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Auplish A, Raj E, Booijink Y, de Balogh K, Peyre M, Taylor K, Sumption K, Häsler B. Current evidence of the economic value of One Health initiatives: A systematic literature review. One Health 2024; 18:100755. [PMID: 38770400 PMCID: PMC11103946 DOI: 10.1016/j.onehlt.2024.100755] [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: 11/04/2023] [Revised: 05/06/2024] [Accepted: 05/08/2024] [Indexed: 05/22/2024] Open
Abstract
Funding and financing for One Health initiatives at country level remain challenging as investments commonly require demonstrated evidence of economic value or returns. The objectives of this review were to i) identify, critically analyse and summarise quantitative evidence of the net economic value of One Health initiatives; ii) document methodologies commonly used in the scientific literature; and iii) describe common challenges and any evidence gaps. Scientific databases were searched for published literature following the PRISMA guidelines and an online survey and workshop with subject matter experts were used to identify relevant grey literature. Studies were included if they reported on quantitative costs and benefits (monetary and non-monetary) and were measured across at least two sectors. Relevant publications were analysed and plotted against the six action tracks of the Quadripartite One Health Joint Plan of Action to help classify the initiatives. Ninety-seven studies were included. Eighty studies involved only two sectors and 78 reported a positive economic value or return. Of those studies that reported a positive return, 49 did not compare with a sectoral counterfactual, 28 studies demonstrated an added value of using a cross-sectoral approach, and 6 studies demonstrated an added value of One Health communication, collaboration, coordination, and capacity building. Included studies most frequently related to endemic zoonotic, neglected tropical and vector-borne diseases, followed by health of the environment and food safety. However, diversity in economic analysis methodology between studies included resulted in difficulty to compare or combine findings. While there is a growing body of evidence of the value of One Health initiatives, a substantial part of the evidence still focuses on "traditional" One Health topics, particularly zoonoses. Developing a standardised and practical approach for One Health economic evaluation will facilitate assessment of the added value and gather evidence for One Health to be invested in and endorsed by multiple sectors.
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Affiliation(s)
- Aashima Auplish
- Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy
| | - Eleanor Raj
- Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy
| | - Yoeri Booijink
- Centre de Coopération Internationale en Recherche Agronomique Pour le Développement (CIRAD), Montpellier Cedex 5 34398, France
| | - Katinka de Balogh
- Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy
| | - Marisa Peyre
- Centre de Coopération Internationale en Recherche Agronomique Pour le Développement (CIRAD), Montpellier Cedex 5 34398, France
| | - Katrin Taylor
- Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy
| | - Keith Sumption
- Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy
| | - Barbara Häsler
- Food and Agriculture Organization of the United Nations (FAO), 00153 Rome, Italy
- Royal Veterinary College, London NW1 0TU, UK
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Nujum ZT, Asaria M, Kurup KK, Mini M, Mazumdar S, Daptardar M, Tiwari H. Cost-effectiveness of One Health interventions for rabies elimination: a systematic review. Trans R Soc Trop Med Hyg 2024; 118:223-233. [PMID: 37903657 DOI: 10.1093/trstmh/trad074] [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: 08/01/2023] [Revised: 08/31/2023] [Accepted: 10/05/2023] [Indexed: 11/01/2023] Open
Abstract
The 'One Health' (OH) approach is the most promising idea in realising the global goal of eliminating canine-mediated human rabies by 2030. However, taking an OH approach to rabies elimination can mean many different things to different people. We conducted a systematic review scrutinizing economic evaluations (EEs) retrieved from MEDLINE OVID, Embase OVID, Global Health OVID, CINAHL EBSCO and ECONLIT EBSCO that used the OH approach with the intent of identifying cost-effective sets of interventions that can be combined to implement an optimal OH-based rabies elimination program and highlight key gaps in the knowledge base. Our review suggests that an optimal OH program to tackle rabies should incorporate mass dog vaccination and integrated bite case management in combination with efficient use of post-exposure prophylaxis along with a shift to a 1-week abbreviated intradermal rabies vaccine regimen in humans. We recommend that future EEs of OH interventions for rabies elimination should be performed alongside implementation research to ensure proposed interventions are feasible and adopt a wider societal perspective taking into account costs and outcomes across both the human health and animal welfare sectors. The systematic review has been registered with PROSPERO.
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Affiliation(s)
- Zinia T Nujum
- Senior Visiting Fellow, Department of Health Policy, London School of Economics and Political Science, London WC2A2AE, UK
| | - Miqdad Asaria
- Assistant Professor, Department of Health Policy, London School of Economics and Political Science, London WC2A2AE, UK
| | - Karishma Krishna Kurup
- Research Fellow, Center for Universal Health, Chatham House (Royal Institute of International Affairs) London, UK
| | - Malathi Mini
- MSc Global Health Policy Candidate, London School of Economics and Political Science, London WC2A2AE, UK
| | - Sumit Mazumdar
- Research Fellow (Global Health), Centre for Health Economics, University of York Visiting Senior Fellow, Institute for Human Development, New Delhi, India
| | | | - Harish Tiwari
- DBT Wellcome India Alliance CPH Intermediate Fellow, Indian Institute of Technology Guwahati, Assam, India
- Research Affiliate, University of Sydney, Sydney, NSW, Australia
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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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Khairullah AR, Kurniawan SC, Hasib A, Silaen OSM, Widodo A, Effendi MH, Ramandinianto SC, Moses IB, Riwu KHP, Yanestria SM. Tracking lethal threat: in-depth review of rabies. Open Vet J 2023; 13:1385-1399. [PMID: 38107233 PMCID: PMC10725282 DOI: 10.5455/ovj.2023.v13.i11.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/10/2023] [Indexed: 12/19/2023] Open
Abstract
An infectious disease known as rabies (family Rhabdoviridae, genus Lyssavirus) causes severe damage to mammals' central nervous systems (CNS). This illness has been around for a very long time. The majority of human cases of rabies take place in underdeveloped regions of Africa and Asia. Following viral transmission, the Rhabdovirus enters the peripheral nervous system and proceeds to the CNS, where it targets the encephalon and produces encephalomyelitis. Postbite prophylaxis requires laboratory confirmation of rabies in both people and animals. All warm-blooded animals can transmit the Lyssavirus infection, while the virus can also develop in the cells of cold-blooded animals. In the 21st century, more than 3 billion people are in danger of contracting the rabies virus in more than 100 different nations, resulting in an annual death toll of 50,000-59,000. There are three important elements in handling rabies disease in post exposure prophylaxis (PEP), namely wound care, administration of anti-rabies serum, and anti-rabies vaccine. Social costs include death, lost productivity as a result of early death, illness as a result of vaccination side effects, and the psychological toll that exposure to these deadly diseases has on people. Humans are most frequently exposed to canine rabies, especially youngsters and the poor, and there are few resources available to treat or prevent exposure, making prevention of human rabies challenging.
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Affiliation(s)
- Aswin Rafif Khairullah
- Division of Animal Husbandry, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Shendy Canadya Kurniawan
- Master Program of Animal Sciences, Department of Animal Sciences, Specialisation in Molecule, Cell and Organ Functioning, Wageningen University and Research, Wageningen, Netherlands
| | - Abdullah Hasib
- School of Agriculture and Food Sustainability, The University of Queensland, Gatton, Australia
| | - Otto Sahat Martua Silaen
- Doctoral Program in Biomedical Science, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Agus Widodo
- Department of Health, Faculty of Vocational Studies, Universitas Airlangga, Surabaya, Indonesia
| | - Mustofa Helmi Effendi
- Division of Veterinary Public Health, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia
| | | | - Ikechukwu Benjamin Moses
- Department of Applied Microbiology, Faculty of Science, Ebonyi State University, Abakaliki, Nigeria
| | - Katty Hendriana Priscilia Riwu
- Department of Veterinary Public Health, Faculty of Veterinary Medicine, Universitas Pendidikan Mandalika, Mataram, Indonesia
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Chen Q, Liu Q, Gong C, Yin W, Mu D, Li Y, Ding S, Liu Y, Yang H, Zhou S, Chen S, Tao Z, Zhang Y, Tang X. Strategies to inTerrupt RAbies Transmission for the Elimination Goal by 2030 In China (STRATEGIC): a modelling study. BMC Med 2023; 21:100. [PMID: 36927437 PMCID: PMC10022085 DOI: 10.1186/s12916-023-02821-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 03/08/2023] [Indexed: 03/18/2023] Open
Abstract
BACKGROUND A global plan has been set to end human deaths from dog-mediated rabies by 2030 ("Zero-by-30"), but whether it could be achieved in some countries, such as China, remains unclear. Although elimination strategies through post-exposure prophylaxis (PEP) use, dog vaccination, and patient risk assessments with integrated bite case management (IBCM) were proposed to be cost-effective, evidence is still lacking in China. We aim to evaluate the future burdens of dog-mediated human rabies deaths in the next decade and provide quantitative evidence on the cost-effectiveness of different rabies-control strategies in China. METHODS Based on data from China's national human rabies surveillance system, we used decision-analytic modelling to estimate dog-mediated human rabies death trends in China till 2035. We simulated and compared the expected consequences and costs of different combination strategies of the status quo, improved access to PEP, mass dog vaccination, and use of IBCM. RESULTS The predicted human rabies deaths in 2030 in China will be 308 (95%UI: 214-411) and remain stable in the next decade under the status quo. The strategy of improved PEP access alone could only decrease deaths to 212 (95%UI: 147-284) in 2028, remaining unchanged till 2035. In contrast, scaling up dog vaccination to coverage of 70% could eliminate rabies deaths by 2033 and prevent approximately 3,265 (95%UI: 2,477-3,687) extra deaths compared to the status quo during 2024-2035. Moreover, with the addition of IBCM, the "One Health" approach through mass dog vaccination could avoid unnecessary PEP use and substantially reduce total cost from 12.53 (95%UI: 11.71-13.34) to 8.73 (95%UI: 8.09-9.85) billion US dollars. Even if increasing the total costs of IBCM from 100 thousand to 652.10 million US dollars during 2024-2035, the combined strategy of mass dog vaccination and use of IBCM will still dominate, suggesting the robustness of our results. CONCLUSIONS The combined strategy of mass dog vaccination and IBCM requires collaboration between health and livestock/veterinary sectors, and it could eliminate Chinese rabies deaths as early as 2033, with more deaths averted and less cost, indicating that adding IBCM could reduce unnecessary use of PEP and make the "One Health" rabies-control strategy most cost-effective.
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Affiliation(s)
- Qiulan Chen
- Key Laboratory of Surveillance and Early-Warning On Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Qiuping Liu
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, 100191, China
| | - Chao Gong
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, 100191, China
| | - Wenwu Yin
- Key Laboratory of Surveillance and Early-Warning On Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Di Mu
- Key Laboratory of Surveillance and Early-Warning On Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Yu Li
- Key Laboratory of Surveillance and Early-Warning On Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Shujun Ding
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Yifang Liu
- Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Hao Yang
- Hunan Provincial Center for Disease Control and Prevention, Changsha, China
| | - Shuwu Zhou
- Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning, China
| | - Sa Chen
- Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, China
| | - Zhongfa Tao
- Guizhou Center for Disease Control and Prevention, Guiyang, China
| | - Yanping Zhang
- Key Laboratory of Surveillance and Early-Warning On Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
| | - Xun Tang
- Department of Epidemiology and Biostatistics, Peking University School of Public Health, Beijing, 100191, China.
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Elimination of human rabies in Goa, India through an integrated One Health approach. Nat Commun 2022; 13:2788. [PMID: 35589709 PMCID: PMC9120018 DOI: 10.1038/s41467-022-30371-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 04/27/2022] [Indexed: 01/13/2023] Open
Abstract
Dog-mediated rabies kills tens of thousands of people each year in India, representing one third of the estimated global rabies burden. Whilst the World Health Organization (WHO), World Organization for Animal Health (OIE) and the Food and Agriculture Organization of the United Nations (FAO) have set a target for global dog-mediated human rabies elimination by 2030, examples of large-scale dog vaccination programs demonstrating elimination remain limited in Africa and Asia. We describe the development of a data-driven rabies elimination program from 2013 to 2019 in Goa State, India, culminating in human rabies elimination and a 92% reduction in monthly canine rabies cases. Smartphone technology enabled systematic spatial direction of remote teams to vaccinate over 95,000 dogs at 70% vaccination coverage, and rabies education teams to reach 150,000 children annually. An estimated 2249 disability-adjusted life years (DALYs) were averted over the program period at 526 USD per DALY, making the intervention 'very cost-effective' by WHO definitions. This One Health program demonstrates that human rabies elimination is achievable at the state level in India.
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Sararat C, Changruenngam S, Chumkaeo A, Wiratsudakul A, Pan-ngum W, Modchang C. The effects of geographical distributions of buildings and roads on the spatiotemporal spread of canine rabies: An individual-based modeling study. PLoS Negl Trop Dis 2022; 16:e0010397. [PMID: 35536861 PMCID: PMC9126089 DOI: 10.1371/journal.pntd.0010397] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/20/2022] [Accepted: 04/06/2022] [Indexed: 11/19/2022] Open
Abstract
Rabies is a fatal disease that has been a serious health concern, especially in developing countries. Although rabies is preventable by vaccination, the spread still occurs sporadically in many countries, including Thailand. Geographical structures, habitats, and behaviors of host populations are essential factors that may result in an enormous impact on the mechanism of propagation and persistence of the disease. To investigate the role of geographical structures on the transmission dynamics of canine rabies, we developed a stochastic individual-based model that integrates the exact configuration of buildings and roads. In our model, the spatial distribution of dogs was estimated based on the distribution of buildings, with roads considered to facilitate dog movement. Two contrasting areas with high- and low-risk of rabies transmission in Thailand, namely, Hatyai and Tepha districts, were chosen as study sites. Our modeling results indicated that the distinct geographical structures of buildings and roads in Hatyai and Tepha could contribute to the difference in the rabies transmission dynamics in these two areas. The high density of buildings and roads in Hatyai could facilitate more rabies transmission. We also investigated the impacts of rabies intervention, including reducing the dog population, restricting owned dog movement, and dog vaccination on the spread of canine rabies in these two areas. We found that reducing the dog population alone might not be sufficient for preventing rabies transmission in the high-risk area. Owned dog confinement could reduce more the likelihood of rabies transmission. Finally, a higher vaccination coverage may be required for controlling rabies transmission in the high-risk area compared to the low-risk area.
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Affiliation(s)
- Chayanin Sararat
- Biophysics Group, Department of Physics, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Suttikiat Changruenngam
- Biophysics Group, Department of Physics, Faculty of Science, Mahidol University, Bangkok, Thailand
| | - Arun Chumkaeo
- Songkhla Provincial Livestock Office, Muang, Songkhla, Thailand
| | - Anuwat Wiratsudakul
- Department of Clinical Sciences and Public Health, and the Monitoring and Surveillance Center for Zoonotic Diseases in Wildlife and Exotic Animals, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand
| | - Wirichada Pan-ngum
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Charin Modchang
- Biophysics Group, Department of Physics, Faculty of Science, Mahidol University, Bangkok, Thailand
- Centre of Excellence in Mathematics, CHE, Ministry of Education, Bangkok, Thailand
- * E-mail:
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Roles of traditional medicine and traditional healers for rabies prevention and potential impacts on post-exposure prophylaxis: A literature review. PLoS Negl Trop Dis 2022; 16:e0010087. [PMID: 35051178 PMCID: PMC8775316 DOI: 10.1371/journal.pntd.0010087] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 12/13/2021] [Indexed: 12/25/2022] Open
Abstract
Introduction Globally, traditional medicine is widely used to treat a variety of injuries and illnesses, including dog bites, and exposures that are risky for rabies. However, efficacy of most traditional remedies used for rabies prevention or treatment has not been demonstrated in controlled trials or proven in community-based surveys. Methods Six databases were searched including the terms rabies, traditional treatment, traditional remedy, traditional therapy, traditional medicine, and medicinal treatment to review traditional remedies used in the prevention and treatment of rabies. In addition, published literature of rabies transmission dynamics was used to estimate statistical likelihood of dog bite victims developing rabies to provide clarity as to why traditional healers have a high apparent success rate when preventing death from rabies in victims bitten by suspected rabid dogs. Results Literature review yielded 50 articles, including three controlled experiments, that described use of traditional remedies for rabies prevention and treatment. Traditional remedies for rabies ranged from plant- or animal-based products to spiritual rituals; however, only a few controlled mice trials were conducted, and none of these trials demonstrated efficacy in preventing or treating rabies. Risk of dying from rabies after a bite from a dog with unknown rabies status is low, 1.90% (0.05%-29.60%). Therefore, traditional healers had a 98.10% (70.40%-99.95%) apparent success rate in preventing death from suspected rabid dog bites despite inefficaciousness of herbal remedies. Conclusion There was no universal plant species or route of administration that was consistently used for rabies prevention or treatment across countries. No traditional remedy was efficacious in the prevention or treatment of rabies in randomized controlled experiments. Understanding the cultural context under which traditional remedies are used may facilitate collaboration of traditional healers with the modern medical system to ensure timely and appropriate use of proven therapies for prevention and clinical management of rabies. Traditional medicine is commonly used worldwide for a variety of ailments and diseases, including animal bite wound care and pre-clinical rabies prevention. Traditional healers often use herbal-based remedies containing local plants. Other traditional remedies include animal-based or spiritual-based methods. This literature review included plant surveys, controlled mice experiments, and community-based studies concerning rabies prevention provided by traditional healers in multiple countries. There was no consistent remedy used across the published literature, and most importantly, there were no published studies supporting effective traditional medicine methods for use in the prevention or treatment of human rabies. Our review of rabies virus transmission rates show that traditional healers have a high apparent success rate of preventing rabies deaths from dog bites, but there is no scientific or medical basis for this perception. Educating communities about proven, effective rabies prevention through post-exposure prophylaxis while understanding the cultural importance of traditional medicine is needed for promoting effective rabies prevention.
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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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Kunkel A, Jeon S, Joseph HC, Dilius P, Crowdis K, Meltzer MI, Wallace R. The urgency of resuming disrupted dog rabies vaccination campaigns: a modeling and cost-effectiveness analysis. Sci Rep 2021; 11:12476. [PMID: 34127783 PMCID: PMC8203735 DOI: 10.1038/s41598-021-92067-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 05/25/2021] [Indexed: 11/04/2022] Open
Abstract
Dog vaccination is a cost-effective approach to preventing human rabies deaths. In Haiti, the last nation-wide dog vaccination campaign occurred in 2018. We estimated the number of human lives that could be saved by resuming dog vaccination in 2021 compared to 2022 and compared the cost-effectiveness of these two scenarios. We modified a previously published rabies transmission and economic model to estimate trends in dog and human rabies cases in Haiti from 2005 to 2025, with varying assumptions about when dog vaccinations resume. We compared model outputs to surveillance data on human rabies deaths from 2005 to 2020 and animal rabies cases from 2018 to 2020. Model predictions and surveillance data both suggest a 5- to 8-fold increase in animal rabies cases occurred in Haiti's capital city between Fall 2019 and Fall 2020. Restarting dog vaccination in Haiti in 2021 compared to 2022 could save 285 human lives and prevent 6541 human rabies exposures over a five-year period. It may also decrease program costs due to reduced need for human post-exposure prophylaxis. These results show that interruptions in dog vaccination campaigns before elimination is achieved can lead to significant human rabies epidemics if not promptly resumed.
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Affiliation(s)
- Amber Kunkel
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging & Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
- Epidemic Intelligence Service, Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Seonghye Jeon
- Emergency Preparedness and Response Branch, Division of Preparedness and Emerging Infections, National Center for Emerging & Zoonotic Infectious Diseases , Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Haim C Joseph
- Ministry of Agriculture, Rural Development, and Natural Resources, Port-au-Prince, Haiti
| | - Pierre Dilius
- Ministry of Agriculture, Rural Development, and Natural Resources, Port-au-Prince, Haiti
| | | | - Martin I Meltzer
- Emergency Preparedness and Response Branch, Division of Preparedness and Emerging Infections, National Center for Emerging & Zoonotic Infectious Diseases , Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ryan Wallace
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging & Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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11
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Yang DK, Kim HH, Park YR, Yoo JY, Park Y, An S, Hyun BH. Immunogenicity of an inactivated rabies vaccine for animals derived from the recombinant ERAGS strain. Clin Exp Vaccine Res 2021; 10:141-147. [PMID: 34222126 PMCID: PMC8217578 DOI: 10.7774/cevr.2021.10.2.141] [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: 02/23/2021] [Revised: 05/17/2021] [Accepted: 05/26/2021] [Indexed: 11/15/2022] Open
Abstract
Purpose The aims of the present study were to evaluate the immunogenicity of an inactivated rabies vaccine based on the ERAGS strain Materials and Methods The ERAGS virus propagated in Vero cells was inactivated with 3 mM binary ethylenimine for 8 hours. Three types of inactivated rabies vaccines were prepared to determine the minimum vaccine virus titers. Four further types of inactivated rabies vaccines were prepared by blending inactivated ERAGS with four different adjuvants; each vaccine was injected into mice, guinea pigs, and dogs to identify the optimal adjuvant. The immunogenicity of a Montanide (IMS) gel-adjuvanted vaccine was evaluated in cats, dogs, and cattle. Humoral immune responses were measured via a fluorescent antibody virus neutralization method and a blocking enzyme-linked immunosorbent assay. Results The minimum virus titer of the inactivated rabies vaccine was over 107.0 50% tissue culture infectious doses (TCID50 values)/mL. Of the four kinds of adjuvants, the IMS gel-adjuvanted vaccine induced the highest mean viral neutralizing antibody (VNA) titers of 6.24 and 2.36 IU/mL in guinea pigs and dogs, respectively, and was thus selected as the vaccine for the target animals. Cats, dogs, and cattle inoculated with the IMS gel-adjuvanted vaccine developed protective VNA titers ranging from 3.5 to 1.2 IU/mL at 4 weeks post-inoculation (WPI). Conclusion Our data indicate that cats, dogs, and cattle inoculated with an inactivated rabies vaccine derived from the ERAGS strain developed protective immune responses that were maintained to 12 WPI.
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Affiliation(s)
- Dong-Kun Yang
- Viral Disease Research Division, Animal and Plant Quarantine Agency, Ministry of Agriculture, Food and Rural Affairs, Gimcheon, Korea
| | - Ha-Hyun Kim
- Viral Disease Research Division, Animal and Plant Quarantine Agency, Ministry of Agriculture, Food and Rural Affairs, Gimcheon, Korea
| | - Yu-Ri Park
- Viral Disease Research Division, Animal and Plant Quarantine Agency, Ministry of Agriculture, Food and Rural Affairs, Gimcheon, Korea
| | - Jae Young Yoo
- Viral Disease Research Division, Animal and Plant Quarantine Agency, Ministry of Agriculture, Food and Rural Affairs, Gimcheon, Korea
| | - Yeseul Park
- Viral Disease Research Division, Animal and Plant Quarantine Agency, Ministry of Agriculture, Food and Rural Affairs, Gimcheon, Korea
| | - Sungjun An
- Viral Disease Research Division, Animal and Plant Quarantine Agency, Ministry of Agriculture, Food and Rural Affairs, Gimcheon, Korea
| | - Bang-Hun Hyun
- Viral Disease Research Division, Animal and Plant Quarantine Agency, Ministry of Agriculture, Food and Rural Affairs, Gimcheon, Korea
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12
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Filla C, Rajeev M, Randriana Z, Hanitriniana C, Rafaliarison RR, Edosoa GT, Andriamananjara M, Razafindraibe NP, Nely J, Ferreira A, Yang AL, Daniel F, Clarke TA, Farris Z, Stone T, Lastdrager J, Rajaonarivelo T, Hampson K, Metcalf CJE, Valenta K. Lessons Learned and Paths Forward for Rabies Dog Vaccination in Madagascar: A Case Study of Pilot Vaccination Campaigns in Moramanga District. Trop Med Infect Dis 2021; 6:tropicalmed6020048. [PMID: 33921499 PMCID: PMC8167587 DOI: 10.3390/tropicalmed6020048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 12/25/2022] Open
Abstract
Canine rabies causes an estimated 60,000 human deaths per year, but these deaths are preventable through post-exposure prophylaxis of people and vaccination of domestic dogs. Dog vaccination campaigns targeting 70% of the population are effective at interrupting transmission. Here, we report on lessons learned during pilot dog vaccination campaigns in the Moramanga District of Madagascar. We compare two different vaccination strategies: a volunteer-driven effort to vaccinate dogs in two communes using static point vaccination and continuous vaccination as part of routine veterinary services. We used dog age data from the campaigns to estimate key demographic parameters and to simulate different vaccination strategies. Overall, we found that dog vaccination was feasible and that most dogs were accessible to vaccination. The static-point campaign achieved higher coverage but required more resources and had a limited geographic scope compared to the continuous delivery campaign. Our modeling results suggest that targeting puppies through community-based vaccination efforts could improve coverage. We found that mass dog vaccination is feasible and can achieve high coverage in Madagascar; however, context-specific strategies and an investment in dog vaccination as a public good will be required to move the country towards elimination.
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Affiliation(s)
- Caitlynn Filla
- Department of Anthropology, University of Florida, Gainesville, FL 32611, USA; (C.F.); (K.V.)
| | - Malavika Rajeev
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA; (A.L.Y.); (C.J.E.M.)
- Correspondence: mailto:
| | - Zoavina Randriana
- The Mad Dog Initiative Akanin’ny Veterinera, Akaikiniarivo, Ambatobe, Antananarivo 101, Madagascar; (Z.R.); (R.R.R.); (A.F.); (F.D.); (T.A.C.); (Z.F.); (T.R.)
| | - Chantal Hanitriniana
- Mention Zoologie et Biodiversité Animale, Faculté des Sciences, Université d’Antananarivo, Antananarivo 101, Madagascar;
| | - Radoniaina R. Rafaliarison
- The Mad Dog Initiative Akanin’ny Veterinera, Akaikiniarivo, Ambatobe, Antananarivo 101, Madagascar; (Z.R.); (R.R.R.); (A.F.); (F.D.); (T.A.C.); (Z.F.); (T.R.)
| | - Glenn Torrencelli Edosoa
- Chargé des Maladies Tropicales Négligées Organisation Mondiale de la Santé Madagascar, Antananarivo 101, Madagascar;
| | - Mamitiana Andriamananjara
- Direction des Services Vétérinaires Ministère Chargé de l’Agriculture et de l’Élevage, Antananarivo 101, Madagascar; (M.A.); (N.P.R.)
| | - Nivohanitra P. Razafindraibe
- Direction des Services Vétérinaires Ministère Chargé de l’Agriculture et de l’Élevage, Antananarivo 101, Madagascar; (M.A.); (N.P.R.)
| | - José Nely
- Service contre les Maladies Endémo-épidémiques et Tropicales Négligées Ministère de la Santé Publique, Antananarivo 101, Madagascar;
| | - Angelique Ferreira
- The Mad Dog Initiative Akanin’ny Veterinera, Akaikiniarivo, Ambatobe, Antananarivo 101, Madagascar; (Z.R.); (R.R.R.); (A.F.); (F.D.); (T.A.C.); (Z.F.); (T.R.)
- Travelling Animal Doctors, Newark, DE 19711-2916, USA; (T.S.); (J.L.)
| | - Annie L. Yang
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA; (A.L.Y.); (C.J.E.M.)
| | - Fenomanana Daniel
- The Mad Dog Initiative Akanin’ny Veterinera, Akaikiniarivo, Ambatobe, Antananarivo 101, Madagascar; (Z.R.); (R.R.R.); (A.F.); (F.D.); (T.A.C.); (Z.F.); (T.R.)
| | - Tara A. Clarke
- The Mad Dog Initiative Akanin’ny Veterinera, Akaikiniarivo, Ambatobe, Antananarivo 101, Madagascar; (Z.R.); (R.R.R.); (A.F.); (F.D.); (T.A.C.); (Z.F.); (T.R.)
- Department of Sociology and Anthropology, North Carolina State University, Raleigh, NC 27695-8107, USA
| | - Zachary Farris
- The Mad Dog Initiative Akanin’ny Veterinera, Akaikiniarivo, Ambatobe, Antananarivo 101, Madagascar; (Z.R.); (R.R.R.); (A.F.); (F.D.); (T.A.C.); (Z.F.); (T.R.)
- Department of Health and Exercise Science, Appalachian State University, Boone, NC 28608, USA
| | - Terry Stone
- Travelling Animal Doctors, Newark, DE 19711-2916, USA; (T.S.); (J.L.)
| | - Jochem Lastdrager
- Travelling Animal Doctors, Newark, DE 19711-2916, USA; (T.S.); (J.L.)
| | - Tsiky Rajaonarivelo
- The Mad Dog Initiative Akanin’ny Veterinera, Akaikiniarivo, Ambatobe, Antananarivo 101, Madagascar; (Z.R.); (R.R.R.); (A.F.); (F.D.); (T.A.C.); (Z.F.); (T.R.)
| | - 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;
| | - C. Jessica E. Metcalf
- Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ 08544, USA; (A.L.Y.); (C.J.E.M.)
| | - Kim Valenta
- Department of Anthropology, University of Florida, Gainesville, FL 32611, USA; (C.F.); (K.V.)
- The Mad Dog Initiative Akanin’ny Veterinera, Akaikiniarivo, Ambatobe, Antananarivo 101, Madagascar; (Z.R.); (R.R.R.); (A.F.); (F.D.); (T.A.C.); (Z.F.); (T.R.)
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Brunt S, Solomon H, Brown K, Davis A. Feline and Canine Rabies in New York State, USA. Viruses 2021; 13:v13030450. [PMID: 33802123 PMCID: PMC7998993 DOI: 10.3390/v13030450] [Citation(s) in RCA: 6] [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: 01/28/2021] [Revised: 03/03/2021] [Accepted: 03/06/2021] [Indexed: 01/28/2023] Open
Abstract
In New York State, domestic animals are no longer considered rabies vector species, but given their ubiquity with humans, rabies cases in dogs and cats often result in multiple individuals requiring post-exposure prophylaxis. For over a decade, the New York State rabies laboratory has variant-typed these domestic animals to aid in epidemiological investigations, determine exposures, and generate demographic data. We produced a data set that outlined vaccination status, ownership, and rabies results. Our data demonstrate that a large percentage of felines submitted for rabies testing were not vaccinated or did not have a current rabies vaccination, while canines were largely vaccinated. Despite massive vaccination campaigns, free clinics, and education, these companion animals still occasionally contract rabies. Barring translocation events, we note that rabies-positive cats and dogs in New York State have exclusively contracted a raccoon variant. While the United States has made tremendous strides in reducing its rabies burden, we hope these data will encourage responsible pet ownership including rabies vaccinations to reduce unnecessary animal mortality, long quarantines, and post-exposure prophylaxis in humans.
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14
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González-Roldán JF, Undurraga EA, Meltzer MI, Atkins C, Vargas-Pino F, Gutiérrez-Cedillo V, Hernández-Pérez JR. Cost-effectiveness of the national dog rabies prevention and control program in Mexico, 1990-2015. PLoS Negl Trop Dis 2021; 15:e0009130. [PMID: 33661891 PMCID: PMC7963054 DOI: 10.1371/journal.pntd.0009130] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 03/16/2021] [Accepted: 01/12/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Rabies is a viral zoonosis that imposes a substantial disease and economic burden in many developing countries. Dogs are the primary source of rabies transmission; eliminating dog rabies reduces the risk of exposure in humans significantly. Through mass annual dog rabies vaccination campaigns, the national program of rabies control in Mexico progressively reduced rabies cases in dogs and humans since 1990. In 2019, the World Health Organization validated Mexico for eliminating rabies as a public health problem. Using a governmental perspective, we retrospectively assessed the economic costs, effectiveness, and cost-effectiveness of the national program of rabies control in Mexico, 1990-2015. METHODOLOGY Combining various data sources, including administrative records, national statistics, and scientific literature, we retrospectively compared the current scenario of annual dog vaccination campaigns and post-exposure prophylaxis (PEP) with a counterfactual scenario without an annual dog vaccination campaign but including PEP. The counterfactual scenario was estimated using a mathematical model of dog rabies transmission (RabiesEcon). We performed a thorough sensitivity analysis of the main results. PRINCIPAL FINDINGS Results suggest that in 1990 through 2015, the national dog rabies vaccination program in Mexico prevented about 13,000 human rabies deaths, at an incremental cost (MXN 2015) of $4,700 million (USD 300 million). We estimated an average cost of $360,000 (USD 23,000) per human rabies death averted, $6,500 (USD 410) per additional year-of-life, and $3,000 (USD 190) per dog rabies death averted. Results were robust to several counterfactual scenarios, including high and low rabies transmission scenarios and various assumptions about potential costs without mass dog rabies vaccination campaigns. CONCLUSIONS Annual dog rabies vaccination campaigns have eliminated the transmission of dog-to-dog rabies and dog-mediated human rabies deaths in Mexico. According to World Health Organization standards, our results show that the national program of rabies control in Mexico has been highly cost-effective.
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Affiliation(s)
- Jesús Felipe González-Roldán
- Centro Nacional de Programas Preventivos y Control de Enfermedades (CENAPRECE), Secretaría de Salud México, Ciudad de México, México
| | - Eduardo A. Undurraga
- Escuela de Gobierno, Pontificia Universidad Católica de Chile, Santiago, Región Metropolitana, Chile
- Millennium Initiative for Collaborative Research in Bacterial Resistance (MICROB-R), Santiago, Región Metropolitana, Chile
| | - Martin I. Meltzer
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Charisma Atkins
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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15
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Wallace RM, Cliquet F, Fehlner-Gardiner C, Fooks AR, Sabeta CT, Setién AA, Tu C, Vuta V, Yakobson B, Yang DK, Brückner G, Freuling CM, Knopf L, Metlin A, Pozzetti P, Suseno PP, Shadomy SV, Torres G, Vigilato MAN, Abela-Ridder B, Müller T. Role of Oral Rabies Vaccines in the Elimination of Dog-Mediated Human Rabies Deaths. Emerg Infect Dis 2020; 26:1-9. [PMID: 33219786 PMCID: PMC7706920 DOI: 10.3201/eid2612.201266] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Domestic dogs are responsible for nearly all the »59,000 global human rabies deaths that occur annually. Numerous control measures have been successful at eliminating dog-mediated human rabies deaths in upper-income countries, including dog population management, parenteral dog vaccination programs, access to human rabies vaccines, and education programs for bite prevention and wound treatment. Implementing these techniques in resource-poor settings can be challenging; perhaps the greatest challenge is maintaining adequate herd immunity in free-roaming dog populations. Oral rabies vaccines have been a cornerstone in rabies virus elimination from wildlife populations; however, oral vaccines have never been effectively used to control dog-mediated rabies. Here, we convey the perspectives of the World Organisation for Animal Health Rabies Reference Laboratory Directors, the World Organisation for Animal Health expert committee on dog rabies control, and World Health Organization regarding the role of oral vaccines for dogs. We also issue recommendations for overcoming hesitations to expedited field use of appropriate oral vaccines.
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16
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Multisectoral approach to achieve canine rabies controlled zone using Intervention Mapping: Preliminary results. PLoS One 2020; 15:e0242937. [PMID: 33259498 PMCID: PMC7707495 DOI: 10.1371/journal.pone.0242937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 11/11/2020] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Annually, in India, millions of dog bite cases occur; most of them are inflicted by a stray dog. There are over 25 million dogs in the country. The rate of stray dog vaccination is suboptimal in India. This study aims to develop an intervention strategy, using Intervention Mapping framework, tailored for the target community to achieve canine rabies controlled zone. METHODOLOGY This is an exploratory, cross-sectional study conducted at a tertiary care Medical Institute at Jodhpur, Rajasthan, India, from 2018-2019. The semi-structured, In-Depth Discussion was conducted with a multidisciplinary planning group comprising of members from veterinary, health, and administrative sectors. The In-Depth Discussion focused on knowledge regarding complete stray dog vaccination schedule, self-efficacy (to prevent dog bites), challenges, and barriers faced by residents to achieve canine rabies controlled zone. Further, discussion with veterinary stakeholders focused on challenges faced for rigorous implementation of stray dog vaccination and sterilization. RESULTS In-Depth Discussion revealed the following challenges: Lack of participation by the study population for canine vaccination, incomplete knowledge about annual canine vaccination schedule, lack of understanding of dog gestures, lack of infrastructure and resources at veterinary hospitals. The majority of the dogs in the study area were stray dogs that were partially or non-vaccinated and non-sterilized. An intersectoral collaboration was achieved between the community members, veterinary stakeholders both private and Non-Governmental organisations, and heath sector. Following which 35 (76.0%) stray dogs were vaccinated, and 17 (35.4%) were sterilized with community support. Burden of dog bite cases also decreased. The stray dog density map was prepared, and community engagement activity on dog gestures was conducted. CONCLUSION The present study demonstrates the feasibility of achieving canine rabies controlled zone. When implemented in a phase-wise manner across all Medical and Residential complex, this strategy would ensure achieving canine rabies controlled zone through multi-stakeholder engagement.
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17
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Larkins AJ, Reece JF, Shaw APM, Thrusfield MV. An economic case study of the control of dog-mediated rabies by an animal welfare organisation in Jaipur, India. Prev Vet Med 2020; 183:105120. [PMID: 32890917 DOI: 10.1016/j.prevetmed.2020.105120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 08/09/2020] [Accepted: 08/09/2020] [Indexed: 11/24/2022]
Abstract
A global strategic plan for the elimination of dog-mediated human rabies deaths by 2030 was announced in 2018. The cost-effectiveness of annual mass dog vaccination programmes, as a control and elimination method, has been advocated on many occasions. Complementary methods, such as animal birth control (ABC) activities, have received less attention. This paper provides a case-study of a programme operated by Help in Suffering (HIS) in Jaipur, India from 1994/95 until 2016/17 comprising both ABC and additional vaccination-only activities. The availability of cost data alongside information on dog numbers, dog bites and human rabies cases provided an exceptionally detailed and unique retrospective dataset recording actual events and expenditures. Updated to 2016/17 prices, the total cost of the programme was 658,744 USD. Since 2007/2008, activity costs have been separated and returned costs of 10.78 USD per dog, both sterilised and vaccinated, and 1.86 USD per dog, vaccinated only. Over the course of the programme, the number of disability-adjusted life years (DALYs) due to premature death and the distress associated with dog bites was estimated to be 36,246 fewer than would have been expected if HIS had not been operating, based on a counterfactual scenario using pre-intervention values. Linking the DALY figure to the cost of the activities undertaken by HIS yields a cost of 26 USD per DALY averted. Discounted at 3%, the DALYs averted equate to 16,587 at a cost of 40 USD per DALY averted. Both cases make it a very cost-effective intervention, in relation to the threshold of investing one year's gross domestic product (GDP) per DALY averted (1981 USD in 2016/17). The monetary benefit from fewer dog bites and clinical human rabies cases requiring treatment amounted to 5.62 million USD after discounting, which, if attributed to Help in Suffering, yields a monetary benefit-cost ratio of 8.5. Thus, the potential monetary benefits greatly outweigh the programme costs, even without considering the DALYs averted. If a modest notional monetary value of one year's GDP is assigned to represent the human capital or production value of DALYs averted, the discounted societal economic benefit reaches 38.48 million USD and implies a benefit-cost ratio of 58.4. These economic analyses demonstrate that ABC activities in combination with additional vaccination efforts can be a cost-effective control measure for dog-mediated human rabies.
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Affiliation(s)
- A J Larkins
- Department of Primary Industries and Regional Development, 20 Gregory St, Geraldton, WA 6530, Australia.
| | - J F Reece
- Help in Suffering, Maharani Farm, Durgapura, Jaipur, Rajasthan 302018, India
| | - A P M Shaw
- Infection Medicine, Edinburgh Medical School: Biomedical Sciences, The University of Edinburgh, 1 George Square, Edinburgh EH8 9TB, United Kingdom; AP Consultants, 22 Walworth Enterprise Centre, Andover, SP10 5AP, United Kingdom
| | - M V Thrusfield
- Veterinary Clinical Sciences, Royal (Dick) School of Veterinary Studies, College of Medicine and Veterinary Medicine, Easter Bush Veterinary Centre, Easter Bush, Roslin, Midlothian EH25 9RG, United Kingdom
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Undurraga EA, Millien MF, Allel K, Etheart MD, Cleaton J, Ross Y, Wallace RM. Costs and effectiveness of alternative dog vaccination strategies to improve dog population coverage in rural and urban settings during a rabies outbreak. Vaccine 2020; 38:6162-6173. [PMID: 32616327 DOI: 10.1016/j.vaccine.2020.06.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 06/01/2020] [Accepted: 06/02/2020] [Indexed: 12/25/2022]
Abstract
Dog-rabies elimination programs have typically relied upon parenteral vaccination at central-point locations; however, dog-ownership practices, accessibility to hard-to-reach sub-populations, resource limitations, and logistics may impact a country's ability to reach the 70% coverage goal recommended by the World Organization for Animal Health (OIE) and World Health Organization (WHO). Here we report the cost-effectiveness of different dog-vaccination strategies during a dog-rabies outbreak in urban and peri-urban sections of Croix-des-Bouquets commune of the West Department, Haiti, in 2016. Three strategies, mobile static point (MSP), mobile static point with capture-vaccinate-release (MSP + CVR), and door-to-door vaccination with oral vaccination (DDV + ORV), were applied at five randomly assigned sites and assessed for free-roaming dog vaccination coverage and total population coverage. A total of 7065 dogs were vaccinated against rabies during the vaccination campaign. Overall, free-roaming dog vaccination coverage was estimated at 52% (47%-56%) for MSP, 53% (47%-60%) for DDV + ORV, and 65% (61%-69%) for MSP + CVR (differences with MSP and DDV + ORV significant at p < 0.01). Total dog vaccination coverage was 33% (95% CI: 26%-43%) for MSP, 49% (95% CI: 40%-61%) for MSP + CVR and 78% (77%-80%) for DDV + ORV (differences significant at p < 0.001). Overall, the least expensive campaign was MSP, with an estimated cost of about $2039 per day ($4078 total), and the most expensive was DDV + ORV with a cost of $3246 per day ($6492 total). Despite the relative high cost of an ORV bait, combining DDV and ORV was the most cost-effective strategy in our study ($1.97 per vaccinated dog), largely due to increased efficiency of the vaccinators to target less accessible dogs. Costs per vaccinated dog were $2.20 for MSP and $2.28 for MSP + CVR. We hope the results from this study will support the design and implementation of effective dog vaccination campaigns to achieve the goal of eliminating dog-mediated human rabies deaths by 2030.
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Affiliation(s)
- Eduardo A Undurraga
- Escuela de Gobierno, Pontificia Universidad Católica de Chile, Santiago, Región Metropolitana, Chile.
| | | | - Kasim Allel
- Escuela de Gobierno, Pontificia Universidad Católica de Chile, Santiago, Región Metropolitana, Chile
| | - Melissa D Etheart
- Haiti Country Office, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Port-au-Prince, Haiti
| | - Julie Cleaton
- 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
| | - Yasmeen Ross
- 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
| | | | - 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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Fasina FO, Mtui-Malamsha N, Mahiti GR, Sallu R, OleNeselle M, Rubegwa B, Makonnen YJ, Kafeero F, Ruheta M, Nonga HE, Swai E, Makungu S, Killewo J, Otieno EG, Lupindu AM, Komba E, Mdegela R, Assenga JK, Bernard J, Hussein M, Marandu W, Warioba J, Kaaya E, Masanja P, Francis G, Kessy VM, Savy J, Choyo H, Ochieng J, Hoogesteijn AL, Fasina MM, Rivas AL. Where and when to vaccinate? Interdisciplinary design and evaluation of the 2018 Tanzanian anti-rabies campaign. Int J Infect Dis 2020; 95:352-360. [PMID: 32205283 DOI: 10.1016/j.ijid.2020.03.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/20/2020] [Accepted: 03/25/2020] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES Hoping to improve health-related effectiveness, a two-phase vaccination against rabies was designed and executed in northern Tanzania in 2018, which included geo-epidemiological and economic perspectives. METHODS Considering the local bio-geography and attempting to rapidly establish a protective ring around a city at risk, the first phase intervened on sites surrounding that city, where the population density was lower than in the city at risk. The second phase vaccinated a rural area. RESULTS No rabies-related case has been reported in the vaccinated areas for over a year post-immunisation; hence, the campaign is viewed as highly cost-effective. Other metrics included: rapid implementation (concluded in half the time spent on other campaigns) and the estimated cost per protected life, which was 3.28 times lower than in similar vaccinations. CONCLUSIONS The adopted design emphasised local bio-geographical dynamics: it prevented the occurrence of an epidemic in a city with a higher demographic density than its surrounding area and it also achieved greater effectiveness than average interventions. These interdisciplinary, policy-oriented experiences have broad and immediate applications in settings of limited and/or time-sensitive (expertise, personnel, and time available to intervene) resources and conditions.
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Affiliation(s)
- Folorunso O Fasina
- Food and Agriculture Organization of the United Nations, Dar es Salaam, United Republic of Tanzania.
| | - Niwael Mtui-Malamsha
- Food and Agriculture Organization of the United Nations, Dar es Salaam, United Republic of Tanzania
| | - Gladys R Mahiti
- Muhimbili University of Health and Allied Sciences, United Republic of Tanzania; One Health Central and Eastern Africa, Eastern Africa, United Republic of Tanzania
| | - Raphael Sallu
- Food and Agriculture Organization of the United Nations, Dar es Salaam, United Republic of Tanzania
| | - Moses OleNeselle
- Food and Agriculture Organization of the United Nations, Dar es Salaam, United Republic of Tanzania
| | - Bachana Rubegwa
- Food and Agriculture Organization of the United Nations, Dar es Salaam, United Republic of Tanzania
| | - Yilma J Makonnen
- Food and Agriculture Organization of the United Nations, Dar es Salaam, United Republic of Tanzania
| | - Fred Kafeero
- Food and Agriculture Organization of the United Nations, Dar es Salaam, United Republic of Tanzania
| | - Martin Ruheta
- Ministry of Livestock and Fisheries, Dodoma, United Republic of Tanzania
| | - Hezron E Nonga
- Ministry of Livestock and Fisheries, Dodoma, United Republic of Tanzania
| | - Emmanuel Swai
- Ministry of Livestock and Fisheries, Dodoma, United Republic of Tanzania
| | - Selemani Makungu
- Ministry of Livestock and Fisheries, Dodoma, United Republic of Tanzania
| | - Japhet Killewo
- Muhimbili University of Health and Allied Sciences, United Republic of Tanzania; One Health Central and Eastern Africa, Eastern Africa, United Republic of Tanzania
| | - Edward G Otieno
- One Health Central and Eastern Africa, Eastern Africa, United Republic of Tanzania; Sokoine University of Agriculture, Morogoro, United Republic of Tanzania
| | - Athumani M Lupindu
- One Health Central and Eastern Africa, Eastern Africa, United Republic of Tanzania; Sokoine University of Agriculture, Morogoro, United Republic of Tanzania
| | - Erick Komba
- One Health Central and Eastern Africa, Eastern Africa, United Republic of Tanzania; Sokoine University of Agriculture, Morogoro, United Republic of Tanzania
| | - Robinson Mdegela
- One Health Central and Eastern Africa, Eastern Africa, United Republic of Tanzania; Sokoine University of Agriculture, Morogoro, United Republic of Tanzania
| | - Justine K Assenga
- Ministry of Livestock and Fisheries, Dodoma, United Republic of Tanzania; One Health Coordination Desk, Prime Minister's Office, Dodoma, United Republic of Tanzania
| | - Jubilate Bernard
- One Health Coordination Desk, Prime Minister's Office, Dodoma, United Republic of Tanzania; Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, United Republic of Tanzania
| | - Mohamed Hussein
- Muhimbili University of Health and Allied Sciences, United Republic of Tanzania; One Health Central and Eastern Africa, Eastern Africa, United Republic of Tanzania
| | - Walter Marandu
- District Veterinary Office, Moshi District, United Republic of Tanzania
| | - James Warioba
- Zonal Veterinary Center, Arusha, United Republic of Tanzania
| | - Eliona Kaaya
- Tanzania Veterinary Laboratory Agency, Dar es Salaam, United Republic of Tanzania
| | - Pius Masanja
- Tanzania Veterinary Laboratory Agency, Dar es Salaam, United Republic of Tanzania
| | - Gundelinda Francis
- Tanzania Veterinary Laboratory Agency, Dar es Salaam, United Republic of Tanzania
| | - Violet M Kessy
- Tanzania National Parks Authority, Same, United Republic of Tanzania
| | - Janique Savy
- Unit of Geoinformation and Mapping, University of Pretoria, Pretoria, South Africa
| | - Hija Choyo
- Food and Agriculture Organization of the United Nations, Dar es Salaam, United Republic of Tanzania
| | - Justus Ochieng
- AVRDC - The World Vegetable Center, Eastern and Southern Africa, Arusha, United Republic of Tanzania
| | - Almira L Hoogesteijn
- Human Ecology, Centro de Investigación y de Estudios Avanzados (CINVESTAV), Mérida, Yucatán, Mexico
| | - Margaret M Fasina
- Department of Nursing Science, University of Pretoria, Pretoria, South Africa
| | - Ariel L Rivas
- Center for Global Health, School of Medicine, University of New Mexico, Albuquerque, NM, USA
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Barbosa Costa G, Ludder F, Monroe B, Dilius P, Crowdis K, Blanton JD, Pieracci EG, Head JR, Gibson AD, Wallace RM. Barriers to attendance of canine rabies vaccination campaigns in Haiti, 2017. Transbound Emerg Dis 2020; 67:2679-2691. [PMID: 32438530 PMCID: PMC7754310 DOI: 10.1111/tbed.13622] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 04/04/2020] [Accepted: 05/02/2020] [Indexed: 12/11/2022]
Abstract
We conducted a cross-sectional survey to better understand the barriers to attendance at canine rabies vaccination campaigns in Haiti. A structured community-based questionnaire was conducted over a 15-day period during May-June 2017, focused on socio-economic status correlated with participation at canine rabies vaccination campaigns. Questions phrased as a bidding game were asked to determine individuals' willingness to pay (WTP) for dog rabies vaccination and willingness to walk (WTW) to fixed-point vaccination campaigns. The Kaplan-Meier estimator was applied to determine relationships between survey variables. Logistic regression was used to examine factors associated with participants' WTP and WTW. A total of 748 households from eight communities were surveyed. Respondents were predominantly female (54.4%) and had a median age of 45 years. The total number of owned dogs reported from households was 926, yielding a human-to-dog ratio in dog-owning households of 5.2:1. The majority of dogs (87.2%) were acquired for security, and 49% were allowed to roam freely; 42.0% of dog owners reported that they were unable to manage (or restrain) their dogs using a leash. Seventy per cent of dog owners were willing to pay up to 15.9 gourdes (0.25 USD) and/or walk up to 75 m to vaccinate their dogs. Households that owned free-roaming dogs, owned dogs for the purpose of companionship and owned dogs that they were unable to walk on a leash were associated with a higher WTP for vaccination. Living in Artibonite Department, having a middle or higher household income, and owning a dog for security purpose were associated with a higher WTW for vaccination. Low leash use and propensity for dogs to roam freely are barriers to successful fixed-point vaccination methods in Haiti, and alternative methods such as door to door (DD), capture-vaccinate-release (CVR) or oral vaccination should be explored. There may be some prospect for fee-for-service vaccination in Haiti; however, this programme should be introduced as a supplement, rather than a replacement for free rabies vaccination programmes so that mass dog vaccination is not discouraged.
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Affiliation(s)
- Galileu Barbosa Costa
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, USA.,Oak Ridge Institute for Science and Education, Centers for Disease Control and Prevention Participation Program, Atlanta, GA, USA
| | - Fleurinord Ludder
- Ministry of Agriculture and Natural Resources, Port-au-Prince, Haiti
| | - Benjamin Monroe
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Pierre Dilius
- Ministry of Agriculture and Natural Resources, Port-au-Prince, Haiti
| | | | - Jesse D Blanton
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Emily G Pieracci
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jennifer R Head
- Center for Global Health, Centers for Disease Control and Prevention Participation Program, Atlanta, GA, USA
| | - Andrew D Gibson
- Mission Rabies, Dorset, UK.,Division of Genetics and Genomics, The Roslin Institute and The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Hospital for Small Animals, Easter Bush Veterinary Centre, Midlothian, UK
| | - Ryan M Wallace
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Abstract
Dogs harbor numerous zoonotic pathogens, many of which are controlled through vaccination programs. The delivery of these programs can be difficult where resources are limited. We developed a dynamic model to estimate vaccination coverage and cost-per-dog vaccinated. The model considers the main factors that affect vaccination programs: dog demographics, effectiveness of strategies, efficacy of interventions and cost. The model was evaluated on data from 18 vaccination programs representing eight countries. Sensitivity analysis was performed for dog confinement and vaccination strategies. The average difference between modelled vaccination coverage and field data was 3.8% (2.3%–5.3%). Central point vaccination was the most cost-effective vaccination strategy when >88% of the dog population was confined. More active methods of vaccination, such as door-to-door or capture-vaccinate-release, achieved higher vaccination coverage in free-roaming dog populations but were more costly. This open-access tool can aid in planning more efficient vaccination campaigns in countries with limited resources.
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Gibson AD, Wallace RM, Rahman A, Bharti OK, Isloor S, Lohr F, Gamble L, Mellanby RJ, King A, Day MJ. Reviewing Solutions of Scale for Canine Rabies Elimination in India. Trop Med Infect Dis 2020; 5:E47. [PMID: 32210019 PMCID: PMC7157614 DOI: 10.3390/tropicalmed5010047] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 03/14/2020] [Accepted: 03/18/2020] [Indexed: 12/18/2022] Open
Abstract
Canine rabies elimination can be achieved through mass vaccination of the dog population, as advocated by the WHO, OIE and FAO under the 'United Against Rabies' initiative. Many countries in which canine rabies is endemic are exploring methods to access dogs for vaccination, campaign structures and approaches to resource mobilization. Reviewing aspects that fostered success in rabies elimination campaigns elsewhere, as well as examples of largescale resource mobilization, such as that seen in the global initiative to eliminate poliomyelitis, may help to guide the planning of sustainable, scalable methods for mass dog vaccination. Elimination of rabies from the majority of Latin America took over 30 years, with years of operational trial and error before a particular approach gained the broad support of decision makers, governments and funders to enable widespread implementation. The endeavour to eliminate polio now enters its final stages; however, there are many transferrable lessons to adopt from the past 32 years of global scale-up. Additionally, there is a need to support operational research, which explores the practicalities of mass dog vaccination roll-out and what are likely to be feasible solutions at scale. This article reviews the processes that supported the scale-up of these interventions, discusses pragmatic considerations of campaign duration and work-force size and finally provides an examples hypothetical resource requirements for implementing mass dog vaccination at scale in Indian cities, with a view to supporting the planning of pilot campaigns from which expanded efforts can grow.
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Affiliation(s)
- Andrew D. Gibson
- Mission Rabies, 4 Castle Street, Cranborne, Dorset BH21 5PZ, UK
- The Royal (Dick) School of Veterinary Studies and the Roslin Institute, Easter Bush Campus, The University of Edinburgh, Roslin, Midlothian EH25 9RG, UK;
| | - Ryan M. Wallace
- United States Centers for Disease Control and Prevention, Poxvirus and Rabies Branch, Atlanta, GA 30333, USA
| | - Abdul Rahman
- Commonwealth Veterinary Association 123, 7th B Main Road, 4th Block West, Jayanagar, Bangalore 560011, Karnataka, India
| | - Omesh K. Bharti
- State Institute of Health and Family Welfare, Parimahal, Kasumpti, Shimla 171009, Himachal Pradesh, India
| | - Shrikrishna Isloor
- Bangalore Veterinary College, KVAFSU, Hebbal, Bangalore 560024, Karnataka, India
| | - Frederic Lohr
- Mission Rabies, 4 Castle Street, Cranborne, Dorset BH21 5PZ, UK
| | - Luke Gamble
- Mission Rabies, 4 Castle Street, Cranborne, Dorset BH21 5PZ, UK
| | - Richard J. Mellanby
- The Royal (Dick) School of Veterinary Studies and the Roslin Institute, Easter Bush Campus, The University of Edinburgh, Roslin, Midlothian EH25 9RG, UK;
| | | | - Michael J. Day
- World Small Animal Veterinary Association and School of Veterinary and Life Sciences, Murdoch University, Murdoch 6150, Australia
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Jeon S, Cleaton J, Meltzer MI, Kahn EB, Pieracci EG, Blanton JD, Wallace R. Determining the post-elimination level of vaccination needed to prevent re-establishment of dog rabies. PLoS Negl Trop Dis 2019; 13:e0007869. [PMID: 31790398 PMCID: PMC6907870 DOI: 10.1371/journal.pntd.0007869] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 12/12/2019] [Accepted: 10/24/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Once a canine rabies-free status has been achieved, there is little guidance available on vaccination standards to maintain that status. In areas with risk of reintroduction, it may be practical to continue vaccinating portions of susceptible dogs to prevent re-establishment of canine rabies. METHODS We used a modified version of RabiesEcon, a deterministic mathematical model, to evaluate the potential impacts and cost-effectiveness of preventing the reintroduction of canine rabies through proactive dog vaccination. We analyzed four scenarios to simulate varying risk levels involving the reintroduction of canine rabies into an area where it is no longer present. In a sensitivity analysis, we examined the influences of reintroduction frequency and intensity, the density of susceptible dog population, dog birth rate, dog life expectancy, vaccine efficacy, rate of loss of vaccine immunity, and the basic reproduction number (R0). RESULTS To prevent the re-establishment of canine rabies, it is necessary to vaccinate 38% to 56% of free-roaming dogs that have no immunity to rabies. These coverage levels were most sensitive to adjustments in R0 followed by the vaccine efficacy and the rate of loss of vaccine immunity. Among the various preventive vaccination strategies, it was most cost-effective to continue dog vaccination at the minimum coverage required, with the average cost per human death averted ranging from $257 to $398 USD. CONCLUSIONS Without strong surveillance systems, rabies-free countries are vulnerable to becoming endemic when incursions happen. To prevent this, it may be necessary to vaccinate at least 38% to 56% of the susceptible dog population depending on the risk of reintroduction and transmission dynamics.
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Affiliation(s)
- Seonghye Jeon
- Emergency Preparedness and Response Branch, Division of Preparedness and Emerging Infections, National Center for Emerging & Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Julie Cleaton
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging & Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Martin I. Meltzer
- Emergency Preparedness and Response Branch, Division of Preparedness and Emerging Infections, National Center for Emerging & Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Emily B. Kahn
- Emergency Preparedness and Response Branch, Division of Preparedness and Emerging Infections, National Center for Emerging & Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Emily G. Pieracci
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging & Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jesse D. Blanton
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging & Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ryan Wallace
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging & Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Gibson AD, Mazeri S, Yale G, Desai S, Naik V, Corfmat J, Ortmann S, King A, Müller T, Handel I, Bronsvoort BM, Gamble L, Mellanby RJ, Vos A. Development of a Non-Meat-Based, Mass Producible and Effective Bait for Oral Vaccination of Dogs against Rabies in Goa State, India. Trop Med Infect Dis 2019; 4:E118. [PMID: 31487795 PMCID: PMC6789727 DOI: 10.3390/tropicalmed4030118] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 08/28/2019] [Accepted: 08/29/2019] [Indexed: 11/16/2022] Open
Abstract
Introduction: To achieve the global goal of canine-mediated human rabies elimination by 2030 there is an urgent need to scale-up mass dog vaccination activities in regions with large dog populations that are difficult to access; a common situation in much of India. Oral rabies vaccination may enable the vaccination of free-roaming dogs that are inaccessible to parenteral vaccination, and is considered a promising complementary measure to parenteral mass dog vaccination campaigns. WHO and OIE have published detailed minimum requirements for rabies vaccines and baits to be used for this purpose, requiring that baits must not only be well-accepted by the target population but must also efficiently release the vaccine in the oral cavity. For oral rabies vaccination approaches to be successful, it is necessary to develop baits which have a high uptake by the target population, are culturally accepted and amenable to mass production. The aim of this study was to compare the interest and uptake rates of meat-based and an egg-based prototype bait constructs by free roaming dogs in Goa, India. Methods: Three teams randomly distributed two prototype baits; an egg-flavoured bait and a commercial meat dog food (gravy) flavoured bait. The outcomes of consumption were recorded and compared between baits and dog variables. Results: A total of 209 egg-bait and 195 gravy-bait distributions were recorded and analysed. No difference (p = 0.99) was found in the percentage of dogs interested in the baits when offered. However, significantly more dogs consumed the egg-bait than the gravy-bait; 77.5% versus 68.7% (p = 0.04). The release of the blue-dyed water inside the sachet in the oral cavity of the animals was significant higher in the dogs consuming an egg-bait compared to the gravy-bait (73.4% versus 56.7%, p = 0.001). Conclusions: The egg-based bait had a high uptake amongst free roaming dogs and also enabled efficient release of the vaccine in the oral cavity, whilst also avoiding culturally relevant materials of bovine or porcine meat products.
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Affiliation(s)
- Andrew D Gibson
- Mission Rabies, Cranborne, Dorset BH21 5PZ, UK.
- The Royal (Dick) School of Veterinary Studies and the Roslin Institute, Easter Bush Campus, The University of Edinburgh, Roslin, Midlothian EH25 9RG, UK.
| | - Stella Mazeri
- Mission Rabies, Cranborne, Dorset BH21 5PZ, UK.
- The Royal (Dick) School of Veterinary Studies and the Roslin Institute, Easter Bush Campus, The University of Edinburgh, Roslin, Midlothian EH25 9RG, UK.
| | - Gowri Yale
- Mission Rabies, Tonca, Miramar, Panjim, Goa 403002, India.
| | - Santosh Desai
- Department of Animal Husbandry and Veterinary Services, Government of Goa, Panjim, Goa 403001, India.
| | - Vilas Naik
- Department of Animal Husbandry and Veterinary Services, Government of Goa, Panjim, Goa 403001, India.
| | - Julie Corfmat
- Mission Rabies, Tonca, Miramar, Panjim, Goa 403002, India.
| | | | | | - Thomas Müller
- Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, WHO Collaborating Centre for Rabies Surveillance and Research, 17493, Greifswald, Insel Riems, Germany.
| | - Ian Handel
- The Royal (Dick) School of Veterinary Studies and the Roslin Institute, Easter Bush Campus, The University of Edinburgh, Roslin, Midlothian EH25 9RG, UK.
| | - Berend MdeC Bronsvoort
- The Royal (Dick) School of Veterinary Studies and the Roslin Institute, Easter Bush Campus, The University of Edinburgh, Roslin, Midlothian EH25 9RG, UK.
| | - Luke Gamble
- Mission Rabies, Cranborne, Dorset BH21 5PZ, UK.
| | - Richard J Mellanby
- The Royal (Dick) School of Veterinary Studies and the Roslin Institute, Easter Bush Campus, The University of Edinburgh, Roslin, Midlothian EH25 9RG, UK.
| | - Ad Vos
- IDT Biologika GmbH, 06861 Dessau, Rosslau, Germany.
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Mtui-Malamsha N, Sallu R, Mahiti GR, Mohamed H, OleNeselle M, Rubegwa B, Swai ES, Makungu S, Otieno EG, Lupindu AM, Komba E, Mdegela R, Assenga JA, Bernard J, Marandu W, Warioba J, Makondo Z, Chang'a J, Mramba F, Nonga H, Killewo J, Kafeero F, Makonnen YJ, Rivas AL, Fasina FO. Ecological and Epidemiological Findings Associated with Zoonotic Rabies Outbreaks and Control in Moshi, Tanzania, 2017-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2816. [PMID: 31394794 PMCID: PMC6719226 DOI: 10.3390/ijerph16162816] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 07/25/2019] [Accepted: 08/05/2019] [Indexed: 02/05/2023]
Abstract
Approximately 1500 people die annually due to rabies in the United Republic of Tanzania. Moshi, in the Kilimanjaro Region, reported sporadic cases of human rabies between 2017 and 2018. In response and following a One Health approach, we implemented surveillance, monitoring, as well as a mass vaccinations of domestic pets concurrently in >150 villages, achieving a 74.5% vaccination coverage (n = 29, 885 dogs and cats) by September 2018. As of April 2019, no single human or animal case has been recorded. We have observed a disparity between awareness and knowledge levels of community members on rabies epidemiology. Self-adherence to protective rabies vaccination in animals was poor due to the challenges of costs and distances to vaccination centers, among others. Incidence of dog bites was high and only a fraction (65%) of dog bite victims (humans) received post-exposure prophylaxis. A high proportion of unvaccinated dogs and cats and the relative intense interactions with wild dog species at interfaces were the risk factors for seropositivity to rabies virus infection in dogs. A percentage of the previously vaccinated dogs remained unimmunized and some unvaccinated dogs were seropositive. Evidence of community engagement and multi-coordinated implementation of One Health in Moshi serves as an example of best practice in tackling zoonotic diseases using multi-level government efforts. The district-level establishment of the One Health rapid response team (OHRRT), implementation of a carefully structured routine vaccination campaign, improved health education, and the implementation of barriers between domestic animals and wildlife at the interfaces are necessary to reduce the burden of rabies in Moshi and communities with similar profiles.
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Affiliation(s)
- Niwael Mtui-Malamsha
- Food and Agriculture Organization of the United Nations, Dar es Salaam 14111, Tanzania
| | - Raphael Sallu
- Food and Agriculture Organization of the United Nations, Dar es Salaam 14111, Tanzania
| | - Gladys R Mahiti
- Department of Developmental Studies, Muhimbili University of Health and Allied Sciences, Dar es Salaam 11103, Tanzania
- One Health Central and Eastern Africa, Dar es Salaam 11103, Tanzania
| | - Hussein Mohamed
- Department of Developmental Studies, Muhimbili University of Health and Allied Sciences, Dar es Salaam 11103, Tanzania
- One Health Central and Eastern Africa, Dar es Salaam 11103, Tanzania
| | - Moses OleNeselle
- Food and Agriculture Organization of the United Nations, Dar es Salaam 14111, Tanzania
| | - Bachana Rubegwa
- Food and Agriculture Organization of the United Nations, Dar es Salaam 14111, Tanzania
| | | | | | - Edward G Otieno
- One Health Central and Eastern Africa, Dar es Salaam 11103, Tanzania
- College of Veterinary Medeicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro 67000, Tanzania
| | - Athuman M Lupindu
- One Health Central and Eastern Africa, Dar es Salaam 11103, Tanzania
- College of Veterinary Medeicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro 67000, Tanzania
| | - Erick Komba
- One Health Central and Eastern Africa, Dar es Salaam 11103, Tanzania
- College of Veterinary Medeicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro 67000, Tanzania
| | - Robinson Mdegela
- One Health Central and Eastern Africa, Dar es Salaam 11103, Tanzania
- College of Veterinary Medeicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro 67000, Tanzania
| | - Justine A Assenga
- Ministry of Livestock and Fisheries, Dodoma 41000, Tanzania
- One Health Coordination Desk, Prime Minister's Office, Dodoma 41000, Tanzania
| | - Jubilate Bernard
- One Health Coordination Desk, Prime Minister's Office, Dodoma 41000, Tanzania
- Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma 41000, Tanzania
| | - Walter Marandu
- District Veterinary Office, Moshi District 25101, Tanzania
| | | | - Zacharia Makondo
- Tanzania Veterinary Laboratory Agency, Dar es Salaam 15101, Tanzania
| | - Jelly Chang'a
- Tanzania Veterinary Laboratory Agency, Dar es Salaam 15101, Tanzania
| | - Furaha Mramba
- Tanzania Veterinary Laboratory Agency, Dar es Salaam 15101, Tanzania
| | - Hezron Nonga
- Ministry of Livestock and Fisheries, Dodoma 41000, Tanzania
- College of Veterinary Medeicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro 67000, Tanzania
| | - Japhet Killewo
- Department of Developmental Studies, Muhimbili University of Health and Allied Sciences, Dar es Salaam 11103, Tanzania
- One Health Central and Eastern Africa, Dar es Salaam 11103, Tanzania
| | - Fred Kafeero
- Food and Agriculture Organization of the United Nations, Dar es Salaam 14111, Tanzania
| | - Yilma J Makonnen
- Food and Agriculture Organization of the United Nations, 00153 Rome, Italy
| | - Ariel L Rivas
- Center for Global Health, School of Medicine, University of New Mexico, Albuquerque, NM 87131, USA
| | - Folorunso O Fasina
- Food and Agriculture Organization of the United Nations, Dar es Salaam 14111, Tanzania.
- Department of Veterinary Tropical Diseases, Faculty of Veterinary Science, University of Pretoria, Onderstepoort 0110, South Africa.
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Rupprecht CE, Salahuddin N. Current status of human rabies prevention: remaining barriers to global biologics accessibility and disease elimination. Expert Rev Vaccines 2019; 18:629-640. [PMID: 31159618 DOI: 10.1080/14760584.2019.1627205] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Introduction: Rabies is a serious, neglected tropical disease. Zoonotic agents are RNA viruses (Genus Lyssavirus, Family Rhabdoviridae), global in distribution. As an acute, progressive, incurable encephalitis, rabies has the highest case fatality of any infectious disease. Warm-blooded vertebrates are susceptible hosts. Major mammalian reservoirs include mesocarnivores and bats. Given wildlife perpetuation, rabies is not eradicable, but is preventable and controllable, especially under newly available international guidelines. Areas covered: Literature review over the past 5 years reveals development of sensitive, specific diagnostic tests and safe and highly effective human and veterinary vaccines. Yet, tens of thousands of human fatalities occur annually, usually in Africa and Asia, primarily after canine exposure. Human and domestic animal vaccination, before or after exposure, is the single greatest preventative strategy following a rabid animal bite. Expert opinion: Significant progress occurred during the twenty-first century regarding vaccine development, doses, and schedules. Remaining barriers to widespread rabies vaccination include an inter-related set of economic, cultural, social, educational, ecological and technological factors. A basic understanding of local and regional root causes of cases historically allows for broader accessibility to vaccination in a trans-disciplinary fashion to meet the global elimination of human rabies caused via dogs (GEHRD) by 2030.
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Affiliation(s)
| | - Naseem Salahuddin
- b Infectious Disease Division, Department of Medicine , The Indus Hospital , Karachi , Pakistan
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Anderson A, Kotzé J, Shwiff SA, Hatch B, Slootmaker C, Conan A, Knobel D, Nel LH. A bioeconomic model for the optimization of local canine rabies control. PLoS Negl Trop Dis 2019; 13:e0007377. [PMID: 31116732 PMCID: PMC6548399 DOI: 10.1371/journal.pntd.0007377] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 06/04/2019] [Accepted: 04/10/2019] [Indexed: 12/25/2022] Open
Abstract
We present a new modeling tool that can be used to maximize the impact of canine rabies management resources that are available at the local level. The model is accessible through a web-based interface that allows for flexibility in the management strategies that can be investigated. Rabies vaccination, sterilization, chemo-contraception, and euthanasia can be specified and limited to specific demographic groups. Additionally, we allowed for considerable complexity in the specification of management costs. In many areas, the costs of contacting additional dogs increases as management effort increases, and this can have important strategic implications. We illustrated the application of the model by examining several alternative management strategies in an area of Mpumalanga Province, South Africa. Our results based on this dog population suggested that puppies should be vaccinated and sterilization would not be optimal if the spatial extent of management is not large (and perhaps not even then). Furthermore, given a sufficient budget, it was evident that vaccination campaigns should be repeated annually.
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Affiliation(s)
- Aaron Anderson
- USDA National Wildlife Research Center, Fort Collins, CO, United States of America
- * E-mail:
| | - Johann Kotzé
- MSD Animal Health Malelane Research Unit, Malelane, South Africa
| | - Stephanie A. Shwiff
- USDA National Wildlife Research Center, Fort Collins, CO, United States of America
| | - Brody Hatch
- USDA National Wildlife Research Center, Fort Collins, CO, United States of America
| | - Chris Slootmaker
- USDA National Wildlife Research Center, Fort Collins, CO, United States of America
| | - Anne Conan
- Center for Conservation Medicine and Ecosystem Health, Ross University School of Veterinary Medicine, Basseterre, St Kitts and Nevis
| | - Darryn Knobel
- Center for Conservation Medicine and Ecosystem Health, Ross University School of Veterinary Medicine, Basseterre, St Kitts and Nevis
- Department of Veterinary Tropical Diseases, University of Pretoria, Pretoria, South Africa
| | - Louis H. Nel
- Department of Biochemistry, Genetics and Microbiology, University of Pretoria, Pretoria, South Africa
- Global Alliance for Rabies Control SA NPC, Pretoria, South Africa
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Octaria R, Salyer SJ, Blanton J, Pieracci EG, Munyua P, Millien M, Nel L, Wallace RM. From recognition to action: A strategic approach to foster sustainable collaborations for rabies elimination. PLoS Negl Trop Dis 2018; 12:e0006756. [PMID: 30359378 PMCID: PMC6201874 DOI: 10.1371/journal.pntd.0006756] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Rany Octaria
- Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Stephanie J. Salyer
- Epidemiology, Informatics, Surveillance, and Laboratory Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- One Health Office, National Center for Emerging and Zoonotic Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jesse Blanton
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Emily G. Pieracci
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Peninah Munyua
- Epidemiology, Informatics, Surveillance, and Laboratory Branch, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Global Disease Detection Center–Kenya, Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Max Millien
- Ministry of Agriculture, Natural Resources and Rural Development, Port-au-Prince, Haiti
| | - Louis Nel
- Department of Biochemistry, Genetics and Microbiology, University of Pretoria, South Africa and Global Alliance for Rabies Control, Manhattan, Kansas, United States of America
| | - Ryan M. Wallace
- Poxvirus and Rabies Branch, Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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