicals is clear doctor-patient communication and sharing of up-to-date knowledge among healthcare professionals. Conclusions This resource will help ensuring that no life is lost to rabies, an incurable yet preventable disease.
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Affiliation(s)
- Deborah Nadal
- Department of Humanities, Ca’ Foscari University of Venice: Malcanton Marcorà, Dorsoduro 3484/D, 30123 Venice, Italy
- Department of Control of Neglected Tropical Diseases, World Health Organization, Avenue Appia 20, 1202 Geneva, Switzerland
| | - Katrin Bote
- Department of Control of Neglected Tropical Diseases, World Health Organization, Avenue Appia 20, 1202 Geneva, Switzerland
| | - Ramesh Masthi
- Department of Community Medicine at the Kempegowda Institute of Medical Sciences Hospital & Research Centre, Krishna Rajendra Road, 560004 Bengaluru, Karnataka, India
| | - Ashwath Narayana
- Department of Community Medicine at the Kempegowda Institute of Medical Sciences Hospital & Research Centre, Krishna Rajendra Road, 560004 Bengaluru, Karnataka, India
| | - Yasmeen Ross
- US Centers for Disease Control and Prevention, Clifton Road 1600, 30333 Atlanta, GA, United States
| | - Ryan Wallace
- US Centers for Disease Control and Prevention, Clifton Road 1600, 30333 Atlanta, GA, United States
| | - Bernadette Abela
- Department of Control of Neglected Tropical Diseases, World Health Organization, Avenue Appia 20, 1202 Geneva, Switzerland
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10
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Granerod J, Huang Y, Davies NWS, Sequeira PC, Mwapasa V, Rupali P, Michael BD, Solomon T, Easton A. Global Landscape of Encephalitis: Key Priorities to Reduce Future Disease Burden. Clin Infect Dis 2023; 77:1552-1560. [PMID: 37436770 PMCID: PMC10686956 DOI: 10.1093/cid/ciad417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/28/2023] [Accepted: 07/10/2023] [Indexed: 07/13/2023] Open
Abstract
Encephalitis affects people across the lifespan, has high rates of mortality and morbidity, and results in significant neurological sequelae with long-term consequences to quality of life and wider society. The true incidence is currently unknown due to inaccurate reporting systems. The disease burden of encephalitis is unequally distributed across the globe being highest in low- and middle-income countries where resources are limited. Here countries often lack diagnostic testing, with poor access to essential treatments and neurological services, and limited surveillance and vaccination programs. Many types of encephalitis are vaccine preventable, whereas others are treatable with early diagnosis and appropriate management. In this viewpoint, we provide a narrative review of key aspects of diagnosis, surveillance, treatment, and prevention of encephalitis and highlight priorities for public health, clinical management, and research, to reduce the disease burden.
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Affiliation(s)
- Julia Granerod
- Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Science, University of Liverpool, Liverpool, United Kingdom
- Dr JGW Consulting Ltd., London, United Kingdom
| | - Yun Huang
- Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Science, University of Liverpool, Liverpool, United Kingdom
- National Institute for Health and Care Research (NIHR) Health Protection Research Unit for Emerging and Zoonotic Infection, Liverpool, United Kingdom
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
| | | | | | - Victor Mwapasa
- University of Malawi, College of Medicine, Blantyre, Malawi
| | - Priscilla Rupali
- Department of Infectious Diseases, Christian Medical College Vellore, Vellore, Tamil Nadu, India
| | - Benedict D Michael
- Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Science, University of Liverpool, Liverpool, United Kingdom
- National Institute for Health and Care Research (NIHR) Health Protection Research Unit for Emerging and Zoonotic Infection, Liverpool, United Kingdom
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
| | - Tom Solomon
- Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Science, University of Liverpool, Liverpool, United Kingdom
- National Institute for Health and Care Research (NIHR) Health Protection Research Unit for Emerging and Zoonotic Infection, Liverpool, United Kingdom
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, United Kingdom
- The Pandemic Institute, Liverpool, United Kingdom
| | - Ava Easton
- Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary, and Ecological Science, University of Liverpool, Liverpool, United Kingdom
- The Encephalitis Society, Malton, United Kingdom
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11
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Hongtu Q, BoLi L, Jianguo C, Shusheng P, Ming M. Immunogenicity of rabies virus G mRNA formulated with lipid nanoparticles and nucleic acid immunostimulators in mice. Vaccine 2023; 41:7129-7137. [PMID: 37866995 DOI: 10.1016/j.vaccine.2023.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/07/2023] [Accepted: 10/10/2023] [Indexed: 10/24/2023]
Abstract
Rabies is a preventable zoonotic disease caused by rabies virus (RABV) with high mortality. Messenger RNA (mRNA) vaccines have opened up new avenues for vaccine development and pandemic preparedness with potent scalability, which may overcome the only licensed rabies inactived vaccine' shortcoming of time and cost wasting. Here, we designed an RABV mRNA vaccines expressed RABV G protein and capsulated with lipid nanoparticle (LNP) and different nucleic acid immunostimulator (CPG 1018, CPG 2395 and Poly I:C) and then assessed the immunogenicity and protective capacity in mice. While RABV mRNA capsulated with LNP and CPG 1018 could induce more potent humoral response with highest and durable RABV-G specific IgG titers and virus neutralizing titers, but also induced stronger RABV G-specific cell-mediated immunity (CMI) responses, including the highest proportions of interferon-γ (IFN-γ) and tumor necrosis factor alpha (TNFα)- producing CD4+/CD8 + T cells according to a flow cytometry assay in mice. In addition, in the pre- and post-exposure challenge assays, LNP + CPG 1018 capsulated RABV G mRNA induced 100 % protection against 25 LD50 of RABV infection with highest inhibition efficacy of viral replication with the decreased virus genome detected by qRT-PCR. These results showed that RABV G mRNA capsulated with LNP immune-stimulating nucleic acids CPG 1018 showed promise as a safe and economical rabies vaccine candidate.
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Affiliation(s)
- Qiao Hongtu
- Scientific Research Department, Chengdu Qingbaijiang District People's Hospital, Chengdu, China.
| | - Liu BoLi
- Emergency Department, Chengdu Qingbaijiang District People's Hospital, Chengdu, China
| | - Chen Jianguo
- Medical Laboratory, Chengdu Qingbaijiang District People's Hospital, Chengdu, China
| | - Peng Shusheng
- Medical Laboratory, Chengdu Qingbaijiang District People's Hospital, Chengdu, China
| | - Min Ming
- Medical Laboratory, Chengdu Qingbaijiang District People's Hospital, Chengdu, China
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12
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Auerswald H, Maestri A, Touch S, In S, Ya N, Heng B, Bosch-Castells V, Augard C, Petit C, Dussart P, Peng Y, Cantaert T, Ly S. Side-by-side Comparative Study of the Immunogenicity of the Intramuscular and Intradermal Rabies Post-exposure Prophylaxis Regimens in a Cohort of Suspected Rabies Virus Exposed Individuals. Clin Infect Dis 2023; 77:910-916. [PMID: 37337899 PMCID: PMC10506778 DOI: 10.1093/cid/ciad304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/15/2023] [Accepted: 05/18/2023] [Indexed: 06/21/2023] Open
Abstract
All World Health Organization (WHO) pre-qualified rabies vaccines for humans are inactivated tissue culture rabies virus formulations produced for intramuscular (IM) administration. Due to costs and vaccine shortage, dose-saving intradermal (ID) administration of rabies post-exposure prophylaxis (PEP) is encouraged by WHO. This study compared the immunogenicity of the ID 2-site, 3-visit Institut Pasteur Cambodge (IPC) PEP regimen to the IM 1-site, 4-visit 4-dose Essen regimen using Verorab vaccine (Sanofi). The development of neutralizing antibodies (nAbs) and T cell response was assessed in 210 patients with a category II or III animal exposure in a rabies-endemic country. At day 28, all participants developed nAbs (≥0.5 IU/mL), irrespective of PEP scheme, age, or administration of rabies immunoglobulin. T cell response and nAb titers were similar for both PEP schemes. This study demonstrated that the 1-week ID IPC regimen is as effective as the 2-week IM 4-dose Essen regimen in inducing an anti-rabies immune response under real-life PEP.
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Affiliation(s)
- Heidi Auerswald
- Virology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Alvino Maestri
- Immunology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Sothy Touch
- Rabies Prevention Center, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Saraden In
- Virology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Nisa Ya
- Immunology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Borita Heng
- Immunology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | | | | | | | - Philippe Dussart
- Virology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Yiksing Peng
- Rabies Prevention Center, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Tineke Cantaert
- Immunology Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
| | - Sowath Ly
- Epidemiology and Public Health Unit, Institut Pasteur du Cambodge, Pasteur Network, Phnom Penh, Cambodia
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13
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Shibabaw AD, Nakambale HN, Bangalee V. Inventory management practices: implications on the pharmaceuticals expenditure of rabies vaccine in public health facilities, Namibia. BMC Health Serv Res 2023; 23:823. [PMID: 37533090 PMCID: PMC10394911 DOI: 10.1186/s12913-023-09790-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 07/05/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND To achieve well-regulated distribution, storage, and utilization of the rabies vaccine, health facilities should adhere to standard operating procedures. In Namibia, information on inventory management, utilization, monitoring, and reporting of rabies vaccine adherence to standard operating procedures in public healthcare facilities is insufficient. The aim of this study was to assess adherence to rabies vaccine standard operating procedures and inventory management and to compare rabies vaccine expenditure to the number of patients who received rabies vaccination at the Ministry of Health and Social Services' public healthcare facilities from 2018 to 2020. METHODS A cross-sectional, web-based questionnaire consisting of closed-ended questions was sent to 147 pharmacy staff and warehouse managers working in the 14 regions of Namibia during the period of May 1, 2021, to June 2, 2021. The overall expenditure and the total number of patients vaccinated from 2018 to 2020 were obtained from national-level logistic and vaccination program coordinators. Data were coded and transcribed into Microsoft® Excel® 2013 and analyzed using SPSS® version 27. RESULTS One hundred and thirty-three completed questionnaires were received from sixty-nine public health centers and hospitals. The group of respondents consisted of pharmacist assistants (50%), pharmacy technicians (12%), pharmacists (36.8%), senior pharmacists (0.8%), and chief pharmacists (1.5%). Overall, adherence to standard operating procedures was poor (27.1%). Rabies vaccine distributed to public health facilities from 2018 to 2020 was worth N$75,381,419.91 (~ US$4,074,671.46) and was expected to vaccinate 87,269 patients; however, only 95 cases of both rabies and rabid dog-bite patients were reported. The major inventory management challenges for public healthcare facilities include an inadequate number of pharmacy staff, poor adherence to standardized pharmaceutical warehousing, lack of regular supervision, and inadequate staff training. CONCLUSION Inventory management practices in public healthcare facilities were not in compliance with standard operating procedures. There is a significant discrepancy between rabies vaccine expenditure and the number of patients that were vaccinated. Therefore, there is a need for adequate staff training on inventory management and regular facility supervision to enforce optimal rabies vaccine inventory management practices.
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Affiliation(s)
- Alemnew Dessie Shibabaw
- School of Health Sciences, Department of Pharmaceutical Sciences, University of KwaZulu-Natal, Westville Campus, Private Bag X54001, Durban, 4000, South Africa
- Ministry of Health and Social Services, Windhoek, Namibia
| | - Hilma N Nakambale
- School of Health Sciences, Department of Pharmaceutical Sciences, University of KwaZulu-Natal, Westville Campus, Private Bag X54001, Durban, 4000, South Africa.
| | - Varsha Bangalee
- School of Health Sciences, Department of Pharmaceutical Sciences, University of KwaZulu-Natal, Westville Campus, Private Bag X54001, Durban, 4000, South Africa
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Coertse J, Viljoen N, Weyer J, Markotter W. Comparative Neutralization Activity of Commercial Rabies Immunoglobulin against Diverse Lyssaviruses. Vaccines (Basel) 2023; 11:1255. [PMID: 37515070 PMCID: PMC10383743 DOI: 10.3390/vaccines11071255] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
Novel lyssaviruses, the causative agents of rabies, continue to be described mostly due to increased surveillance in bat hosts. Biologicals for the prevention of rabies in humans have, however, remained largely unchanged for decades. This study aimed to determine if commercial rabies immunoglobulin (RIG) could neutralize diverse lyssaviruses. Two commercial preparations, of human or equine origin, were evaluated against a panel consisting of 13 lyssavirus species. Reduced neutralization was observed for the majority of lyssaviruses compared to rabies virus and was more evident for lyssaviruses outside of phylogroup I. Neutralization of more diverse lyssaviruses only occurred at very high doses, except for Ikoma lyssavirus, which could not be neutralized by the RIG evaluated in this study. The use of RIG is a crucial component of rabies post-exposure prophylaxis and the data generated here indicate that RIG, in its current form, will not protect against all lyssaviruses. In addition, higher doses of RIG may be required for neutralization as the genetic distance from vaccine strains increases. Given the limitations of current RIG preparations, alternative passive immunization options should be investigated.
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Affiliation(s)
- Jessica Coertse
- Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases, A Division of the National Health Laboratory Service, Johannesburg 2131, South Africa
- Centre for Viral Zoonoses, Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria 0001, South Africa
| | - Natalie Viljoen
- Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases, A Division of the National Health Laboratory Service, Johannesburg 2131, South Africa
- Centre for Viral Zoonoses, Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria 0001, South Africa
| | - Jacqueline Weyer
- Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases, A Division of the National Health Laboratory Service, Johannesburg 2131, South Africa
- Centre for Viral Zoonoses, Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria 0001, South Africa
- Department of Microbiology and Infectious Diseases, School of Pathology, University of Witwatersrand, Johannesburg 2131, South Africa
| | - Wanda Markotter
- Centre for Viral Zoonoses, Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria 0001, South Africa
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15
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Piamonte BLC, Easton A, Wood GK, Davies NWS, Granerod J, Michael BD, Solomon T, Thakur KT. Addressing vaccine-preventable encephalitis in vulnerable populations. Curr Opin Neurol 2023; 36:185-197. [PMID: 37078664 DOI: 10.1097/wco.0000000000001158] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
PURPOSE OF REVIEW Vaccinations have been pivotal in lowering the global disease burden of vaccine-preventable encephalitides, including Japanese encephalitis, tick-borne encephalitis, measles encephalitis, and rabies encephalitis, among others. RECENT FINDINGS Populations vulnerable to vaccine-preventable infections that may lead to encephalitis include those living in endemic and rural areas, military members, migrants, refugees, international travelers, younger and older persons, pregnant women, the immunocompromised, outdoor, healthcare and laboratory workers, and the homeless. There is scope for improving the availability and distribution of vaccinations, vaccine equity, surveillance of vaccine-preventable encephalitides, and public education and information. SUMMARY Addressing these gaps in vaccination strategies will allow for improved vaccination coverage and lead to better health outcomes for those most at risk for vaccine-preventable encephalitis.
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Affiliation(s)
- Bernadeth Lyn C Piamonte
- Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Ava Easton
- The Encephalitis Society, Malton
- Department of Clinical Infection, Microbiology, and Immunology, Institute of Infection, Veterinary and Ecological Sciences
| | - Greta K Wood
- Department of Clinical Infection, Microbiology, and Immunology, Institute of Infection, Veterinary and Ecological Sciences
- National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infection, University of Liverpool, Liverpool
| | - Nicholas W S Davies
- The Encephalitis Society, Malton
- Department of Neurology, Chelsea and Westminster Hospital, NHS Trust
| | - Julia Granerod
- Department of Clinical Infection, Microbiology, and Immunology, Institute of Infection, Veterinary and Ecological Sciences
- Dr JGW Consulting Ltd., London
| | - Benedict D Michael
- The Encephalitis Society, Malton
- Department of Clinical Infection, Microbiology, and Immunology, Institute of Infection, Veterinary and Ecological Sciences
- National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infection, University of Liverpool, Liverpool
- Department of Neurology, The Walton Centre NHS Foundation Trust
| | - Tom Solomon
- The Encephalitis Society, Malton
- Department of Clinical Infection, Microbiology, and Immunology, Institute of Infection, Veterinary and Ecological Sciences
- National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infection, University of Liverpool, Liverpool
- Department of Neurology, The Walton Centre NHS Foundation Trust
- Department of Neurological Science, University of Liverpool, Liverpool, United Kingdom
| | - Kiran T Thakur
- The Encephalitis Society, Malton
- Department of Neurology, Columbia University Irving Medical Center/New York Presbyterian Hospital, New York, USA
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16
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Wang X, Terrie L, Wu G, Van Damme EJM, Thorrez L, Fooks AR, Banyard AC, Jochmans D, Neyts J. Urtica dioica Agglutinin Prevents Rabies Virus Infection in a Muscle Explant Model. Pharmaceutics 2023; 15:pharmaceutics15051353. [PMID: 37242595 DOI: 10.3390/pharmaceutics15051353] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/06/2023] [Accepted: 04/26/2023] [Indexed: 05/28/2023] Open
Abstract
Infection with the rabies virus (RABV) results in a 100% lethal neurological disease once symptoms develop. Post-exposure prophylaxis (PEP) consists of a combination of vaccination and anti-rabies immunoglobulins (RIGs); it is 100% effective if administered early after exposure. Because of its limited availability, alternatives for RIGs are needed. To that end, we evaluated a panel of 33 different lectins for their effect on RABV infection in cell culture. Several lectins, with either mannose or GlcNAc specificity, elicited anti-RABV activity, of which the GlcNAc-specific Urtica dioica agglutinin (UDA) was selected for further studies. UDA was found to prevent the entry of the virus into the host cell. To further assess the potential of UDA, a physiologically relevant RABV infection muscle explant model was developed. Strips of dissected swine skeletal muscle that were kept in a culture medium could be productively infected with the RABV. When the infection of the muscle strips was carried out in the presence of UDA, RABV replication was completely prevented. Thus, we developed a physiologically relevant RABV muscle infection model. UDA (i) may serve as a reference for further studies and (ii) holds promise as a cheap and simple-to-produce alternative for RIGs in PEP.
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Affiliation(s)
- Xinyu Wang
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium
- Global Virus Network (GVN), Baltimore, MD 21201, USA
| | - Lisanne Terrie
- Tissue Engineering Lab, Department of Development and Regeneration, Campus Kulak, KU Leuven, 8500 Kortrijk, Belgium
| | - Guanghui Wu
- Animal and Plant Health Agency (APHA), Woodham Lane, Weybridge KT15 3NB, UK
| | - Els J M Van Damme
- Department of Biotechnology, Faculty of Bioscience Engineering, Ghent University, 9000 Gent, Belgium
| | - Lieven Thorrez
- Tissue Engineering Lab, Department of Development and Regeneration, Campus Kulak, KU Leuven, 8500 Kortrijk, Belgium
| | - Anthony R Fooks
- Animal and Plant Health Agency (APHA), Woodham Lane, Weybridge KT15 3NB, UK
| | - Ashley C Banyard
- Animal and Plant Health Agency (APHA), Woodham Lane, Weybridge KT15 3NB, UK
| | - Dirk Jochmans
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium
- Global Virus Network (GVN), Baltimore, MD 21201, USA
| | - Johan Neyts
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, 3000 Leuven, Belgium
- Global Virus Network (GVN), Baltimore, MD 21201, USA
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Shen T, Welburn SC, Sun L, Yang GJ. Progress towards dog-mediated rabies elimination in PR China: a scoping review. Infect Dis Poverty 2023; 12:30. [PMID: 37024944 PMCID: PMC10077633 DOI: 10.1186/s40249-023-01082-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 03/14/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Rabies continues to be a serious threat to global public health endangering people's health and public health safety. In the People's Republic of China, multi-sectoral and comprehensive prevention and control strategies have aimed to extensively curb human rabies transmission. Here, we examine the current state of rabies infection in China, explore strategic interventions put in place in response to WHO's ambition of "Zero rabies deaths by 2030" and critically assess the constraints and feasibility of dog-mediated rabies elimination in China. METHODS This study analyzed and evaluated the process towards dog-mediated rabies elimination in China from five perspectives: namely, human, dog, policy, challenge, and prospects. Evidence-based data on progress of dog-mediated rabies elimination in China was derived from a number of sources; a literature search was undertaken using PubMed, Web of Science and CNKI databases, distribution data for human rabies cases as derived from the Data-center of the China Public Health Science and policy and document data were obtained from official websites of the relevant China ministries and commissions. RESULTS The incidence of human rabies cases in China have shown a downward trend year-on-year since 2007. Implementation of a government-led, multi-sectoral "One Health" approach to combating rabies has driven down the total number of rabies deaths nationwide to around 200 in 2020. The number of provincial-level administrative divisions (PLADs) reporting human cases of rabies has also decreased to 21 in 2020, 13 of which reported less than 10 cases. Furthermore, the number of outpatient visits seeking rabies post-exposure prophylaxis has risen dramatically over the past two decades, with demand being 15 times higher than it was initially. There remain however, significant gaps in rabies elimination outcomes across the different regions of China. To date the target of achieving a canine rabies vaccination rate of > 75% has not been met. The challenges of rabies immunization of dogs and dog management in underdeveloped cities and rural areas need to be addressed together with more effective animal surveillance and rabies risk from and too wildlife and livestock. CONCLUSIONS The Chinese government-led, multi-sectoral "One Health" approach to combating rabies and has made significant progress over the past decade. Development and adoption of more cost-effective One Health strategies can achieve more nationally beneficial rabies elimination outcomes. The ambitious target of "Zero rabies deaths by 2030" can be met through establishment of long-lasting herd immunity in dogs by means of dog mass vaccination campaigns, dog population management, epidemiological surveillance and the application of large-scale oral rabies vaccine to eliminate rabies in wild animals coupled with deployment of cost-effective human post-exposure prophylaxis, and community education.
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Affiliation(s)
- Tianren Shen
- Zhejiang University-University of Edinburgh Joint Institute, Zhejiang University, International Campus, 718 East Haizhou Road, Haining, 314400, People's Republic of China
- Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine and Veterinary Medicine, The University of Edinburgh, 1 George Square, Edinburgh, EH8 9JZ, Scotland, UK
| | - Susan Christina Welburn
- Zhejiang University-University of Edinburgh Joint Institute, Zhejiang University, International Campus, 718 East Haizhou Road, Haining, 314400, People's Republic of China
- Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine and Veterinary Medicine, The University of Edinburgh, 1 George Square, Edinburgh, EH8 9JZ, Scotland, UK
| | - Long Sun
- Department of Infectious Diseases, The First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, Hainan, People's Republic of China
| | - Guo-Jing Yang
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, The School of Tropical Medicine, The First Affiliated Hospital, Hainan Medical University, Haikou, 571199, Hainan, People's Republic of China.
- Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine and Veterinary Medicine, The University of Edinburgh, 1 George Square, Edinburgh, EH8 9JZ, Scotland, UK.
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Mshelbwala PP, J. Soares Magalhães R, Weese JS, Ahmed NO, Rupprecht CE, Clark NJ. Modelling modifiable factors associated with the probability of human rabies deaths among self-reported victims of dog bites in Abuja, Nigeria. PLoS Negl Trop Dis 2023; 17:e0011147. [PMID: 36809362 PMCID: PMC9983858 DOI: 10.1371/journal.pntd.0011147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 03/03/2023] [Accepted: 02/07/2023] [Indexed: 02/23/2023] Open
Abstract
Canine-mediated rabies kills tens of thousands of people annually in lesser-developed communities of Asia, Africa, and the Americas, primarily through bites from infected dogs. Multiple rabies outbreaks have been associated with human deaths in Nigeria. However, the lack of quality data on human rabies hinders advocacy and resource allocation for effective prevention and control. We obtained 20 years of dog bite surveillance data across 19 major hospitals in Abuja, incorporating modifiable and environmental covariates. To overcome the challenge of missing information, we used a Bayesian approach with expert-solicited prior information to jointly model missing covariate data and the additive effects of the covariates on the predicted probability of human death after rabies virus exposure. Only 1155 cases of dog bites were recorded throughout the study period, out of which 4.2% (N = 49) died of rabies. The odds for risk of human death were predicted to decrease among individuals who were bitten by owned dogs compared to those bitten by free-roaming dogs. Similarly, there was a predicted decrease in the probability of human death among victims bitten by vaccinated dogs compared to those bitten by unvaccinated dogs. The odds for the risk of human death after bitten individuals received rabies prophylaxis were predicted to decrease compared to no prophylaxis. We demonstrate the practical application of a regularised Bayesian approach to model sparse dog bite surveillance data to uncover risk factors for human rabies, with broader applications in other endemic rabies settings with similar profiles. The low reporting observed in this study underscores the need for community engagement and investment in surveillance to increase data availability. Better data on bite cases will help to estimate the burden of rabies in Nigeria and would be important to plan effective prevention and control of this disease.
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Affiliation(s)
- Philip P. Mshelbwala
- School of Veterinary Science, The University of Queensland, Gatton, Australia
- Department of Veterinary Medicine, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
- * E-mail: ,
| | - Ricardo J. Soares Magalhães
- School of Veterinary Science, The University of Queensland, Gatton, Australia
- Children’s Health and Environment Program, UQ Children’s Health Research Centre, The University of Queensland, South Brisbane, Australia
| | - J. Scott Weese
- Department of Pathobiology, Ontario Veterinary College, Guelph, Canada
| | | | - Charles E. Rupprecht
- LYSSA LLC, Atlanta, Georgia, United States of America
- Auburn University, Auburn, Alabama, United States of America
| | - Nicholas J. Clark
- School of Veterinary Science, The University of Queensland, Gatton, Australia
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Thumbi SM, Blumberg L, le Roux K, Salahuddin N, Abela B. A call to accelerate an end to human rabies deaths. Lancet 2022; 400:2261-2264. [PMID: 36528379 PMCID: PMC9754655 DOI: 10.1016/s0140-6736(22)02487-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/23/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022]
Affiliation(s)
- S M Thumbi
- Center for Epidemiological Modelling and Analysis, University of Nairobi, Nairobi, Kenya; Institute of Immunology and Infection Research, University of Edinburgh, Edinburgh, UK; Paul G Allen School for Global Health, Washington State University, Pullman, WA, USA.
| | - Lucille Blumberg
- Right to Care, Centurion, South Africa; Faculty of Veterinary Science, University of Pretoria, Tshwane, South Africa
| | - Kevin le Roux
- Epidemiology Unit, Veterinary Services, Department of Agriculture and Rural Development, KwaZulu-Natal, South Africa; South African Rabies Advisory Group, Pretoria, South Africa
| | - Naseem Salahuddin
- Faculty of Medicine and Infectious Diseases, Indus Hospital and Health Network, Karachi, Pakistan
| | - Bernadette Abela
- Department of the Control of Neglected Tropical Diseases, WHO, Geneva, Switzerland
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20
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Baker HJ, Martin DR, Gross AL, Chamorro MF, Naskou MC, Johnson AK, Brock KV, Van Kampen KR, Willoughby RE. Rabies: who should care? J Am Vet Med Assoc 2022; 261:592-596. [PMID: 36476414 DOI: 10.2460/javma.22.09.0420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Rabies is the deadliest viral infection known, with no reliable treatment, and although it is entirely preventable, rabies continues to kill more than 60,000 people every year, mostly children in countries where dog rabies is endemic. America is only 1 generation away from the time when rabies killed more than 10,000 animals and 50 Americans every year, but 3 to 5 Americans continue to die annually from rabies. Distressingly, > 50,000 Americans undergo rabies prevention therapy every year after exposure to potentially rabid animals. While enormous progress has been made, more must be done to defeat this ancient but persistent, fatal zoonosis. In the US, lack of public awareness and ambivalence are the greatest dangers imposed by rabies, resulting in unnecessary exposures, anxiety, and risk. Veterinarians have a special role in informing and reassuring the public about prevention and protection from rabies. This summary of current facts and future advances about rabies will assist veterinarians in informing their clients about the disease.
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Affiliation(s)
- Henry J Baker
- 1Scott-Ritchey Research Center, College of Veterinary Medicine, Auburn University, AL
- 2Department of Pathobiology, College of Veterinary Medicine, Auburn University, AL
| | - Douglas R Martin
- 1Scott-Ritchey Research Center, College of Veterinary Medicine, Auburn University, AL
- 3Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, AL
| | - Amanda L Gross
- 1Scott-Ritchey Research Center, College of Veterinary Medicine, Auburn University, AL
| | - Manuel F Chamorro
- 4Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, AL
| | - Maria C Naskou
- 1Scott-Ritchey Research Center, College of Veterinary Medicine, Auburn University, AL
- 2Department of Pathobiology, College of Veterinary Medicine, Auburn University, AL
| | - Aime K Johnson
- 1Scott-Ritchey Research Center, College of Veterinary Medicine, Auburn University, AL
- 4Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, AL
| | - Kenny V Brock
- 5Edward Via College of Osteopathic Medicine, Auburn, AL
| | | | - Rodney E Willoughby
- 7Medical College of Wisconsin and Milwaukee Children's Hospital, Milwaukee, WI
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21
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Rabies research in Ethiopia: A systematic review. One Health 2022; 15:100450. [DOI: 10.1016/j.onehlt.2022.100450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/17/2022] [Accepted: 10/17/2022] [Indexed: 11/08/2022] Open
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22
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Leme J, Guardalini LGO, Bernardino TC, Astray RM, Tonso A, Núñez EGF, Jorge SAC. Sf9 Cells Metabolism and Viability When Coinfected with Two Monocistronic Baculoviruses to Produce Rabies Virus-like Particles. Mol Biotechnol 2022; 65:970-982. [PMCID: PMC9672645 DOI: 10.1007/s12033-022-00586-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 10/14/2022] [Indexed: 11/19/2022]
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Zhang H, Huang J, Song Y, Liu X, Qian M, Huang P, Li Y, Zhao L, Wang H. Regulation of innate immune responses by rabies virus. Animal Model Exp Med 2022; 5:418-429. [PMID: 36138548 PMCID: PMC9610147 DOI: 10.1002/ame2.12273] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/31/2022] [Indexed: 11/10/2022] Open
Abstract
Rabies virus (RABV) is an infectious and neurotropic pathogen that causes rabies and infects humans and almost all warm-blooded animals, posing a great threat to people and public safety. It is well known that innate immunity is the critical first line of host defense against viral infection. It monitors the invading pathogens by recognizing the pathogen-associated molecular patterns and danger-associated molecular patterns through pattern-recognition receptors, leading to the production of type I interferons (IFNα/β), inflammatory cytokines, and chemokines, or the activation of autophagy or apoptosis to inhibit virus replication. In the case of RABV, the innate immune response is usually triggered when the skin or muscle is bitten or scratched. However, RABV has evolved many ways to escape or even hijack innate immune response to complete its own replication and eventually invades the central nervous system (CNS). Once RABV reaches the CNS, it cannot be wiped out by the immune system or any drugs. Therefore, a better understanding of the interplay between RABV and innate immunity is necessary to develop effective strategies to combat its infection. Here, we review the innate immune responses induced by RABV and illustrate the antagonism mechanisms of RABV to provide new insights for the control of rabies.
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Affiliation(s)
- Haili Zhang
- State Key Laboratory for Zoonotic Diseases, Key Laboratory for Zoonosis Research of the Ministry of EducationInstitute of Zoonosis, and College of Veterinary Medicine, Jilin UniversityChangchunChina
| | - Jingbo Huang
- State Key Laboratory for Zoonotic Diseases, Key Laboratory for Zoonosis Research of the Ministry of EducationInstitute of Zoonosis, and College of Veterinary Medicine, Jilin UniversityChangchunChina
| | - Yumeng Song
- State Key Laboratory for Zoonotic Diseases, Key Laboratory for Zoonosis Research of the Ministry of EducationInstitute of Zoonosis, and College of Veterinary Medicine, Jilin UniversityChangchunChina
| | - Xingqi Liu
- State Key Laboratory for Zoonotic Diseases, Key Laboratory for Zoonosis Research of the Ministry of EducationInstitute of Zoonosis, and College of Veterinary Medicine, Jilin UniversityChangchunChina
| | - Meichen Qian
- State Key Laboratory for Zoonotic Diseases, Key Laboratory for Zoonosis Research of the Ministry of EducationInstitute of Zoonosis, and College of Veterinary Medicine, Jilin UniversityChangchunChina
| | - Pei Huang
- State Key Laboratory for Zoonotic Diseases, Key Laboratory for Zoonosis Research of the Ministry of EducationInstitute of Zoonosis, and College of Veterinary Medicine, Jilin UniversityChangchunChina
| | - Yuanyuan Li
- State Key Laboratory for Zoonotic Diseases, Key Laboratory for Zoonosis Research of the Ministry of EducationInstitute of Zoonosis, and College of Veterinary Medicine, Jilin UniversityChangchunChina
| | - Ling Zhao
- State Key Laboratory of Agricultural MicrobiologyHuazhong Agricultural UniversityWuhanChina
| | - Hualei Wang
- State Key Laboratory for Zoonotic Diseases, Key Laboratory for Zoonosis Research of the Ministry of EducationInstitute of Zoonosis, and College of Veterinary Medicine, Jilin UniversityChangchunChina
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24
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Matulis GA, Altantogtokh D, Lantos PM, Jones JH, Wofford RN, Janko M, Tsogbadrakh N, Bayar T, Ganzorig S, Boldbaatar B, Poole‐Smith BK, Hertz J, Fiorenzano J, von Fricken ME. Hotspots in a cold land-reported cases of rabies in wildlife and livestock in Mongolia from 2012-2018. Zoonoses Public Health 2022; 69:655-662. [PMID: 35583250 PMCID: PMC9545874 DOI: 10.1111/zph.12954] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 04/14/2022] [Accepted: 04/21/2022] [Indexed: 11/29/2022]
Abstract
The epidemiological profile of rabies virus within Mongolia remains poorly characterized despite 21,302 domestic animal cases being reported between 1970-2005. This lack of knowledge is particularly concerning given that roughly 26% of the population lives a pastoral herding lifestyle and livestock production contributes up to 18% of Mongolia's total gross domestic product (GDP). The gaps in knowledge of the rabies disease ecology within Mongolia combined with the lack of routine vaccination of domestic animals and wildlife poses a significant threat to the more than 60 million heads of livestock within Mongolia. Animal rabies case data from the General Authority for Veterinary Services and National Center for Zoonotic Diseases were used in this study. Each data point included year of report, an animal descriptor, geographic coordinates and the aimag (province) of origin. A total of 2,359 animal rabies cases were reported between 2012-2018. Cattle were the most commonly reported animal overall (861 cases), followed by goats (268), sheep (251) and dogs (221) within the domestic animal category. Red foxes were responsible for most reported wildlife cases (317) followed by wolves (151). Most rabid animals were reported in the Khuvsgul, Uvurkhangai and Govi-Altai aimags, and a positive correlation was found between livestock numbers per soum and the number of rabies cases reported. Rabies poses a significant threat to the Mongolian economy and the health of human and animal populations within Mongolia. The close association of the nomadic pastoralists with both domestic animals and wildlife represents a significant threat for disease emergence and necessitates studies that describe the ecology of rabies, which may threaten these populations.
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Affiliation(s)
- Graham A. Matulis
- Department of Global and Community HealthGeorge Mason UniversityFairfaxVirginiaUSA
| | | | - Paul M. Lantos
- Duke University School of MedicineDurhamNorth CarolinaUSA
- Duke Global Health InstituteDurhamNorth CarolinaUSA
| | - Jordan H. Jones
- Department of Global and Community HealthGeorge Mason UniversityFairfaxVirginiaUSA
| | - Rachel N. Wofford
- Department of Global and Community HealthGeorge Mason UniversityFairfaxVirginiaUSA
| | - Mark Janko
- University of WashingtonSeattleWashingtonUSA
| | | | | | | | | | | | - Jeffrey Hertz
- Naval Medical Research Unit TWO (NAMRU‐2)SembawangSingapore
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25
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Trabelsi K, Zakour MB, Jordan I, Sandig V, Rourou S, Kallel H. Development of an efficient veterinary rabies vaccine production process in the avian suspension cell line AGE1.CR.pIX. BMC Biotechnol 2022; 22:17. [PMID: 35715843 PMCID: PMC9206308 DOI: 10.1186/s12896-022-00747-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/07/2022] [Indexed: 11/30/2022] Open
Abstract
Background Mass vaccination of dogs as important rabies reservoir is proposed to most effectively reduce and eliminate rabies also in humans. However, a minimum coverage of 70% needs to be achieved for control of the disease in zoonotic regions. In numerous developing countries, dog vaccination rate is still dangerously low because of economic constraints and due to a high turnover in dog populations. Improved vaccine production processes may help to alleviate cost and supply limitations. In this work, we studied and optimized the replication and vaccine potency of PV rabies virus strain in the muscovy-duck derived AGE1.CR and AGE1.CR.pIX suspension cell lines. Results The BHK-21-adapted PV rabies virus strain replicated efficiently in the avian cell lines without requirement for prior passaging. CR.pIX was previously shown to augment heat shock responses and supported slightly higher infectious titers compared to the parental CR cell line. Both cell lines allowed replication of rabies virus also in absence of recombinant IGF, the only complex component of the chemically defined medium that was developed for the two cell lines. After scale-up from optimization experiments in shake flask to production in 7-l bioreactors peak virus titers of 2.4 × 108 FFU/ml were obtained. The potency of inactivated rabies virus harvest according to the NIH test was 3.5 IU/ml. Perfusion with the chemically defined medium during the virus replication phase improved the potency of the vaccine twofold, and increased the number of doses 9.6 fold. Conclusion This study demonstrates that a rabies vaccine for animal vaccination can be produced efficiently in the AGE1.CR.pIX suspension cell line in a scalable process in chemically defined medium.
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Affiliation(s)
- Khaled Trabelsi
- Biotechnology Development group, Institut Pasteur de Tunis. Université Tunis El Manar., 13, place Pasteur. BP 74., 1002, Tunis, Tunisia.,Department of Life Sciences, Health Biotechnology Program - King Fahad Chair for Health Biotechnology, College of Graduate Studies, Arabian Gulf University, PO Box 26671, Manama, Kingdom of Bahrain
| | - Meriem Ben Zakour
- Biotechnology Development group, Institut Pasteur de Tunis. Université Tunis El Manar., 13, place Pasteur. BP 74., 1002, Tunis, Tunisia.,Laboratoire Teriak, Zone Industrielle, El Fejja Mornaguia, 1153, La Manouba, Tunisia
| | | | | | - Samia Rourou
- Biotechnology Development group, Institut Pasteur de Tunis. Université Tunis El Manar., 13, place Pasteur. BP 74., 1002, Tunis, Tunisia.
| | - Hela Kallel
- Biotechnology Development group, Institut Pasteur de Tunis. Université Tunis El Manar., 13, place Pasteur. BP 74., 1002, Tunis, Tunisia.,Quantoom Biosciences, Nivelles, Belgium
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Nadal D, Hampson K, Lembo T, Rodrigues R, Vanak AT, Cleaveland S. Where Rabies Is Not a Disease. Bridging Healthworlds to Improve Mutual Understanding and Prevention of Rabies. Front Vet Sci 2022; 9:867266. [PMID: 35782552 PMCID: PMC9240625 DOI: 10.3389/fvets.2022.867266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
Deeply embedded in local social, cultural, and religious settings, traditional healing is part of dog bite and rabies management in many rabies endemic countries. Faith healing, which usually encompasses a more holistic approach to health including physical, mental and social dimensions, is rare in the context of rabies. In Gujarat, Western India, the Hindu goddess Hadkai Mata is worshiped by low-caste communities as the Mother of Rabies in the event of a dog bite to a person or their livestock. This belief might influence people's attitudes and behaviors toward rabies prevention but has never been investigated. Through 31 in-depth interviews with healers and staff of Hadkai Mata temples, this paper explores the system of knowledge around dog and human rabies that is built and shared in these places of worship and healing. Qualitative and quantitative data were analyzed looking for convergences and divergences with the recently launched National Action Plan for dog-mediated Rabies Elimination. Results suggest that while the etiology of human rabies as a social illness is usually explained as the goddess's wish to correct misbehaving people and restore positive interpersonal relations, there is some appreciation for the biological processes of infection that lead to rabies as a physical disease. Hadkai Mata is believed to cure rabies if her patients undergo the necessary process of moral growth. Although conventional post-exposure prophylaxis is not opposed per se, it is often delayed by patients who seek traditional treatment first. Some reluctance was expressed toward mass dog vaccination because it is seen as an interference in how the goddess controls dogs, by enraging them-hence infecting them with rabies-and sending them to bite wrongdoers. Addressing these cultural perceptions is likely to be critical in achieving effective control of dog rabies in this region. The study highlights the value of multidisciplinary approaches in the control and elimination of rabies, as well as other zoonoses. This includes the importance of understanding different culturally- and religiously- mediated ways in which humans relate to animals; and looking for points of convergence and mutual understanding, upon which context-tailored, linguistically-accurate, locally acceptable, feasible and effective strategies can be designed.
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Affiliation(s)
- Deborah Nadal
- Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, United Kingdom
- Center for One Health Research, School of Public Health, University of Washington, Seattle, WA, United States
| | - Katie Hampson
- Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Tiziana Lembo
- Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Rebecca Rodrigues
- Centre for Biodiversity and Conservation, Ashoka Trust for Research in Ecology and The Environment, Bangalore, India
| | - Abi Tamim Vanak
- Centre for Biodiversity and Conservation, Ashoka Trust for Research in Ecology and The Environment, Bangalore, India
- School of Life Sciences, University of KwaZulu-Natal, Westville, South Africa
- DBT/Wellcome Trust India Alliance Program, Hyderabad, India
| | - Sarah Cleaveland
- Institute of Biodiversity, Animal Health & Comparative Medicine, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, United Kingdom
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Chuchu VM, Kitala PM, Bichanga P, Ksee D, Muturi M, Mwatondo A, Nasimiyu C, Maritim M, Mutono N, Beyene TJ, Druelles S, Hampson K, Thumbi SM. Rabies Elimination in Rural Kenya: Need for Improved Availability of Human Vaccines, Awareness and Knowledge on Rabies and Its Management Among Healthcare Workers. Front Public Health 2022; 10:769898. [PMID: 35356016 PMCID: PMC8960031 DOI: 10.3389/fpubh.2022.769898] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 01/31/2022] [Indexed: 12/25/2022] Open
Abstract
Background In Africa, rabies causes an estimated 24,000 human deaths annually. Mass dog vaccinations coupled with timely post-exposure prophylaxis (PEP) for dog-bite patients are the main interventions to eliminate human rabies deaths. A well-informed healthcare workforce and the availability and accessibility of rabies biologicals at health facilities are critical in reducing rabies deaths. We assessed awareness and knowledge regarding rabies and the management of rabies among healthcare workers, and PEP availability in rural eastern Kenya. Methodology We interviewed 73 healthcare workers from 42 healthcare units in 13 wards in Makueni and Kibwezi West sub-counties, Makueni County, Kenya in November 2018. Data on demographics, years of work experience, knowledge of rabies, management of bite and rabies patients, and availability of rabies biologicals were collected and analyzed. Results Rabies PEP vaccines were available in only 5 (12%) of 42 health facilities. None of the health facilities had rabies immunoglobulins in stock at the time of the study. PEP was primarily administered intramuscularly, with only 11% (n = 8) of the healthcare workers and 17% (7/42) healthcare facilities aware of the dose-sparing intradermal route. Less than a quarter of the healthcare workers were aware of the World Health Organization categorization of bite wounds that guides the use of PEP. Eighteen percent (n = 13) of healthcare workers reported they would administer PEP for category I exposures even though PEP is not recommended for this category of exposure. Only one of six respondents with acute encephalitis consultation considered rabies as a differential diagnosis highlighting the low index of suspicion for rabies. Conclusion The availability and use of PEP for rabies was sub-optimal. We identified two urgent needs to support rabies elimination programmes: improving availability and access to PEP; and targeted training of the healthcare workers to improve awareness on bite wound management, judicious use of PEP including appropriate risk assessment following bites and the use of the dose-sparing intradermal route in facilities seeing multiple bite patients. Global and domestic funding plan that address these gaps in the human health sector is needed for efficient rabies elimination in Africa.
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Affiliation(s)
- Veronicah Mbaire Chuchu
- Department of Public Health, Pharmacology and Toxicology, University of Nairobi, Nairobi, Kenya
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
- Washington State University Global Health Program, Nairobi, Kenya
| | - Philip Mwanzia Kitala
- Department of Public Health, Pharmacology and Toxicology, University of Nairobi, Nairobi, Kenya
| | - Philet Bichanga
- Government of Makueni County, Department of Health Services, Wote, Kenya
| | - Daniel Ksee
- Government of Makueni County, Department of Agriculture, Irrigation, Livestock, and Fisheries Development, Wote, Kenya
| | - Mathew Muturi
- Zoonotic Disease Unit, Ministry of Health and Ministry of Agriculture, Livestock and Fisheries, Nairobi, Kenya
| | - Athman Mwatondo
- Zoonotic Disease Unit, Ministry of Health and Ministry of Agriculture, Livestock and Fisheries, Nairobi, Kenya
| | - Carolyne Nasimiyu
- Washington State University Global Health Program, Nairobi, Kenya
- Zoonotic Disease Unit, Ministry of Health and Ministry of Agriculture, Livestock and Fisheries, Nairobi, Kenya
| | - Marybeth Maritim
- Department of Clinical Medicine and Therapeutics, University of Nairobi, Nairobi, Kenya
| | - Nyamai Mutono
- Washington State University Global Health Program, Nairobi, Kenya
- Center for Epidemiological and Modelling Analysis, Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
| | - Tariku J. Beyene
- Center for Health Equity and Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, United States
| | - Sophie Druelles
- Vaccine Epidemiology and Modeling, Sanofi Pasteur, Lyon, France
| | - Katie Hampson
- Institute of Biodiversity, Animal Health & Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - S. M. Thumbi
- Center for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
- Center for Epidemiological and Modelling Analysis, Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
- Institute of Immunology and Infection Research, School of Biological Sciences, University of Edinburgh, Edinburgh, United Kingdom
- NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA), The University of Edinburgh, Edinburgh, United Kingdom
- Paul G Allen School for Global Health, Washington State University, Pullman, WA, United States
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Horta MA, Ledesma LA, Moura WC, Lemos ERS. From dogs to bats: Concerns regarding vampire bat-borne rabies in Brazil. PLoS Negl Trop Dis 2022; 16:e0010160. [PMID: 35239665 PMCID: PMC8893325 DOI: 10.1371/journal.pntd.0010160] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Marco Aurélio Horta
- BSL-3 Facility, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Leandro Augusto Ledesma
- Instituto Nacional de Infectologia Evandro Chagas, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Wlamir Correa Moura
- Instituto Nacional de Controle de Qualidade em Saúde, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Elba Regina Sampaio Lemos
- Laboratory of Hantavirus and Rickettsiosis, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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de Melo GD, Hellert J, Gupta R, Corti D, Bourhy H. Monoclonal antibodies against rabies: current uses in prophylaxis and in therapy. Curr Opin Virol 2022; 53:101204. [PMID: 35151116 DOI: 10.1016/j.coviro.2022.101204] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/11/2022] [Accepted: 01/15/2022] [Indexed: 12/25/2022]
Abstract
Rabies is a severe viral infection that causes an acute encephalomyelitis, which presents a case fatality of nearly 100% after the manifestation of neurological clinical signs. Rabies can be efficiently prevented with post-exposure prophylaxis (PEP), composed of vaccines and anti-rabies immunoglobulins (RIGs); however, no treatment exists for symptomatic rabies. The PEP protocol faces access and implementation obstacles in resource-limited settings, which could be partially overcome by substituting RIGs for monoclonal antibodies (mAbs). mAbs offer lower production costs, consistent supply availability, long-term storage/stability, and an improved safety profile. Here we summarize the key features of the different available mAbs against rabies, focusing on their application in PEP and highlighting their potential in a novel therapeutic approach.
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Affiliation(s)
- Guilherme Dias de Melo
- Institut Pasteur, Université de Paris, Lyssavirus Epidemiology and Neuropathology Unit, Paris, F-75015, France
| | - Jan Hellert
- Centre for Structural Systems Biology, Leibniz-Institut für Experimentelle Virologie (HPI), Notkestrasse 85, Hamburg, 22607, Germany
| | | | - Davide Corti
- Humabs Biomed SA, a Subsidiary of Vir Biotechnology, Bellinzona, Switzerland
| | - Hervé Bourhy
- Institut Pasteur, Université de Paris, Lyssavirus Epidemiology and Neuropathology Unit, Paris, F-75015, France; Institut Pasteur, Université de Paris, National Reference Center for Rabies, Paris, F-75015, France; Institut Pasteur, Université de Paris, WHO Collaborating Centre for Reference and Research on Rabies, Paris, F-75015, France.
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Farr RJ, Godde N, Cowled C, Sundaramoorthy V, Green D, Stewart C, Bingham J, O'Brien CM, Dearnley M. Machine Learning Identifies Cellular and Exosomal MicroRNA Signatures of Lyssavirus Infection in Human Stem Cell-Derived Neurons. Front Cell Infect Microbiol 2022; 11:783140. [PMID: 35004351 PMCID: PMC8739477 DOI: 10.3389/fcimb.2021.783140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 12/07/2021] [Indexed: 12/17/2022] Open
Abstract
Despite being vaccine preventable, rabies (lyssavirus) still has a significant impact on global mortality, disproportionally affecting children under 15 years of age. This neurotropic virus is deft at avoiding the immune system while travelling through neurons to the brain. Until recently, research efforts into the role of non-coding RNAs in rabies pathogenicity and detection have been hampered by a lack of human in vitro neuronal models. Here, we utilized our previously described human stem cell-derived neural model to investigate the effect of lyssavirus infection on microRNA (miRNA) expression in human neural cells and their secreted exosomes. Conventional differential expression analysis identified 25 cellular and 16 exosomal miRNAs that were significantly altered (FDR adjusted P-value <0.05) in response to different lyssavirus strains. Supervised machine learning algorithms determined 6 cellular miRNAs (miR-99b-5p, miR-346, miR-5701, miR-138-2-3p, miR-651-5p, and miR-7977) were indicative of lyssavirus infection (100% accuracy), with the first four miRNAs having previously established roles in neuronal function, or panic and impulsivity-related behaviors. Another 4-miRNA signatures in exosomes (miR-25-3p, miR-26b-5p, miR-218-5p, miR-598-3p) can independently predict lyssavirus infected cells with >99% accuracy. Identification of these robust lyssavirus miRNA signatures offers further insight into neural lineage responses to infection and provides a foundation for utilizing exosome miRNAs in the development of next-generation molecular diagnostics for rabies.
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Affiliation(s)
- Ryan J Farr
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Australian Animal Health Laboratory at the Australian Centre for Disease Preparedness, Geelong, VIC, Australia
| | - Nathan Godde
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Australian Animal Health Laboratory at the Australian Centre for Disease Preparedness, Geelong, VIC, Australia
| | - Christopher Cowled
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Health and Biosecurity at the Australian Centre for Disease Preparedness, Geelong, VIC, Australia
| | - Vinod Sundaramoorthy
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Australian Animal Health Laboratory at the Australian Centre for Disease Preparedness, Geelong, VIC, Australia
| | - Diane Green
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Australian Animal Health Laboratory at the Australian Centre for Disease Preparedness, Geelong, VIC, Australia
| | - Cameron Stewart
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Health and Biosecurity at the Australian Centre for Disease Preparedness, Geelong, VIC, Australia
| | - John Bingham
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Australian Animal Health Laboratory at the Australian Centre for Disease Preparedness, Geelong, VIC, Australia
| | - Carmel M O'Brien
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Manufacturing, Clayton, VIC, Australia.,Australian Regenerative Medicine Institute, Monash University, Clayton, VIC, Australia
| | - Megan Dearnley
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Australian Animal Health Laboratory at the Australian Centre for Disease Preparedness, Geelong, VIC, Australia
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Nyasulu PS, Weyer J, Tschopp R, Mihret A, Aseffa A, Nuvor SV, Tamuzi JL, Nyakarahuka L, Helegbe GK, Ntinginya NE, Gebreyesus MT, Doumbia S, Busse R, Drosten C. Rabies mortality and morbidity associated with animal bites in Africa: a case for integrated rabies disease surveillance, prevention and control: a scoping review. BMJ Open 2021; 11:e048551. [PMID: 34857556 PMCID: PMC8640643 DOI: 10.1136/bmjopen-2020-048551] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 09/08/2021] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE The objective of this scoping review was to map the current situation and available evidence and gaps on rabies morbidity, mortality, integrated rabies surveillance programmes, and existing prevention and control strategies in Africa. METHODS We conducted a systematic scoping review following the Joanna Briggs methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews checklist. Medline, Embase, CINAHL (EBSCOHost), Scopus, Web of Science and rabies web conferences were used to search for peer-reviewed publications between January 1946 and May 2020. Two researchers reviewed the studies and extracted data based on author (year) and region, study design and data collection duration, participants/comparators, interventions, control conditions/exposures and outcomes (rabies mortality and morbidity) and key findings/gaps/challenges. The results were reported narratively using Arksey and O'Malley's methodological framework. RESULTS Electronic search yielded 2775 records, of which 43 studies were included. A total of 543 714 bite victims were censored through the included studies. Most of the victims were less than 15 years of age. The studies included rabies morbidity (21) and mortality (15) fluctuating in space and time across Africa depending on countries' rabies prevention and control practices (16). Others were surveillance (nine studies); surveillance and prevention (five studies); management and control (seven studies); and surveillance, prevention and control (six studies). We found challenges in rabies reporting, existing dog vaccination programmes and post-exposure prophylaxis availability or compliance. CONCLUSION This study found challenges for dog rabies control and elimination in Africa and the need for a policy to drive the goal of zero dog-transmitted rabies to humans by 2030.This is an open-access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build on this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated and the use is non-commercial (see http://creativecommons.org/licenses/by-nc/4.0/).
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Affiliation(s)
- Peter Suwirakwenda Nyasulu
- Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jacqueline Weyer
- Centre for Emerging Zoonosis and Parasitic Diseases, National Institute of Communicable Diseases, Johannesburg, South Africa
- Department of Microbiology and Infectious Diseases, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Rea Tschopp
- Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Adane Mihret
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Abraham Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Samuel Victor Nuvor
- Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Jacques Lukenze Tamuzi
- Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Luke Nyakarahuka
- Department of Biosecurity, Ecosystems and Veterinary Public Health, College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Gideon Kofi Helegbe
- Department of Biochemistry and Molecular Medicine, School of Medicine, University for Development Studies, Tamale, Ghana
| | - Nyanda Elias Ntinginya
- Mbeya Medical Research Centre, National Institute of Medical Research, Mbeya, Tanzania, United Republic of
| | | | - Seydou Doumbia
- Faculty of Medicine and Odontostomatology & University Clinical Research Center, University of Sciences, Techniques and Technology of Bamako, Bamako, Mali
| | - Reinhard Busse
- Department of Health Care Management, Technical University Berlin, Berlin, Germany
| | - Christian Drosten
- Institute of Virology, Charité-University Medicine Berlin, Berlin, Germany
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Kanda K, Jayasinghe A, Jayasinghe C, Yoshida T. Public health implication towards rabies elimination in Sri Lanka: A systematic review. Acta Trop 2021; 223:106080. [PMID: 34364895 DOI: 10.1016/j.actatropica.2021.106080] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND/OBJECTIVES Sri Lanka has been targeted zero rabies by the end of 2025. Towards the elimination, the country needs more effective, evidence-based strategies and efforts to achieve its ultimate goal. Therefore, we conducted a systematic review of scientific literatures and data to assess current human and animal rabies control and prevention strategies in Sri Lanka. METHODS We compiled documents regarding current and previous rabies control and prevention activities implemented in the entire country of Sri Lanka. The documents included published literatures issued between 1946 and 2020 from both online databases and university library in Sri Lanka. All the collected documents were screened based on the PRISMA statement and categorized into several types of rabies control and prevention strategies. Official reports including epidemiological data in Sri Lanka were also filed in order to analyze the current trend of rabies control and prevention in the nation. RESULTS As of end December 2020, we found 119 scientific literatures regarding rabies control and prevention in Sri Lanka. Human rabies deaths in Sri Lanka have been reduced for the last half century by successful implementation of mass dog vaccination, animal birth control and awareness raising activities. However, the country is still facing on sporadic rabies cases, limited dog vaccination coverage and insufficient dog population management in the district level. Despite the nationwide standard of dog to human ratio of 1:8, there are huge disparities or unknown of dog ecology in regions. Awareness raising including has been enhancing for both general public and school children. Surveillance system is poorly operated so that simultaneous data analysis for decision-making is impractical. CONCLUSIONS In order to achieve nationwide rabies elimination, it is highly recommended to implement more effective rabies control and prevention activities and build adequate scientific evidences.
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Whitehouse ER, Person MK, Brown CM, Slavinski S, Rao AK, Blanton JD. Evaluating Surveillance for and Estimating Administration of Rabies Postexposure Prophylaxis in the United States, 2012-2018. PLoS Negl Trop Dis 2021; 15:e0009878. [PMID: 34695115 PMCID: PMC8568135 DOI: 10.1371/journal.pntd.0009878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 11/04/2021] [Accepted: 10/05/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND An evaluation of postexposure prophylaxis (PEP) surveillance has not been conducted in over 10 years in the United States. An accurate assessment would be important to understand current rabies trends and inform public health preparedness and response to human rabies. METHODOLOGY/PRINCIPLE FINDINGS To understand PEP surveillance, we sent a survey to public health leads for rabies in 50 U.S. states, Puerto Rico, Washington DC, Philadelphia, and New York City. Of leads from 54 jurisdictions, 39 (72%) responded to the survey; 12 reported having PEP-specific surveillance, five had animal bite surveillance that included data about PEP, four had animal bite surveillance without data about PEP, and 18 (46%) had neither. Although 12 jurisdictions provided data about PEP use, poor data quality and lack of national representativeness prevented use of this data to derive a national-level PEP estimate. We used national-level and state specific data from the Healthcare Cost & Utilization Project (HCUP) to estimate the number of people who received PEP based on emergency department (ED) visits. The estimated annual average of initial ED visits for PEP administration during 2012-2017 in the United States was 46,814 (SE: 1,697), costing upwards of 165 million USD. State-level ED data for initial visits for administration of PEP for rabies exposure using HCUP data was compared to state-level surveillance data from Maryland, Vermont, and Georgia between 2012-2017. In all states, state-level surveillance data was consistently lower than estimates of initial ED visits, suggesting even states with robust PEP surveillance may not adequately capture individuals who receive PEP. CONCLUSIONS Our findings suggest that making PEP a nationally reportable condition may not be feasible. Other methods of tracking administration of PEP such as syndromic surveillance or identification of sentinel states should be considered to obtain an accurate assessment.
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Affiliation(s)
- Erin R. Whitehouse
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- * E-mail:
| | - Marissa K. Person
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Catherine M. Brown
- Bureau of Infectious Disease and Laboratory Sciences, Massachusetts Department of Public Health, Boston, Massachusetts, United States of America
| | - Sally Slavinski
- New York City Department of Health and Mental Hygiene, New York, New York, United States of America
| | - Agam K. Rao
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jesse D. Blanton
- Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Tiwari HK, Gogoi-Tiwari J, Robertson ID. Eliminating dog-mediated rabies: challenges and strategies. ANIMAL DISEASES 2021. [DOI: 10.1186/s44149-021-00023-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
AbstractRabies is an acute encephalitis caused by a lyssavirus. It is primarily transmitted through bites of infected dogs which results in the worldwide death of an estimated 59000 humans every year. The disease is preventable through the application of post-exposure prophylaxis (PEP) and its elimination has been demonstrated in many countries by applying multiple interventions simultaneously. Nonetheless, rabies is still widespread in many developing countries, primarily due to the poor implementation of intervention strategies that include inadequate dog-bite wound management practices, unavailability/unaffordability of PEP by the communities, failure to control the disease in free-roaming dogs and wildlife, improper dog population management, weak surveillance and diagnostic facilities and a lack of a One Health approach to the disease. In this review, strategies to control dog-mediated rabies through a One Health approach were discussed. We recommend applying multiple interventions against the disease by involving all the concerned stakeholders in selected urban and rural areas of the countries where rabies is endemic. An empirical demonstration of disease freedom in the selected areas through a One Health approach is needed to convince policymakers to invest in rabies prevention and control on the national level. This multifaceted One Health control model will enhance the likelihood of achieving the goal of global rabies eradication by 2030.
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Kim PK, Ahn JS, Kim CM, Seo JM, Keum SJ, Lee HJ, Choo MJ, Kim MS, Lee JY, Maeng KE, Shin JY, Yi KS, Osinubi MOV, Franka R, Greenberg L, Shampur M, Rupprecht CE, Lee SY. A broad-spectrum and highly potent human monoclonal antibody cocktail for rabies prophylaxis. PLoS One 2021; 16:e0256779. [PMID: 34469480 PMCID: PMC8409651 DOI: 10.1371/journal.pone.0256779] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 08/15/2021] [Indexed: 11/18/2022] Open
Abstract
Post-exposure prophylaxis (PEP) is highly effective in preventing disease progression of rabies when used in timely and appropriate manner. The key treatment for PEP is infiltration of rabies immune globulin (RIG) into lesion site after bite exposure, besides wound care and vaccination. Unfortunately, however, RIG is expensive and its supply is limited. Currently, several anti-rabies virus monoclonal antibody (mAb) products are under development as alternatives to RIG, and two recently received regulatory approval in India. In this study, fully human mAbs that recognize different rabies virus glycoprotein conformational antigenic site (II and III) were created from peripheral blood mononuclear cells of heathy vaccinated subjects. These mAbs neutralized a diverse range of lyssavirus types. As at least two anti-rabies virus mAbs are recommended for use in human PEP to ensure broad coverage against diverse lyssaviruses and to minimize possible escape variants, two most potent mAbs, NP-19-9 and 11B6, were selected to be used as cocktail treatment. These two mAbs were broadly reactive to different types of lyssaviruses isolates, and were shown to have no interference with each other. These results suggest that NP-19-9 and 11B6 are potent candidates to be used for PEP, suggesting further studies involving clinical studies in human.
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Affiliation(s)
- Pan Kyeom Kim
- Department of Research and Development, Celltrion, INC, Incheon, Republic of Korea
- * E-mail:
| | - Jung Sun Ahn
- Department of Research and Development, Celltrion, INC, Incheon, Republic of Korea
| | - Cheol Min Kim
- Department of Research and Development, Celltrion, INC, Incheon, Republic of Korea
| | - Ji Min Seo
- Department of Research and Development, Celltrion, INC, Incheon, Republic of Korea
| | - Sun Ju Keum
- Department of Research and Development, Celltrion, INC, Incheon, Republic of Korea
| | - Hyun Joo Lee
- Department of Research and Development, Celltrion, INC, Incheon, Republic of Korea
| | - Min Joo Choo
- Department of Research and Development, Celltrion, INC, Incheon, Republic of Korea
| | - Min Soo Kim
- Department of Research and Development, Celltrion, INC, Incheon, Republic of Korea
| | - Jun Young Lee
- Department of Research and Development, Celltrion, INC, Incheon, Republic of Korea
| | - Ki Eun Maeng
- Department of Research and Development, Celltrion, INC, Incheon, Republic of Korea
| | - Ji Young Shin
- Department of Research and Development, Celltrion, INC, Incheon, Republic of Korea
| | - Kye Sook Yi
- Department of Research and Development, Celltrion, INC, Incheon, Republic of Korea
| | - Modupe O. V. Osinubi
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Richard Franka
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Lauren Greenberg
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Madhusudana Shampur
- National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, India
| | | | - Soo Young Lee
- Department of Research and Development, Celltrion, INC, Incheon, Republic of Korea
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Mshelbwala PP, Weese JS, Sanni-Adeniyi OA, Chakma S, Okeme SS, Mamun AA, Rupprecht CE, Magalhaes RJS. Rabies epidemiology, prevention and control in Nigeria: Scoping progress towards elimination. PLoS Negl Trop Dis 2021; 15:e0009617. [PMID: 34398902 PMCID: PMC8389847 DOI: 10.1371/journal.pntd.0009617] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 08/26/2021] [Accepted: 06/29/2021] [Indexed: 12/25/2022] Open
Abstract
Background Human rabies remains a significant public health problem in Africa with outbreaks reported in most countries. In Nigeria–the most populous country in Africa–rabies causes a significant public health burden partly due to perennial obstacles to implementing a national prevention and control program. Methods We conducted a scoping review using standard Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify and select published articles from Nigeria during 1978–2020 reporting on rabies virus infections (human, canine, livestock, and wildlife), canine bites, knowledge, attitudes and practices (KAP) surveys on rabies and canine ecology studies. We extracted information on study location, year and additional details of each study such as rabies prevalence, general characteristics of offending dogs, dog vaccination status and health-seeking behaviours. Findings Between 1978 and 2020, 90 published articles met our inclusion criteria. The prevalence of rabies virus antigen detection varied between 3% and 28%, with more studies in the north. Most bites were unprovoked from dog bite studies (36.4%-97%), by dogs with low vaccination rates (12–38%). A more significant proportion of biting dogs were owned (31–90%). Laboratory confirmation for biting was available for only a small proportion of studies (6%; n = 2/32). Of the dogs surveyed during ecology studies, indigenous dogs accounted for the majority (62–98%), used mostly for security purposes (52–98%), with the vaccination rate between 15% and 38% in most states. Studies conducted in areas distant from rabies diagnostic facilities accounted for more human rabies cases and fewer dog rabies cases. Conclusion Significant improvements are necessary to achieve the elimination of human rabies mediated via dogs by 2030. Rabies remains one of the deadliest zoonoses known to humanity since antiquity, resulting in tens of thousands of human deaths each year, mostly in African and Asian countries. Mass dog vaccination, enhanced surveillance, improved access to Pre-exposure prophylaxis(PrE) and (Post-exposure prophylaxis(PEP) to at-risk groups, enforcement of responsible dog ownership and public education are keystones to rabies prevention and control. Since the first reported case in Nigeria during 1912, rabies has continued to take its toll on human and animal lives. However, gross underreporting due to a frail health care infrastructure, deficient reporting systems, and misdiagnosis with neurological diseases further complicated by socio-cultural practices have resulted in a lack of empirical data to support rabies prioritization, per the global target of 2030. We used the standard PRISMA guidelines to select Nigerian rabies studies between 1978 and 2020. Rabies risk, coupled with welfare concerns identified in this study, demonstrates the need for continued advocacy towards legislation prohibiting the dog trade in Nigeria and elsewhere. The high-risk community groups identified in this review (i.e., children, butchers, and adult males) need to be educated on response to dog bite exposure to reduce the impact of this invariable fatal but preventable disease. Moreover, there is a need for mandatory dog vaccination and implementation of a national rabies program to attain the World Health Organization (WHO) recommended vaccination coverage of at least 70%. We unravel the need to establish rabies diagnostic centres in the country’s six geopolitical zones. Local inclusion of dog bite occurrence by Disease Surveillance and Notification Officers (DSNOs), with related community surveillance tools, can help in rabies/dog surveillance. In addition, there is a need for investment into pathogen discovery by enhancing laboratory-based surveillance for wildlife rabies, understanding its potential role in Nigeria and the need for quantitative research to understand the various risk factors for disease perpetuation.
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Affiliation(s)
- Philip P. Mshelbwala
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, University of Queensland, Gatton, Australia
- Department of Veterinary Medicine, University of Abuja, Abuja, Nigeria
- * E-mail: ,
| | - J. Scott Weese
- Department of Pathobiology, Ontario Veterinary College, Guelph, Canada
| | | | - Shovon Chakma
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, University of Queensland, Gatton, Australia
| | - Stephen S. Okeme
- Agriculture & Rural Development Secretariat, Federal Capital Territory Administration Abuja Nigeria
| | - Abdullah A. Mamun
- Institute of Social Science Research, the University of Queensland, Long Pocket, Australia
| | | | - R. J. Soares Magalhaes
- UQ Spatial Epidemiology Laboratory, School of Veterinary Science, University of Queensland, Gatton, Australia
- Children’s Health and Research Centre, Children’s Health and Environment Program, the University of Queensland, South Brisbane, Australia
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Williams BM, Purcell L, Kayange L, Gallaher J, Charles A. Characteristic and outcomes of human and animal bites in Malawi. Injury 2021; 52:2188-2193. [PMID: 33785190 PMCID: PMC8380653 DOI: 10.1016/j.injury.2021.03.045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 03/14/2021] [Accepted: 03/17/2021] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Bites are an important contributor to traumatic injury worldwide. In low- and middle-income countries, data regarding bite injuries outside of rabies is limited. Therefore, we sought to describe the injury characteristics and outcomes of bites in Lilongwe, Malawi, and determine risk factors for animals and human bites. METHODS We performed a retrospective analysis of the Kamuzu Central Hospital trauma registry from 2008-2018. We performed Bivariate analyses comparing bite to non-bite trauma and human to animal bites. Multivariable Poisson regression modeling then estimated risk factors for bites. RESULTS A total of 124,394 patients were captured by the registry, of which 3,680 (3%) had a bite injury mechanism. Human bites accounted for 14.5% of bite injuries, and animals represented the remaining 85.5%. In rare cases, animal bite victims had serious complications, such as amputation (n = 6, 0.2%), orthopedic procedures (n = 5, 0.2%), and death (n = 7, 0.2%). Risk factors for an animal bite included being on a farm, field, or lake and being at home, whereas risk factors for a human bite included alcohol use and being at home. CONCLUSION Animal bite injuries in Malawi can confer a risk of serious complications, such as amputation and, in rare cases, death. Alcohol-associated, in-home interpersonal violence is a significant risk factor for human bite injuries. Further studies are needed to identify risk factors for complications and mortality.
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Affiliation(s)
- Brittney M Williams
- Department of Surgery, University of North Carolina, Chapel Hill, North Carolina 27599, USA
| | - Laura Purcell
- Department of Surgery, University of North Carolina, Chapel Hill, North Carolina 27599, USA
| | - Linda Kayange
- Department of Surgery, Kamuzu Central Hospital, Lilongwe Malawi
| | - Jared Gallaher
- Department of Surgery, University of North Carolina, Chapel Hill, North Carolina 27599, USA
| | - Anthony Charles
- Department of Surgery, University of North Carolina, Chapel Hill, North Carolina 27599, USA; Department of Surgery, Kamuzu Central Hospital, Lilongwe Malawi.
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Changalucha J, Hampson K, Jaswant G, Lankester F, Yoder J. Human rabies: prospects for elimination. CAB REVIEWS : PERSPECTIVES IN AGRICULTURE, VETERINARY SCIENCE, NUTRITION AND NATURAL RESOURCES 2021; 16:039. [PMID: 34765015 PMCID: PMC8580373 DOI: 10.1079/pavsnnr202116039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Almost half of all countries in the world are effectively free of human deaths from dog-mediated rabies. But the disease still affects people in low- and middle-income countries, especially the rural poor, and children. Successful regional elimination of human rabies is attributable to advances in significant and sustained investment in dog vaccination, post-exposure vaccination and surveillance, illustrated by productive efforts to reduce human rabies in Latin America over the last 35 years. Nonetheless, countries still facing endemic rabies face significant barriers to elimination. Using the 2017 Global Strategic Plan to end human rabies deaths from dog-mediated rabies by 2030 as a reference point and an organizing framework, we assess progress toward global rabies elimination by examining the characteristics of successful regional control efforts and barriers to elimination. Although substantive barriers exist for countries where rabies remains endemic, advances in knowledge, technology, institutions, and economics provide a basis for optimism.
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Affiliation(s)
- Joel Changalucha
- Environmental Health and Ecological Science Department, Ifakara Health Institute, P.O. Box 78373, Dar es salaam, 14112, Tanzania
- Boyd Orr Centre for Population and ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, G12, 8QQ, UK
- College of Veterinary Medicine and Biomedical Science, Sokoine University of Agriculture, P.O. Box 3021, Morogoro, 23, Tanzania
| | - Katie Hampson
- Boyd Orr Centre for Population and ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, G12, 8QQ, UK
| | - Gurdeep Jaswant
- Boyd Orr Centre for Population and ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, G12, 8QQ, UK
- University of Nairobi Institute of Tropical and Infectious Diseases (UNITID), P.O. Box 30197, Nairobi, 00202, Kenya
- Tanzania Industrial Research Development Organisation (TIRDO), P.O. Box 23235, Dar es salaam, Tanzania
| | - Felix Lankester
- Global Animal Health Tanzania, Ngorongoro Conservation Area Authority Building, P.O. Box 1642, Arusha, Tanzania
- Paul G. Allen School for Global Animal Health, Washington state University, P.O. Box 647090, Pullman, Washington, WA 99164 United States of America
| | - Jonathan Yoder
- Paul G. Allen School for Global Animal Health, Washington state University, P.O. Box 647090, Pullman, Washington, WA 99164 United States of America
- School of Economic Sciences, Washington State University, P.O. Box 646210, Pullman, Washington, WA 99164-6210, United States of America
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Cai L, Wang L, Guan X, Wang L, Hu X, Wu Y, Tong Y, Wang P. Epidemiological Analysis of Rabies in Central China from 2013 to 2018. Infect Drug Resist 2021; 14:2753-2762. [PMID: 34305400 PMCID: PMC8297554 DOI: 10.2147/idr.s314881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/02/2021] [Indexed: 11/23/2022] Open
Abstract
Objective The study aimed to timely grasp the epidemiologic status of rabies in Central China from 2013 to 2018 and provide scientific evidence for the implementation of follow-up prevention and control measures. Methods We initiated a retrospective observational and descriptive study of bite-related injuries data and rabies disease data in Hubei province from 2013 to 2018, managed by the Center for Disease Control and Prevention. Results A total of 2,028,691 individuals were exposed to bites from 2013 to 2018, of which 221 were diagnosed with rabies and deceased. Among those cases, the incubation periods of rabies varied from 3 days to 18,406 days, which has been shown to be statistically associated with where the infected person was exposed and whether the wound care has been conducted. Conclusion Epidemiological studies have shown that from 2013 to 2018, the current situation of rabies in Central China is still severe. The case fatality rate keeps virtually 100%. The rural population is still the most vulnerable group to rabies, characterized by a high exposure ratio and low treatment rate as well as poor vaccination compliance. Hoewever, larger populations are warranted to validate our findings.
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Affiliation(s)
- Li Cai
- School of Health Sciences, Wuhan University, Wuhan, 430071, People's Republic of China.,Wuhan Center for Disease Control and Prevention, Wuhan, 430015, People's Republic of China
| | - Lixian Wang
- Xiaonan Center for Disease Control and Prevention, Xiaogan, 432100, People's Republic of China
| | - Xuhua Guan
- Hubei Center for Disease Control and Prevention, Wuhan, Hubei, 430079, People's Republic of China
| | - Lei Wang
- Hubei Center for Disease Control and Prevention, Wuhan, Hubei, 430079, People's Republic of China
| | - Xinyi Hu
- Global Study Institute, University of Geneva, Geneva, Switzerland
| | - Yang Wu
- Hubei Center for Disease Control and Prevention, Wuhan, Hubei, 430079, People's Republic of China
| | - Yeqing Tong
- Hubei Center for Disease Control and Prevention, Wuhan, Hubei, 430079, People's Republic of China
| | - Peigang Wang
- School of Health Sciences, Wuhan University, Wuhan, 430071, People's Republic of China
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Kisaka S, Makumbi FE, Majalija S, Kagaha A, Thumbi SM. "As long as the patient tells you it was a dog that bit him, why do you need to know more?" A qualitative study of how healthcare workers apply clinical guidelines to treat dog bite injuries in selected hospitals in Uganda. PLoS One 2021; 16:e0254650. [PMID: 34260651 PMCID: PMC8279313 DOI: 10.1371/journal.pone.0254650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 06/30/2021] [Indexed: 11/19/2022] Open
Abstract
Dog-mediated rabies is on the increase in Uganda despite the availability of post-exposure prophylaxis (PEP). PEP procedures are expounded in the Uganda Clinical Guidelines (UCG) of 2016. We assessed adherence by health workers to UCG while managing dog bites in two PEP centers and obtained insights into motivations of their practices. Using qualitative methods, we observed the health worker-patient encounters, reviewed medical records, and interviewed 14 health workers that were involved in managing dog bite injuries. We used deductive thematic analysis to identify codes in themes developed from UCG. We found that much of the history of the bites was taken, but it was neither verified nor written down on the patient's file. Classification of wounds was inaccurate and ancillary laboratory assessments like culture and sensitivity tests were not conducted in all cases. Although antibiotics were given for both treatment and prophylactic purposes, the prescription was based on availability and affordability, not UCG recommendations. Rabies immunoglobulin (RIG) was not administered to deserving patients due to unavailability and high costs to the patient. Anti-rabies vaccine (ARV) was prescribed indiscriminately and some health workers attributed this to pressure from patients. Health education regarding prevention of dog bites was not given to patients due to time constraints on the side of the providers as a result of high caseloads at the emergency departments. Challenges to adherence to guidelines were identified as frequent ARV stock outs; inadequate cooperation among health facilities; and insufficient knowledge and skills on how injuries and rabies should be managed. We conclude that clinical management of dog bites is not fully in line with UCG. We argue that adoption of an integrated bite case management and cost-saving strategies as well as continuing medical education programs on rabies control and management could improve the clinical management of dog bites.
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Affiliation(s)
- Stevens Kisaka
- University of Nairobi Institute of Tropical and Infectious Diseases, Nairobi, Kenya
- School of Public Health, Makerere University, Kampala, Uganda
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | | | - Samuel Majalija
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Alexander Kagaha
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - S. M. Thumbi
- University of Nairobi Institute of Tropical and Infectious Diseases, Nairobi, Kenya
- Rabies Free Africa, Washington State University, Pullman, Washington, United States of America
- Paul G Allen School for Global Animal Health, Washington State University, Pullman, Washington, United States of America
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Bastos V, Mota R, Guimarães M, Richard Y, Lima AL, Casseb A, Barata GC, Andrade J, Casseb LMN. Challenges of Rabies Surveillance in the Eastern Amazon: The Need of a One Health Approach to Predict Rabies Spillover. Front Public Health 2021; 9:624574. [PMID: 34249829 PMCID: PMC8267869 DOI: 10.3389/fpubh.2021.624574] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 05/21/2021] [Indexed: 11/18/2022] Open
Abstract
Brazil has been promoting essential improvements in health indicators by implementing free-access health programs, which successfully reduced the prevalence of neglected zoonosis in urban areas, such as rabies. Despite constant efforts from the authorities to monitor and control the disease, sylvatic rabies is a current issue in Amazon's communities. The inequalities among Amazon areas challenge the expansion of high-tech services and limit the implementation of active laboratory surveillance to effectively avoid outbreaks in human and non-human hosts, which also reproduces a panorama of vulnerability in risk communities. Because rabies is a preventable disease, the prevalence in the particular context of the Amazon area highlights the failure of surveillance strategies to predict spillovers and indicates the need to adapt the public policies to a “One Health” approach. Therefore, this work assesses the distribution of free care resources and facilities among Pará's regions in the oriental Amazon; and discusses the challenges of implanting One Health in the particular context of the territory. We indicate a much-needed strengthening of the sylvatic and urban surveillance networks to achieve the “Zero by 30” goal, which is inextricable from multilateral efforts to combat the progressive biome's degradation.
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Affiliation(s)
- Victor Bastos
- Federal University of Pará, Institute of Biological Sciences, Belém, Brazil.,Department of Arbovirology and Hemorrhagic Fevers, Evandro Chagas Institute, Ananindeua, Brazil
| | - Roberta Mota
- Federal University of Pará, Institute of Biological Sciences, Belém, Brazil.,Department of Arbovirology and Hemorrhagic Fevers, Evandro Chagas Institute, Ananindeua, Brazil
| | - Mylenna Guimarães
- Department of Arbovirology and Hemorrhagic Fevers, Evandro Chagas Institute, Ananindeua, Brazil
| | - Yuri Richard
- Federal University of Pará, Institute of Biological Sciences, Belém, Brazil
| | - André Luis Lima
- Federal Rural University of the Amazon, Institute of Animal Health and Production, Belém, Brazil
| | - Alexandre Casseb
- Federal Rural University of the Amazon, Institute of Animal Health and Production, Belém, Brazil
| | | | - Jorge Andrade
- Pará State Health Secretary, Health Surveillance Directorate, Belém, Brazil
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How geographic access to care shapes disease burden: The current impact of post-exposure prophylaxis and potential for expanded access to prevent human rabies deaths in Madagascar. PLoS Negl Trop Dis 2021; 15:e0008821. [PMID: 33901194 PMCID: PMC8102000 DOI: 10.1371/journal.pntd.0008821] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 05/06/2021] [Accepted: 02/24/2021] [Indexed: 11/24/2022] Open
Abstract
Background Post-exposure prophylaxis (PEP) is highly effective at preventing human rabies deaths, however access to PEP is limited in many rabies endemic countries. The 2018 decision by Gavi to add human rabies vaccine to its investment portfolio should expand PEP availability and reduce rabies deaths. We explore how geographic access to PEP impacts the rabies burden in Madagascar and the potential benefits of improved provisioning. Methodology & principal findings We use spatially resolved data on numbers of bite patients seeking PEP across Madagascar and estimates of travel times to the closest clinic providing PEP (N = 31) in a Bayesian regression framework to estimate how geographic access predicts reported bite incidence. We find that travel times strongly predict reported bite incidence across the country. Using resulting estimates in an adapted decision tree, we extrapolate rabies deaths and reporting and find that geographic access to PEP shapes burden sub-nationally. We estimate 960 human rabies deaths annually (95% Prediction Intervals (PI): 790–1120), with PEP averting an additional 800 deaths (95% PI: 640–970) each year. Under these assumptions, we find that expanding PEP to one clinic per district (83 additional clinics) could reduce deaths by 19%, but even with all major primary clinics provisioning PEP (1733 additional clinics), we still expect substantial rabies mortality. Our quantitative estimates are most sensitive to assumptions of underlying rabies exposure incidence, but qualitative patterns of the impacts of travel times and expanded PEP access are robust. Conclusions & significance PEP is effective at preventing rabies deaths, and in the absence of strong surveillance, targeting underserved populations may be the most equitable way to provision PEP. Given the potential for countries to use Gavi funding to expand access to PEP in the coming years, this framework could be used as a first step to guide expansion and improve targeting of interventions in similar endemic settings where PEP access is geographically restricted and baseline data on rabies risk is lacking. While better PEP access should save many lives, improved outreach, surveillance, and dog vaccination will be necessary, and if rolled out with Gavi investment, could catalyze progress towards achieving zero rabies deaths. Canine rabies causes an estimated 60,000 deaths each year across the world, primarily in low- and middle-income countries where people have limited access to both human vaccines (post-exposure prophylaxis or PEP) and dog rabies vaccines. Given that we have the tools to prevent rabies deaths, a global target has been set to eliminate deaths due to canine rabies by 2030, and recently, Gavi, a multilateral organization that aims to improve access to vaccines in the poorest countries, added human rabies vaccine to it’s portfolio. In this study, we estimated reported incidence of patients seeking PEP in relation to travel times to clinics provisioning PEP and extrapolate human rabies deaths in Madagascar. We find that PEP currently averts around 800 deaths each year, but that the burden remains high (1000 deaths/year), particularly in remote, hard-to-reach areas. We show that expanding PEP availability to more clinics could significantly reduce rabies deaths in Madagascar, but our results reaffirm that expansion alone is will not achieve the global goal of zero human deaths from dog-mediated rabies by 2030. Combining PEP expansion with outreach, surveillance, and mass dog vaccination programs will be necessary to move Madagascar, and other Low- and Middle-Income countries, forward on the path to rabies elimination.
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Traoré A, Keita Z, Léchenne M, Mauti S, Hattendorf J, Zinsstag J. Rabies surveillance-response in Mali in the past 18 years and requirements for the future. Acta Trop 2020; 210:105526. [PMID: 32447031 DOI: 10.1016/j.actatropica.2020.105526] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 05/01/2020] [Accepted: 05/04/2020] [Indexed: 10/24/2022]
Abstract
CONTEXT Rabies is endemic in Mali, but little is known about the distribution of rabies and its surveillance across the country. Documenting the evolution of rabies and the problems related to surveillance is useful to facilitate elimination of human rabies by 2030. METHOD Data collected at the Central Veterinary Laboratory (LCV) from 1999 to 2017 and through the surveillance system functioning at household, health and veterinary structure levels, as established by the Global Vaccine Alliance funded project on the burden of rabies, between 2016 and 2017 in Bamako and the Sikasso region were used in this study. All data on animals examined for rabies by the direct fluorescence antibody test (DFA) during the specified time period were summarized, and the proportion of rabies positive tested among animals suspected of rabies was estimated. From the number of dogs tested positive for rabies, a cumulative incidence was estimated for the total canine population. The number of positive tested samples was divided by the product of the estimated canine population and number of years (18). In addition, the number of human rabies cases was analyzed to estimate a cumulative incidence. RESULTS Among all animal samples suspected for rabies, 93.2% [95% CI 90.6-95.3] were positive by the DFA test. From the 486 included animal samples, 94.7% [95% CI 92.3-96.5] were domestic dogs with 90.9% [95% CI 87.9-93.3] positive, which stands out as the main reservoir of rabies in Mali. Cats, cattle, sheep and donkeys also tested positive using the DFA test. The cumulative incidence of canine rabies was estimated at 0.371 [95% CI: 0.336-0.408] / 10'000 dogs. The highest incidence was observed in Bamako, the capital of Mali, with a cumulative incidence of 2.242 [95% CI: 2.001-2.504] / 10'000 dogs, followed by Koulikoro with 0.335 [95% CI: 0.258-0.429] / 10'000 dogs. For other areas far from LCV, the cumulative incidence was low, with zero in Kidal. Nationally reported cases of human rabies declined in recent years with an average of 12.6 [95% CI: 8.7-16.5] deaths per year. This result gives an annual incidence of 0.1047 [0.0742-0.1352] / 100'000 inhabitants. CONCLUSION Over the past 18 years, rabies is endemically stable in Mali despite the decrease in reported human cases. The disparity among regions in number of samples tested indicates a low level of clinical and laboratory surveillance and likely a high level of underreporting. Dogs play the main role in rabies transmission in Mali. Monitoring of and decisions for post-exposure prophylaxis (PEP) includes other animals (cats, cattle, and monkeys) involved in transmission. Mali should develop a national rabies strategy to include better communication between the public health and animal health sectors, strengthening of laboratory surveillance capacity, mass vaccination of dogs and guaranteed access to PEP.
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Liu X, Zhang J, Li F, Hagoss YT, Tesfagaber W, Wang L, Wang Z, Zhao D, Bu Z. Host protein ABCE1 interacts with the viral phosphoprotein and promotes rabies virus replication. BIOSAFETY AND HEALTH 2020. [DOI: 10.1016/j.bsheal.2020.07.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Bihon A, Meresa D, Tesfaw A. Rabies: Knowledge, Attitude and Practices in and Around South Gondar, North West Ethiopia. Diseases 2020; 8:E5. [PMID: 32102458 PMCID: PMC7151027 DOI: 10.3390/diseases8010005] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 01/16/2020] [Accepted: 02/06/2020] [Indexed: 11/23/2022] Open
Abstract
A cross-sectional study was conducted from February 2017 to April 2017 to assess knowledge, attitude and practices of the community towards rabies in south Gondar zone, Ethiopia. A structured closed ended questionnaire was used to collect the data through face to face interviews among 384 respondents. The data were then analyzed using SPSS statistical software version 20. Almost all (91.5%) surveyed individuals were aware of rabies. Bite was known as mode of rabies transmission by majority of the respondents (71.1%) with considerable means of transmission through wound contact with saliva of diseased animals. Sudden change of behavior was described as a major clinical sign of rabies in animals by the majority of the respondents. Nearly half of the respondents (48.2%) believed that consumption of rabid animal's meat can be a medicine for human rabies and majority of the respondents (66.7%) indicated crossing a river before 40 days after dog bite increases severity of the disease. More than eighty percent of the respondents prefer traditional medicines for treating rabies in humans. In total, 51% of the respondents had poor Knowledge, Attitudes and Practices (KAP) level about the disease rabies. Educational status (χ2 = 21.152), Monthly income (χ2 = 23.059), Sex (χ2 = 11.249), source of information (χ2 = 8.594) and Residence (χ2 = 4.109) were significantly associated with KAP scores (p < 0.05). Education and awareness creation should be given to increase communities KAP about the disease with special focus to traditional healers.
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Affiliation(s)
- Amare Bihon
- School of Veterinary Medicine, Woldia University, Woldia 7220, Ethiopia
| | - Desalegn Meresa
- College of Health Science, Mekele University, Mekele 7000, Ethiopia;
| | - Abraham Tesfaw
- College of Veterinary Medicine, Samara University, Samara 7240, Ethiopia;
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Nguyen HT, Le ND, Pham TN, Urabe MI, Afriyie DO, Otsu S, Tran DN, Tran HG, Nguyen HV, Le HT, Tran CH. Evaluation of Vietnam's post-exposure prophylaxis delivery system, 2017. Vaccine 2019; 37 Suppl 1:A20-A27. [PMID: 31235373 PMCID: PMC6880765 DOI: 10.1016/j.vaccine.2019.02.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 01/18/2019] [Accepted: 02/15/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Canine-mediated human rabies deaths typically occur in poor and rural populations with limited access to rabies biologics: vaccine and immunoglobulin. A critical aspect of reducing rabies deaths is understanding how these countries procure, deliver, and forecast rabies biologics. Vietnam is one of the few endemic countries where biologics is widely available. However, a formal evaluation of its current rabies biologics distribution system has not been conducted. METHODS In 2017, we conducted a formal evaluation of Vietnam's rabies biologics distribution system. Our goals were (1) to identify centers providing rabies biologics (2) identify costs to the patient and centers and (3) assess the rabies biologic procurement and delivery system at eligible district and provincial centers (provides and orders biologics for itself and other centers directly from the manufacture). To conduct the formal evaluation, we developed a standardized survey that was distributed to centers. RESULTS Of the 780 designated rabies biologics centers in Vietnam, 659 (84%) of them provide rabies immunoglobulin (eRIG), vaccine, or both. Of the 177 eligible centers, 90% (160) responded to the survey. The average costs to patients were $8.45 (range: 5.43-12.77) for one dose of IM injection, $13.90 (range: 11.86-16.71) for domestic eRIG, and $23 (21.11-27.11) for imported eRIG. Respondents reported experiencing delays in receiving vaccine in 50 centers and eRIG in 14 centers within the past year. Respondents stated their top three challenges in providing biologics were: delays or shortages from manufactures, lack of funds to pay for biologics, and the high cost of biologics. CONCLUSIONS AND RELEVANCE Despite the wide availability of biologics in Vietnam, more work is needed to provide affordable and reliable supply of biologics to patients. This includes the expansion of ID injection use throughout the country to lower vaccine demand, and decrease the costs to centers and patients. Furthermore, a more coordinated effort to share biologics among centers, possibly through a more centralized system at the provincial level may alleviate delays and shortages.
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Affiliation(s)
- Huong Tt Nguyen
- National Institute of Hygiene and Epidemiology, Ministry of Health, 1 Yersin Street, Hanoi, Viet Nam.
| | - Nhan Dt Le
- Institute of Public Health, Ho Chi Minh City, Vietnam, 159 Hung Phu Street, 8 Ward, 8 District, HCMC, Viet Nam; Field Epidemiology Training Program, Ministry of Health, Hanoi, Vietnam, 135 Nui Truc Street, Ba Dinh District, Hanoi, Viet Nam
| | - Thach N Pham
- National Institute of Hygiene and Epidemiology, Ministry of Health, 1 Yersin Street, Hanoi, Viet Nam
| | - Maho I Urabe
- World Health Organization, Representative Office for Vietnam, 304 Kim Ma Street, Hanoi, Viet Nam
| | - Doris O Afriyie
- U.S. Centers for Disease Control and Prevention Country Office in Vietnam, 2 Ngo Quyen, Hanoi, Viet Nam
| | - Satoko Otsu
- World Health Organization, Representative Office for Vietnam, 304 Kim Ma Street, Hanoi, Viet Nam
| | - Duong N Tran
- National Institute of Hygiene and Epidemiology, Ministry of Health, 1 Yersin Street, Hanoi, Viet Nam
| | - Huong Gt Tran
- International Cooperation Department, Ministry of Health, 138A Giang Vo, Hanoi, Viet Nam
| | - Hoang V Nguyen
- National Institute of Hygiene and Epidemiology, Ministry of Health, 1 Yersin Street, Hanoi, Viet Nam
| | - Ha T Le
- Hanoi Medical University, No 1 Ton That Tung, Hanoi, Viet Nam
| | - Cuc H Tran
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, USA; Poxvirus and Rabies Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, USA
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